Medications to Help Treat Fibroids
By: Sharon Sutherland, MD • Posted on September 30, 2021
What are Fibroids?
Uterine fibroids are non-cancerous growths that develop from the muscle layer of the uterus. Fibroids are usually diagnosed in women ages 30-40, and up to half of all women will be diagnosed with fibroids in their lifetime. Fibroids may be located inside the uterine cavity, on the outer surface of the uterus or within the uterine wall. The size and location of fibroids can determine whether a patient has symptoms, such as heavy menstrual flow, bleeding between periods, pelvic pain due to pressure on adjacent organs or infertility.
When is treatment needed?
- Heavy, prolonged or painful periods and bleeding between periods
- Pelvic pain or pressure due to fibroids pressing on adjacent organs
- Fibroid located in the uterine cavity that may interfere with pregnancy
- Rapid growth or other features concerning for development of cancer
What medications have been used to treat fibroids?
- Hormones, such as oral contraceptives, Depo Provera injections and progestin-containing IUDs thin the lining of the uterus and can reduce heaviness and pain with periods
- Gonadotropin-releasing hormone (GnRH) agonists suppress a woman’s estrogen level, which can cause temporary shrinkage of fibroids. However, these are not typically used for more than 6 months due to adverse side effects
What is the new medication approved for fibroid treatment?
Myfembree is a combination of hormones and GnRH agonist that can be used to treat symptomatic fibroids in healthy premenopausal women for up to 24 months.
- Myfembree contains relugolix (GnRH agonist to shrink fibroids) as well as estradiol and norethindrone acetate in low doses (hormones to prevent bone loss and hot flashes caused by relugolix).
- In medication trials, women taking MYFEMBREE had more than an 80% reduction in menstrual flow from baseline, which was significantly better than treatment with a placebo.
- Possible side effects of use are hot flashes, thinning of hair and decreased sex drive.
- Women should not take this medication if they are over age 35 and smoke, have a history of blood clots, stroke or heart attack, have uncontrolled high blood pressure or high cholesterol.
- Women should not take this medication if they are or would like to be pregnant in the near future.
- Women should not take this medication if they have breast cancer, osteoporosis, liver disease or other conditions where hormone treatment should be avoided.
- Women taking these medications may be at risk for increased blood glucose and lipid levels, so patients may need lab tests to monitor for complications.
- This medication can affect absorption of other medications, such as medications to treat underactive thyroid or underactive adrenal gland, so monitoring and dose adjustments may be needed.
What are other treatment options for fibroids?
- Oriahnn: another medication used to treat heavy monthly bleeding due to fibroids. It is very similar to Myfembree and was the first oral medication of its kind to be FDA-approved for this condition. Like Myfembree, it contains a GnRH agonist, an estrogen and a progestin.
- Laparoscopic myomectomy: surgeon removes one or more fibroids through small incisions in the abdominal wall
- Hysteroscopic myomectomy: surgeon removes one or more fibroids from the uterine lining by inserting a camera through the cervix
- Hysterectomy: surgeon removes the uterus and all fibroids contained within the uterus
- Uterine artery embolization: radiologist inserts catheter into blood vessels supplying the uterus and inserts particles that block blood flow, causing gradual shrinkage of the uterus and fibroids.
If you suffer from uterine fibroids, talk to your healthcare professional about treatment options would work best for you.
Be Strong, Be Healthy, Be in Charge!
- Sharon Sutherland, MD
About Sharon Sutherland, MD
Sharon A. Sutherland, MD joined Cleveland Clinic in 2003, and in 2011 was appointed the Quality Improvement Officer for Obstetrics/Gynecology and Women's Health Institute at Cleveland Clinic. Starting in 2016, she has served as Associate Chief Quality Officer for Cleveland Clinic Akron General Health System, comprising nine business entities with sixty-nine locations.
Dr. Sutherland is certified by the American Board of Obstetrics and Gynecology. Dr. Sutherland has a special interest in minimally invasive gynecology procedures, including operative hysteroscopy and treatment of cervical dysplasia. She mentors ob/gyn residents, and she is a Clinical Assistant Professor at Case Western Reserve University Cleveland Clinic Lerner College of Medicine.
- Fibroids and Menstrual Disorders Treatment Guide
- Are You at Risk for Uterine Fibroids?
- FDA Approves Myfembree to Treat Heavy Monthly Bleeding
- Chronic Pelvic Pain: What’s a Woman to do?
- New Treatments Can Help You Avoid Hysterectomy