At NYU Langone, doctors prescribe medication for women with fibroids that cause mild-to-moderate symptoms, such as pelvic discomfort and heavy menstrual bleeding. The goal is to relieve pain, reduce menstrual blood flow, and in some cases, shrink the growths.
Taking birth control pills may help control heavy menstrual bleeding. They can be a good option for women who aren’t planning a pregnancy soon. Your doctor can discuss any side effects with you.
Medications called gonadotropin-releasing hormone (GnRH) agonists decrease estrogen and progesterone levels in the body, which helps to shrink fibroids and reduce uterine bleeding. GnRH agonists also prevent ovulation, reduce the size of the uterus, and stop menstrual periods. Sometimes GnRH therapy is prescribed to shrink fibroids prior to surgery.
The medications can be injected or sprayed into the nose. Side effects include hot flashes, mood changes, and vaginal dryness. To prevent an irreversible loss of bone density, GnRH agonists that are prescribed without add-back therapy—estrogen and progestin to control bone-thinning—are discontinued after six months of use.
Progestins are synthetic versions of the hormone progesterone that thin the lining of the uterus and may reduce heavy menstrual bleeding associated with fibroids. Progestins are taken by mouth and may have several side effects, such as breast pain or dizziness, which tend to lessen as your body gets accustomed to the medication. If you’re not planning to become pregnant for a while, your doctor may recommend a hormonal intrauterine device (IUD), which he or she inserts into the uterus through your vagina. It may stay in place for as long as five years. The hormonal IUD, which is called Mirena®, releases small amounts of progestin into the uterus. Side effects include cramping, spotting, and vaginal discharge.
Because fibroids can cause heavy menstrual bleeding and anemia, your doctor may recommend iron supplements, which are available over the counter. Iron helps to replenish your body’s supply of red blood cells. Side effects include constipation, but time-released iron supplements can lessen the effect. Talk to your doctor about the dose that’s right for you.
Your doctor may recommend an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) such as ibuprofen or naproxen to help relieve mild pain. NSAIDs can also reduce heavy menstrual bleeding caused by fibroids. The most common side effect is abdominal pain. In some women, using the medication for 90 days or longer can lead to gastrointestinal ulcers.