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Fibroids And The Pill

Fibroids are extremely common, benign tumors of the uterus.  There is no medication to "cure" fibroids, but there are a number of drugs available to control symptoms, from pain management to actually shrinking the fibroid.

The mainstay of treatment is over the counter NSAIDs (non-steroidal anti-inflammatory drugs) to treat mild pain symptoms.  Birth control pills with small amounts of estrogen have also been used as a form of therapy.  Even though fibroids are estrogen sensitive, the small amount of estrogen in most contraceptive pills is enough to "turn off" the body's natural production of estrogen in the ovaries and not enough to stimulate fibroid tissue growth.  On the contrary, the "pill" is useful to reduce cramping and heavy menstrual bleeding. Many women mistakenly think that if they have fibroids, they can't take oral contraception.  This may be in part because of the impact of older data from the time when birth control pills contained much higher estrogen levels.  It may also be in part due to confusion with the estrogen in  hormone replacement therapy for menopausal women, which can, in fact, stimulate fibroids to grow.

While birth control pills may provide some symptom relief, they have no effect on the growth rates of fibroids in either direction.  There are other hormones called gonadotropin releasing hormone agonists (GnRH agonists), such as Lupron Depot®, Synarel® and Depo Provera® which limit estrogen activity, creating an artificial state of menopause (called "medical menopause"). Lack of estrogen does slow the growth of fibroids and can even cause them to shrink.

Created: 12/9/2003  -  Donnica Moore, M.D.

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