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Nonsurgical Treatment of Uterine Fibroids
 
  


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Nonsurgical Treatment of Uterine Fibroids  

My gynecologist says that a uterine fibroid is the reason for the pain and heavy bleeding I am experiencing. What can be done to treat the fibroid?

For a discussion of the nature, location, causes, and symptoms of uterine fibroids, see our Q&A called Uterine Fibroids. In the absence of treatment, asymptomatic (i.e., not causing symptoms) or symptomatic fibroids may shrink due to a decrease in either blood supply or level of estrogen.

An estimated 10% to 20% of women with fibroids have symptoms significant enough to require treatment.[2] A variety of options to treat symptomatic fibroids are available, including:
• Naturopathic approach
• Homeopathic approach
• Hormonal approaches
• Chelation therapy
• Interventional procedure to stop nourishing the fibroid
• Laser treatment of the fibroid
• Treatment of the lining of the uterus
• Hysteroscopic surgery to remove the fibroid tumor
• Surgical removal (myomectomy) of the fibroid tumor
• Surgical removal of the uterus (hysterectomy)

Naturopathy is a type of alternative medicine that emphasizes a sensible diet, avoidance of toxins in the environment, regular exercise, adequate rest, and botanical remedies. These healthy lifestyle behaviors and the naturopathic approach are designed to stimulate the body’s vital force and immune system to heal itself and restore the body to a natural state of health balance. The naturopathic approach to treat fibroids includes:[1, 4-7]

• Achieving and maintaining a weight-to-height ratio that is not considered overweight
• Avoiding caffeine-containing foods and beverages
• Avoiding excessive consumption of alcoholic beverages
• Eating a diet that limits the amount of estrogen consumed from animal products, tends to counteracts estrogen dominance (i.e., counteracts a higher ratio of levels of estrogen to levels of androgen such as progesterone) in the body, and/or tends to have anti-estrogen effects
• Taking supplements that counteract estrogen dominance and/or have anti-estrogen effects. Examples are supplements containing chastetree berries, diindolylmethane (DIM), flavinoids, flaxseeds or flaxseed oil, lady’s mantle, lipotropic factors, saw palmetto, and yarrow flowers.
• Taking supplements such as thyroid glandular extracts to help improve the function of a diagnosed under-active thyroid gland
• Taking herbal supplements to maintain health of the liver, whose role is to detoxify the body. Examples are supplements containing artichoke leaf, barberry, choline, dandelion root, goldenseal, inositol, lecithin, lipotropic factors (which help break down fat and estrogen, methionine, S-adenosyl methionine, and silymarin.
• Taking herbal supplements to help stimulate blood flow to the pelvis. Herbal ingredients for this purpose include cayenne pepper and the Chinese combination herbal preparation, Bupleurum Entangled Qi Formula. Consult your integrative medical physician for guidance on the dose and supplement that is appropriate for you.
• Taking supplements to help the function of the immune system and maintain uterine health. Examples of supplements are arginine, coenzyme Q10, lysine, malate mushrooms, vitamin A, vitamin C, and zinc.
• Taking supplements that have anti-inflammatory activity and/or anti-oxidant activity. Examples of supplements are those containing beta-carotene, borage oil, evening primrose oil (which contains gamma linoleic acid), selenium, vitamin C, and vitamin E.
• Taking supplements that can detoxify the body by helping eliminate heavy metals. Examples of supplements are cysteine, glutathione, kelp, and selenium.
• Taking supplements such as calcium and magnesium to prevent and reduce muscle cramps.
• Taking supplements, such as kelp, that can reduce the severity of fibroids and aid in healing from fibroids
• Taking supplements that can help break down fibroids. Examples of supplements are pancreatic enzymes and proteolytic enzymes.
• Applying warm packs of castor oil to the skin over the area of the fibroid when you are experiencing pain from the fibroid
• Taking prescription (natural or synthetic) thyroid hormone (i.e., thyroxin) if you have been diagnosed as being hypothyroid (i.e, having an under-active or inactive thyroid gland)
• Using natural progesterone cream for pre-menopausal women with fibroids and post-menopausal women with fibroids. For pre-menopausal women with fibroids, the cream is applied except when menstruating. Consult your integrative medical physician for guidance on the dose that is appropriate for you.
• Avoiding smoking
• Avoiding exposure to environmental toxins, including cigarette smoke from other people
• Regularly exercising for a minimum of 20 minutes per session, performed at least 3 times per week
• Doing daily or every-other-day exercise (such as certain yoga routines) that involve movement of the pelvis, to enhance blood flow to and removal of toxins from the pelvic region
• Having acupuncture for correcting energy flow and reducing pain
• Stress reduction and relaxation methods, including meditation
• Exploring creative endeavors
• Doing other activities that are healthy, give you pleasure, and make you happy
• Building and maintaining good relationships with a romantic partner, family, friends, and work colleagues
• Having an active and fulfilling sex life with a romantic partner
• Personally evaluating both any situations that may be resulting in powerful negative emotions, such as frustration, anxiety and stress. Working with a psychologist can help you to examine your life, modify undesirable situations, and change your feelings.
• Practicing visualization techniques to help shrink the fibroid
• Practicing prayer to help shrink the fibroid

Consult your integrative medicine physician for guidance on nutrition and supplements that are appropriate for you. By avoiding eating foods that came from animals that may have been fed hormones, a woman with fibroids can be exposed to less estrogen, which otherwise could stimulate the growth of the fibroids. Also, eating whole grains is recommended, because they contain lignins that have anti-estrogen effects and fibers that help the body eliminate excess estrogen.

A diet that is "non-estrogenic" and lacks foods known to stimulate the growth of fibroids consists of:[1, 6, 7]
• Adequate amounts of purified or glass-bottled water
• Avoidance of caffeine containing beverages (e.g., coffee and cola) and caffeine-containing foods (e.g., chocolate)
• Freshly caught fish that do not have high levels of mercury
• Avoidance of farm-raised fish, because they may have been fed hormones
• Avoidance of non-organically raised poultry and avoidance of red meat, because the animals may have been fed hormones
• Avoidance of non-organic dairy products, because the animals may have been fed hormones. Note that the hormonal contaminants may be more concentrated in the cream portion of the dairy products.
• If desired, limited amounts of organically-raised poultry
• If desired, limited amounts of organic dairy products, including nonfat milk and nonfat cottage cheese.
• Nuts and seeds
• Whole grains (e.g., flaxseed, rye, buckwheat, millet, oats, barley, corn, rice, and wheat), which are rich in lignins and fibers
• Fresh, organic fruits
• Fresh organic vegetables. Leafy green vegetables are helpful because they are rich in iron, which may be low in women with excessive menstrual bleeding. Also, leafy green vegetables can stimulate the flow of bile that aids in removal of excess estrogen from the body.
• Avoidance of fried foods and other foods with high fat content
• Intake of soy products is controversial, because they contain the isoflavones, genistein and daidzein, which have estrogen-like activity.
• Avoidance of salt
• To normalize the level of blood sugar (i.e., the glycemic index), avoidance of sugar and sugar-containing foods
• Avoidance of caffeine containing beverages (e.g., coffee and cola) and caffeine-containing foods (e.g., chocolate)
• Avoidance of alcohol

Types of proteolytic enzymes (i.e., enzymes that break down proteins) used to treat fibroids include pancreatic enzymes and enzymes extracted from plants. A supplement containing a blend of proteolytic enzymes (protease, serrapeptase, papain, bromelain, amylase), a fat-digesting enzyme (lipase), and other active ingredients (rutin and amia) is reported to shrink the size of uterine tumors significantly in 6 weeks to 6 months.[8]

Potential side effects of treatment with proteolytic enzymes, are:[4, 9]
• Flu-like symptoms characteristic of a detoxification process that lasts for a few days while the enzymes release toxins from the body
• Bleeding in women taking anticoagulant medications (e.g., Coumadin, heparin, Plavix)
• Bleeding in women who are hemophiliacs
• Bleeding if surgery is performed within 2 weeks of receiving pancreatic enzyme therapy
• Endangering fetus if woman is pregnant

If you have any of the following conditions, do not take pancreatic enzymes without the guidance of your doctors:[3, 5]
• Pregnancy
• Lactating
• Hemophilia (genetic condition characterized by insufficient clotting activity of the blood)
• Having a family history of coagulation disorders of the blood (i.e., delayed or insufficient clotting)
• Taking anticoagulants
• Having surgery within 2 weeks

Before taking any supplements to treat uterine fibroids, see your integrative medicine physician for guidance. Because some herbs may cause side effects in a few people, start with the smallest amount recommended by your integrative medicine physician.

Early use of a homeopathic approach may prevent the need for more invasive therapy, such as interventional treatment of the fibroid or surgery.[3] The homeopathic approach to treating fibroids consists of two components:
• The naturopathic, non-estrogenic diet described previously
• Homeopathic remedy

Certain homeopathic remedies have been used to control excessive menstrual flow and other symptoms (e.g., pain, cramping, and urinary problems) associated with fibroids. If you are considering a homeopathic remedy for this purpose, consult a homeopath (a healthcare professional specializing in the use of homeopathy) for guidance on selection of the proper remedy and a dose that is appropriate for you. Also, let your gynecologist know that you are taking a homeopathic remedy to control excessive menstrual flow, so that your gynecologist can test you periodically for the presence of anemia.

The homeopathic remedies used to control excessive menstrual flow and symptoms associated with fibroids include:[6, 7]
• Caulophylum
• Lachesis
• Lavender
• Kali phosphoricum
• Phosphorus
• Sepia
• Secale cornatum
• Silica (flint)

Certain homeopathic remedies have been used to try to shrink the fibroid or stop or slow the growth of the fibroid, thereby lessening its symptoms.[4, 6, 7] Although use of a homeopathic remedy rarely results in complete disappearance of a fibroid, some women have found a homeopathic remedy to be successful in reducing the size of the fibroid. Furthermore, many women have found a homeopathic remedy to be effective in stopping or slowing the growth of the fibroid and reducing its symptoms (e.g., pain, cramping, and urinary problems).

If you are considering a homeopathic remedy for the goal of shrinkage of the fibroid, stopping or slowing the growth of the fibroid, or reducing its symptoms (e.g., pain, cramping, and urinary problems), consult a homeopath for guidance on selection of the proper remedy and a dose that is appropriate for you. Also, let your gynecologist know that you are taking a homeopathic remedy, so that the size of the fibroid can be monitored at intervals.

The homeopathic remedies used to help shrink the fibroid, stop or slow its growth, and reduce symptoms include:[4, 6, 7]
• Aurum metallicum
• Calcarea carbonica
• Lachesis
• Natrum muriaticum
• Nux vomica
• Phosphorus
• Platinum metallicum
• Sepia
• Silica (flint)

Speed of symptomatic relief with homeopathic remedies depends on several factors, including the size of the fibroid. Based on published observations by homeopaths, some women with fibroids experience improvement of symptoms within 1 to 2 months after being treated with a homeopathic remedy, whereas other women with fibroids require a longer period of treatment with a homeopathic remedy in order for the symptoms to resolve.[4, 6, 7] According to published reports by several homeopaths, most women with fibroids that were treated with homeopathic remedies have avoided undergoing hysterectomies for the condition.

If the naturopathic, homeopathic, and psychological approaches to treatment of fibroids do not resolve symptoms, the following options to treat symptomatic fibroids are available, including:
• Hormonal approaches
• Chelation therapy
• Interventional procedure to stop nourishing the fibroid
• Laser treatment of the fibroid
• Treatment of the lining of the uterus
• Hysteroscopic surgery to remove the fibroid tumor
• Surgical removal (myomectomy) of the fibroid tumor
• Surgical removal of the uterus (hysterectomy)

Before other hormonal approaches should be considered, the level of functioning of the thyroid gland should be determined by an integrative medical physician, gynecologist, or endocrinologist (a physician specializing in the treatment of hormonal disorders). If the thyroid gland is under-active (a condition known as hypothyroidism) despite the use of supplements containing thyroid glandular extracts to try to restore the proper functioning of the thyroid gland, prescription natural or synthetic thyroid hormone may be administered.[1]

Another simple hormonal approach to treating fibroids is to limit the amount of exposure to estrogen, progesterone, and progestin coming from outside the body by:
• Eating a diet that limits the amount of estrogen consumed from animal products
• Avoiding taking birth control pills
• Avoiding taking hormone replacement therapy (HRT)

A naturopathic approach involving blocking estrogen production and promoting the metabolism of estrogen is to use the supplement, diindolylmethane (DIM), to treat fibroids and prevent their re-occurrence.[8] Side effects of DIM depend on the amount of estrogen in a woman’s body and the dose of DIM used. Possible side effects of DIM are:
• Hot flashes in women who had not experienced them previously
• Increase in hot flashes in peri-menopausal and menopausal women

Some physicians treat fibroids with progesterone or progestin, although some researchers and other physicians disagree with the approach.[1] Natural progesterone cream may be used for pre-menopausal women with fibroids and post-menopausal women with fibroids. For pre-menopausal women with fibroids, the cream is applied except when menstruating. Consult your integrative medical physician or gynecologist for guidance on the dose that is appropriate for you.

A hormonal approach to treating symptomatic fibroids in pre-menopausal women is the use of low-dose birth control pills, which can balance the ratio of estrogen and progesterone in the body, thereby reducing estrogen dominance. For post-menopausal women who have been taking and wish to continue taking hormonal replacement therapy (HRT) despite having symptomatic fibroids,
bio-identical hormones may be used to balance the ratio of estrogen and progesterone. Consult your integrative medical physician or gynecologist for guidance on the hormonal medication(s) and dose that is appropriate for you.

For a more aggressive approach, anti-hormonal medications that block the production of estrogen in the body may be used to:[1, 4]
• Shrink existing fibroids
• Prevent existing fibroids from becoming larger
• Prevent the growth of additional fibroids
• Decrease the size of a uterus that had been abnormally enlarged due to fibroids
• Reduce heavy uterine bleeding

Fibroids that cause anemia due to heavy menstrual bleeding may be treated by the use of prescription medications that work by inhibiting gonadotropin-releasing hormone (GnRH).[1, 21] Examples of these types of prescription medications are Synarel and Lupron Depot (leuprolide acetate for depot suspension). Treatment with leuprolide acetate has been shown to result in:
• Significant reduction in size of uterine fibroids
• Diminished size of uterus previously enlarged due to fibroids
• Decrease in symptoms of fibroids

Because the following side effects of leuprolide acetate associated with low levels of estrogen can occur, some physicians do not prescribe the medication for chronic treatment of fibroids:[1, 9]
• Menopausal symptoms of hot flashes, lack of menstruation (i.e., amenorrhea), and vaginal dryness
• Headache
• Small amount of loss of bone mineral during treatment
• High blood pressure was reported in a few women

A disadvantage of leuprolide acetate treatment is that discontinuation can result in rapid re-growth of fibroids.[10]

A more common way to treat fibroids by blocking the production of estrogen is to use a low dose of an aromatase-inhibiting prescription medication (e.g., 1 mg of Arimidex several times a week).[1] Another possible benefit of Arimidex therapy is that it may reduce the risk of breast cancer. Possible side effects of Arimidex, however, are some menopausal symptoms (e.g., hot flashes) resulting from estrogen deficiency. These side effects may be managed by using a lower dose of Arimidex.

Consult your integrative medical physician and gynecologist for guidance on anti-hormonal approaches to treating uterine fibroids.

A more aggressive alternative method to help treat uterine fibroids by detoxifying (i.e., removing toxic substances such as) heavy metals from the body is chelation therapy. This approach involves treatment with ethylenediaminetetraacetic acid (EDTA), a compound that binds to certain minerals, including heavy metals, and helps eliminate them through the kidney.[1] Therefore, the bound complex of EDTA and the toxic metals is excreted from the body.

Some types of chelation therapy involve intravenous (i.e., through the veins) administration of EDTA, followed by replacement of helpful types of minerals.[1] If you are considering chelation therapy, talk to your integrative medicine physician in advance to determine whether chelation therapy is appropriate for you.

Uterine fibroid embolization (UFE), which sometimes is called UAE (uterine artery embolization), is a less invasive procedure than is surgical removal of either the fibroid or the uterus.[3,11] The goal of embolization as a therapy is to stop or block the supply of blood that otherwise would feed the tumor.[3, 5, 13] UFE involves:[3, 5, 13-15]

• Making a small incision in the groin area
• Using X-rays and contrast material (e.g., a dye that helps the blood vessels be seen by the physicians) to guide the positioning of a tiny catheter (i.e., a tube) into the femoral artery in the leg, through a branch of the aorta (i.e., a large artery from the heart), and into the arteries leading to the uterus
• Injecting FDA-approved microspheres (made of tris-acryl gelatin), gelatin sponge (called Gelfoam), or plastic particles (composed of polyvinyl alcohol) through the catheter into branches of the arteries supplying blood to the uterine fibroids

UFE works due to the injected particles wedging in the arteries that otherwise would feed blood to the uterine fibroid.[15] When the blood supply to the fibroid is blocked by UFE, the muscle cells of the fibroid tumor degenerate and scar.[3, 14] As the fibroid shrinks in size, symptoms of the fibroid diminish.[3, 15, 16]

In most cases, a fibroid will shrink to half its pre-procedure size 3 to 6 months following UFE.[3, 15,-17] Average shrinkage of fibroids after UFE range from 48% smaller to 78% smaller than that of the pre-procedure size.[10] Some physicians think that a fibroid can shrink to 10% of its pre-procedure size 6 months following UFE.[18] Moreover, after UFE, patients with a previously enlarged uterus experience an average of 35% reduction to 50% reduction in the size of the uterus.[10, 17]

Approximately 81% to 92% of patients who underwent UFE for fibroid-related excessive bleeding experienced significant reduction or total relief of abnormal bleeding from the uterus.[9, 10] Typically, heavy menstrual bleeding subsides during the first menstrual period after UFE is performed.[5, 15, 17, 18]

Importantly, in 79% to 94% of women who undergo UFE, the procedure provides significant reduction or total relief of pain, pressure, and other symptoms of fibroids.[5, 10, 15, 17, 18] Generally, symptoms such as pain and pressure from the fibroid improve 2 to 3 months following UFE.

According to a recent clinical study of 182 women whose fibroids were treated with UFE, the outcome was still successful in 73% of the patients 5 years after the procedure was performed.[3] These results are similar to that reported for surgical removal of the fibroids. Usually, fibroids treated by UFE do not re-grow, nor do new fibroids appear.[15]

On the other hand, if fibroid-related symptoms persist despite UFE, surgical removal of the fibroid or hysterectomy (i.e., surgical removal of the uterus) eventually may be required.[15] However, less than 1% of women who undergo UFE later require a hysterectomy.

Advantages of UFE compared to surgery are:[3, 5, 14, 15]
• Can be used to treat single or multiple fibroids of various sizes, whereas surgical removal of fibroids (myomectomy) usually is not used for multiple fibroids
• Can be performed under local anesthesia (i.e., with the use of anesthetics applied to the area of the body where the procedure is performed)
• Small incision, which is bandaged, but does not require stitches
• Typically, no significant loss of blood
• Usually only one night of hospitalization required.
• Faster recovery after the procedure
• Does not require removal of any of the uterine lining
• Preservation of the uterus
• Less serious complications
• Recurrences of fibroids usually do not occur after UFE, whereas recurrences are not uncommon after myomectomy (i.e., surgical removal of the uterine fibroid)

UFE is not performed if a patient is:[15]
• Allergic to contrast materials used in imaging
• Has poorly functioning kidneys (i.e., renal insufficiency)
• Pregnant

Disadvantages of UFE compared to surgical removal of the uterus are:[3, 15]
• Exposure to low levels of X-rays during the imaging
• Theoretical possible growth of new fibroids

Immediately following UFE, common symptoms that may last for several days include:[5, 12, 15-21]
• Moderate to severe pelvic pain and cramping, which may persist for 6 to 12 hours or for several days. Typically, the pain diminishes in intensity over several days. Intravenous medication to manage pain is administered in the hospital, followed by oral medication for outpatient use.
• Vaginal discharge
• Mild nausea and vomiting, which occurs in 1% of patients
• Low-grade fever, which occurs in 1% to 30% of patients
• Fatigue, which occurs in 15% to 30% of patients

Most women who undergo UFE return to their normal activities after 1-2 weeks following the procedure.[5, 15] Complications, however, may occur in approximately 3% to 5% of women undergoing UFE.[20] Possible complications of UFE are:[5, 15, 17-21]
• Allergic reaction to the contrast material used to image the blood vessels
• Infection
• Rare cases of septic shock, resulting from infection
• Blood clot at site of incision
• Bruising or bleeding from site of incision and insertion of catheter
• Injury to an artery, which occurs in less than 1% of patients
• Uterine bleeding
• Damage from catheter to blood vessels in leg or pelvis
• Persistent pelvic pain
• Persistent vaginal discharge
• Expulsion (i.e., movement) of small pieces of fibroid tissue (especially from submucosal fibroids) into cervix or vagina, which occurs in 2% to 3% of women treated and may require dilatation and curretage (i.e., scraping of tissue)
• Misembolization, the movement of microspheres, gelatin sponge, or plastic particles into organs or tissues. Some physicians do not believe, however, that the materials can migrate out of the blood vessel into organs or tissues. Research studies are in progress to determine whether misembolization actually occurs.
• Formation of uterine adhesions (i.e., scar tissue)
• Breakdown of other tissue in uterus
• Breakdown of tissue in ovaries
• Menopausal symptoms due to lowered or cessation of production of estrogen in ovaries, which may occur in 1% to 5% of women shortly after UFE. Women over 45 years of age are most susceptible to this side effect.
• Infertility due to damage to function of ovaries and uterus
• Difficulty in achieving orgasm
• Breakdown of tissue in bladder, resulting in lack of urinary control
• Breakdown of skin in labial (i.e., lips of the vagina) and buttock areas

In approximately 1% of women who undergo UFE, the uterus is damaged by the procedure.[5] A type of uterine damage resulting from UFE is insufficient blood supply to the organ.[10] Some of the women who suffer a damaged uterus due to UFE require a hysterectomy.[5, 10] Also, an estimated 1% of women who undergo UFE experience an infection that necessitates a hysterectomy.[10. 18]

Furthermore, the frequency or severity of the following theoretical long-term effects of UFE are not known:[2, 5, 10, 11, 16-18]
• Effects of embolic microspheres or polyvinyl alcohol particles that remain within the uterine arteries. However, the materials used in most UFE procedures were FDA-approved more than 20 years ago for various medical uses and have demonstrated long-term safety.
• Effects on blood supply to the uterus. However, some physicians believe that, after UFE, the other arteries supplying the uterus become larger and continue to nourish the uterus
• Effects on blood supply to the ovaries
• Effects on future fertility and childbearing, because UFE may weaken the wall of the uterus. Patients are advised to wait 6 to 12 months after UFE before trying to become pregnant.

If you are considering UFE, consult with your gynecologist and interventional radiologist about your medical history, future plans regarding childbearing, and possible side effects of the procedure to determine whether UFE is appropriate for you.

Laparascopic myolysis is an interventional procedure in which the fibroid tumor is treated with heat from a laser probe.[10] Steps of laparascopic myolysis are:
• Making a small incision in the pelvic area
• Using imaging methods to guide the positioning of a tiny laser probe into the fibroid
• Using the laser probe to heat coagulate the fibroid

Advantages of laparascopic myolysis compared to surgery are:[10]
• Small incision
• Typically, no significant loss of blood
• Faster recovery after the procedure
• Does not require removal of any of the uterine lining
• Preservation of the uterus
• Less serious complications

Typically, fibroid tumors treated by laparascopic myolysis shrink up to 40% by 6 months following the procedure.[10] Possible complications of laparascopic myolysis include formations of adhesions (i.e., scar tissue) between the uterus and the small intestine.

To control bleeding from submucosal fibroids, the lining of the uterus (i.e., the endometrium) may be treated. In a procedure known as endometrial ablation, the endometrium is scraped and treated with heat, so that menstrual periods do not occur.[10]

Advantages of endometrial ablation compared to surgery are:[10]
• Outpatient, rather than inpatient, procedure
• Short recovery time

Approximately 32% of women treated with endometrial ablation, however, still experience bleeding from submucosal fibroids 2 years following the procedure.[10] Potential disadvantages of endometrial ablation compared to surgery are:
• Less improvement of symptoms of bleeding
• The endometrium may grow into another part of the uterus
• Infertility, whereas patients treated with myomectomy may be able to bear children

Possible complications of endometrial ablation include:[10]
• Infection
• Infertlity

For a discussion of surgical options for treatment of uterine fibroids, see our Q&A called Surgical Treatment of Uterine Fibroids.

If you have uterine fibroids, be kind to yourself and first explore the less invasive options of integrative medical, alternative medical, and other standard medical therapies for achieving and maintaining good health. Be informed about all your health options, as well as learning about the potential side effects and possible complications of the treatment options. Get many opinions from different healthcare professionals. Talk extensively with your gynecologist and your other healthcare professionals to determine which types of treatment are appropriate for you.

REFERENCES

1. Life Extension Foundation Uterine Fibroids. In Disease Prevention and Treatment, 4th edition. Hollywood, FL: Life Extension Media.
2. Uterine fibroids symptoms and diagnosis. Society of Interventional Radiology. Accessed at www.airweb.org/ patPub/uterine.shtml.
3. R. Preidt. Nonsurgical technique effective against fibroids: treatment avoids surgery, preserves uterus. HealthDay News. 04/01/05. Accessed at www.ivillage.com.
4. J. Reichenberg-Ullman. Homeopathy for uterine fibroids. Townsend Letter for Doctors and Patients. 11/04.
5. Uterine fibroid embolization: a new way to treat fibroids. Accessed at www.familydoctor.org.
6. I. Ikenze. Menopause & Homeopathy: A Guide for Women in Midlife. 1998. Berkeley, CA: North Atlantic Books.
7. J. Reichenberg-Ullman. Whole Woman’s Homeopathy. 2004. Edmonds, WA: Picnic Point Press.
8. Vitalzym. Accessed at www.energeticnutrition.com.
9. LupronDepot. Accessed at www.fibroidfacts.com.
10. S.J. Smith. Uterine fibroid emolization. American Family Physician. 2000; 61:3601-3607, 3611-3612.
11. Long term effects. Uterine Artery Embolization. Accessed at www.uterinearteryemolization.com.
12. A.B. DeMello. Uterine artery embolization. AORN Journal. 2001; 73(4):790-813.
13. Facts. Uterine Artery Embolization. Accessed at www.uterinearteryemolization.com.
14. Nonsurgical treatment of uterine fibroids. Accessed at www.drfibroid.com.
15. ACR RSNA. Uterine fibroid embolization. RadiologyInfo. Accessed at www.radiologyinfo.org/contentinterventional/
ufibroid-embol.hrm.
16. F.L. Hutchins, Jr., and R. Worthington-Kirsch. Embolotheraoy for myoma-induced menorrhagia. Obstetrics and Gynecology Clinics of North America. 2000; 27(2):387-
405.
17. Fibroid Medical Center of Northern California. Uterine fibroid embolization (uterine artery embolization. Accessed at www.fibroidworld.com/UAE.hrm.
18. Fibroid Treatment Collective. Treatments: Uterine artery embolization. FTC. Accessed at www.fibroids.com/uterine-
artery-emboliztion.html.
19. Reported adverse effects. Uterine Artery Embolization. Accessed at www.uterinearteryemolization.com
20. Medical journal references. Uterine Artery Embolization. Accessed at www.uterinearteryemolization.com.
21. G.C.H. Wong, S.J.Muir, A.P.W. Lai, and S. C. Goodwin. Uterine artery embolization: a minimally-invasive technique for the treatment of uterine fibroids. Journal of Women’s Health and Gender-Based Medicine. 2000; 9(4):357-362.




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My gynecologist said that I have a uterine fibroid. What is it? What symptoms could it cause?
My gynecologist says that a uterine fibroid is the reason for the pain and heavy bleeding I am experiencing. Also, my gynecologist recommended surgery as treatment. What types of surgery are involved in treating uterine fibroids?
What are yeast infections of the vagina? What causes these infections? What are the symptoms?
What can be done to treat yeast infections of the vagina?
What is non-infectious cystitis? What is interstitial cystitis?
What can be done to treat non-infectious cystitis or interstitial cystitis?
What causes bladder infections? What are the symptoms of bladder infections?
What can I do to prevent getting bladder infections? What can be done to treat bladder infections?
What causes bacterial infections of the vagina? What are the symptoms of bacterial infections of the vagina?
What can I do to prevent and treat bacterial infections of the vagina?
What causes migraine headaches? What are the symptoms of migraine headaches?
What causes premenstrual syndrome (PMS)? What are the symptoms of PMS?
What can I do to prevent and treat premenstrual syndrome (PMS)?
What can I do to prevent and treat migraine headaches?
Although my husband and I have tried to have a child for 2 years, our doctor says that my husband’s sperm count is normal. Therefore, I seem to be the one who has the infertility problem. What causes infertility in a woman?
Although my husband and I have tried to have a child for 2 years, our doctor says that my husband’s sperm count is normal. Therefore, I seem to be the one who has the infertility problem. What can I do to get pregnant?
What is breast engorgement?

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