Hormone Replacement Therapy

Hormone Replacement Therapy and Fibroid Embolization

Many patients who have problems with fibroids in their 40s are only advised a hysterectomy and sadly all too often fibroid embolization is not discussed with them by the gynaecologists. Because of this, many patients delay treatment hoping that post-menopausally the fibroids will shrink. This is a myth and post-menopausally most fibroid masses remain the same; some do shrink if the blood supply to the fibroids is tenuous but that situation is unusual. For this reason, we not infrequently perform fibroid embolizations on women in their sixties who have persisting fibroid masses in their abdomen.

Another disadvantage, of course, of not having your fibroids treated pre-menopausally is that after the menopause you may have persisting fibroid problems if you choose to go on hormone replacement therapy, as this can feed the fibroids. A great advantage of fibroid embolization is that it kills all the fibroid mass at one hit in the overwhelming majority of cases. This is also an advantage over something called MRI guided ablation of fibroids which is very limited in the fibroids it can treat and appears in many cases to cause only a partial improvement leaving viable fibroid tissue behind.

Women who have fibroid embolization pre-menopausally can be satisfied that after the menopause they can go onto hormone replacement therapy with impunity. Hormone replacement therapy is continually being improved and indeed there is a new product coming out on the market which may actually help protect against breast cancer currently being approved, I gather, by the FDA.