Uterine Fibroids - Medications

Medications

Medicine can be used to help relieve uterine fibroid problems. The goals of medicine treatment are to:

• Relieve severe pain or other symptoms caused by fibroids.
• Correct anemia caused by heavy bleeding.
• Shrink fibroids before fibroid removal (myomectomy) or uterus removal (hysterectomy).
• Avoid hysterectomy.

When treatment is stopped, symptoms usually return.

Medication Choices

The following medicines are used to relieve heavy menstrual bleeding, anemia, or painful periods—they do not shrink fibroids:

• Nonsteroidal anti-inflammatory drug (NSAID) therapy relieves menstrual cramping and greatly reduces heavy menstrual bleeding for many women.⁷ But there are no studies that show that NSAIDs decrease fibroid pain or bleeding.⁶
• Birth control hormones (pill, patch, or ring) reduce heavy menstrual periods and pain while preventing pregnancy. But they usually do not affect the size of uterine fibroids.⁸
• A progestin shot (Depo-Provera) every 3 months may lighten your bleeding. It also prevents pregnancy. Based on different studies, progestin may improve fibroids, or may make them grow.^{9, 5} This might be different for each woman.
• Iron supplements, available without a prescription, are an important part of correcting anemia caused by fibroid blood loss.

The following medicine is used to shrink fibroids before surgery and to temporarily relieve symptoms:

• Gonadotropin-releasing hormone analogue (GnRH-a) therapy puts the body in a state like menopause, which shrinks the uterus and fibroids. GnRH-a therapy should be used for only a few months, because it can weaken the bones. It may also cause unpleasant menopausal symptoms. Fibroids grow back after GnRH-a therapy is stopped.¹⁶

Should I use GnRH-a therapy to treat uterine fibroids?

What To Think About

If you have pain or heavy menstrual bleeding, it may be from a bleeding uterine fibroid. But it may also be linked to a menstrual cycle problem that can be improved with birth control hormones and/or NSAID therapy. (For more information, see the topic Dysfunctional Uterine Bleeding.) Using the two together is most likely to relieve pain and lighten bleeding.⁷

GnRH-a therapy is sometimes used to stop bleeding and improve anemia. But taking iron supplements can also improve anemia and does not cause the troublesome side effects and bone weakening that can happen with GnRH-a therapy.

NSAID therapy use during conception or early pregnancy may increase the risk of miscarriage.¹⁰ If you are trying to get pregnant, talk to your health professional about whether you can use NSAID therapy.