Medication is often the first treatment used to ease mild to moderate fibroid 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 fibroids. Medication treatment for fibroids is provided by NYU Langone gynecologists and specialists from the Center for Fibroid Care.
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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 and antagonists 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.
GnRH therapy is available as daily tablets or a monthly injection. These medications put you in a temporary menopausal state. Side effects include hot flashes, mood changes, and vaginal dryness. GnRH medications are often prescribed with estrogen and progestin to control bone-thinning. When GnRH is used without these medications, it is discontinued after six months of use to prevent an irreversible loss of bone density.
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, many of which are taken by mouth, may have several side effects, such as breast pain or dizziness, although these tend to lessen as your body gets accustomed to the medication. They also prevent pregnancy.
Your doctor may recommend a hormonal intrauterine device (IUD), which is placed into the uterus through the vagina. The IUD releases small amounts of progestin into the uterus and may stay in place for as long as six years. 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 without a prescription. 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.
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