Descriptions of Selected Treatments for Women's Health Conditions
Through its research into the many diseases and conditions that affect women, the NICHD has made major contributions to finding treatments for many of these conditions.
The information below provides only a "snapshot" of each treatment. It is meant to give you a general description what is involved with each treatment. It is not meant to answer all your questions about the treatment, or to fully inform you about the procedure. Also, many of these treatments have side effects, some of them severe and some of them permanent. If you are considering one of these treatments, make sure that you learn as much about the treatment as possible. Talk to your health care provider about where to get additional information about a specific treatment.
If you have pain related to a gynecological condition, such as vuvlvodynia, uterine fibroids, pelvic pain, and certain forms of vaginitis, your health care provider may suggest over-the-counter pain medication. Or, if your pain is more severe or occurs more often, your provider may want you to use a stronger medication, only available with a prescription. Pain medication is often used when pain or other symptoms are mild.
Antibiotics
Your health care provider will prescribe these medications if you have an infection caused by bacteria, such as bacterial vaginosis. Some antibiotics only work on specific types of bacteria, while other antibiotics work on a broad range of bacteria. Many antibiotics have side effects, so you should talk to your health care provider about these medications before you take them.
It's important that you take antibiotics exactly as prescribed, and that you finish all the medicine. Many people stop taking the medicine when they start to feel better. But even though the symptoms go away, some of the bacteria might still be in the body. So, to avoid getting sick again, you should finish all the medicine to get rid of all the bacteria.
Antibiotics don't work against most infections caused by viruses, such as genital herpes or HPV. Because bacteria can become resistant to antibiotics if the medication is taken too often, your health care provider will probably only prescribe antibiotics when you definitely have an infection, not just when it seems like you have an infection.
You can visit the National Library of Medicine Web site, for more information on
.
Hormone Treatments
Because many gynecological diseases are related to or affected by the menstrual cycle, and the menstrual cycle is controlled by hormones, hormone therapy may be an effective treatment for some conditions. The type and dose of the hormones will differ depending on the specific condition. The method of delivery, that is, whether you take a pill, get an injection or shot, or use a nose spray, may also differ. Ask your health care provider for more information about specific hormone treatments. Some common hormone treatments include:
Oral contraceptives (birth control pills) regulate the growth of the tissue that lines the
, called the endometrium, and usually decreases menstrual flow. Birth control pills contain the hormones estrogen and progestin. Oral contraceptives are a common treatment for endometriosis.
Progesterone and Progestin may relieve symptoms by reducing a woman's menstrual period or stopping it completely. These hormones may be used to treat endometriosis.
Danocrine stops the body from releasing the hormones involved in the menstrual cycle. Danocrine is often used to treat endometriosis.
Gonadatropin-Releasing Hormone (GnRH) Agonists stop the body from making certain hormones involved in the menstrual cycle. In a way, this treatment sends the body into a menopausal state. GnRH agonists are often used to treat endometriosis and uterine fibroids.
Premenopausal Hormone Replacement Therapy (HRT)
HRT is one of the most common treatments for women who have premature ovarian failure (POF). Health care providers use the term POF to describe a stop in normal functioning of the ovaries in a woman under the age of 40; in POF, the ovaries stop making eggs and stop making hormones. HRT gives women who have POF the estrogen and other hormones that their ovaries are not making. Replacing these hormones causes a woman to start having regular periods again. It may also help women with POF lower their risk for osteoporosis.
HRT is usually a combination of the hormones estrogen and progesterone (or the man-made form of progesterone, called progestin). Women can take the therapy as a pill, or they can wear a patch to get the hormones into their bodies.
The HRT taken by women with POF is very different from the hormone therapy that is often taken by women who are going through or have already gone through natural menopause. A recent study found that older women, who had already gone through normal menopause, were at increased risk for certain health conditions whey they took a certain type of hormone therapy, for long periods of time. But, these results do not apply to young women with POF. In women with POF, HRT is truly replacing the hormones that the ovaries would normally be making if the women didn't have POF. Also, the type and amount of HRT prescribed to women with POF is different than the hormone therapy taken by women who have already gone through menopause.
Most health care providers recommend that women with POF take HRT until they reach age 50. After that time, health care providers may suggest going off the HRT because of the increased risks for certain health conditions. If you have questions about HRT, or about the type of HRT you are taking, talk to your health care provider.
Postmenopausal Hormone Replacement Therapy (HRT)
Until recently, many women who were going through, or had already gone through natural menopause took hormone replacement therapy (HRT) to reduce the symptoms of menopause. For many women, taking low doses of estrogen and progestin (the man-made form of the hormone progesterone, produced by the ovaries) relieved the hot flashes, night sweats, and poor concentration that often reported. Health care providers also believed that HRT could lower a woman's risk for certain cancers, heart disease, and osteoporosis.
In 2002, findings from the
found that women who had already gone through menopause were at increased risk for certain health conditions when they took the estrogen/progestin HRT for long periods of time. The WHI is a large, multi-center clinical trial that involved more than 161,000 postmenopausal women in their fifties, sixties, and seventies. The researchers found that these women, who went through natural menopause at the expected age, were at greater risk for stroke, blood clots, heart disease, heart attacks, and breast cancer after taking a specific dose of estrogen/progestin for more than five years.
As a result of these findings, the WHI stopped the estrogen/progestin study, and advised many on the study to stop taking their HRT. In addition, the nation's health care providers menopausal, and postmenopausal women were forced to rethink the reisks and benefits of HRT.
In response to the questions and concerns of women on HRT and their health care providers, the NIH set up a
Web site to provide answers and information
A recent study, funded by the NICHD, found that although postmenopausal women who took estrogen/progestin HRT for more than five years were at increased risk for breast cancer, this risk level returned to normal after the women had been off the HRT for six months. This finding may help reassure postmenopausal women who had been on HRT that their health is not irreversibly changed.
If you are currently taking HRT, or are thinking about taking HRT, talk to your health care provider about the risks and the benefits.
Uterine Fibroid Embolization (UFE)
UFE is a new, non-surgical treatment for uterine fibroids that is minimally invasive. This procedure cuts off the blood supply to the fibroids, which slows their growth and eventually causes them to shrink. UFE involves a small cut into the crease at the top of the leg to get to the femoral artery, the vessel that supplies blood to the lower half of the body. The surgeon inserts small plastic particles into the artery. These particles wedge themselves in right next to the fibroids, so they can't travel anywhere else in the body, and so they get in the way of blood flowing to the fibroid. The surgeon continues to add the particles until the blood supply to the fibroid is cut off completely, or nearly completely.
Although fertility and UFE have not been studied on a large scale, early statistics seem to suggest that women who have UFE to treat various conditions have been able to get pregnant. But, these statistics are based on patient reports, not on clinical studies.
The
, the government agency with primary responsibility for overseeing the safety and effectiveness of medications and treatments for diseases, only recently approved UFE as a treatment for uterine fibroids. Health care providers have used the procedure, also called uterine artery embolization, for more than 20 years to treat cases of heavy bleeding after the delivery of a baby. But, because UFE is still considered a "new" treatment for Abroids, few health insurance companies currently cover the cost of the procedure.
Although UFE has been approved for use as a treatment for fibroids, American College of Obstetricians and Gynecologists indicates that
on the safety and effectiveness of UFE before it can be considered as a standard of care.
The Society of Interventional Radiology Web site provides patient information on
. Talk to your health care provider about whether UFE is an option for you.
Laparoscopy and Hysteroscopy
These two surgical procedures allow a surgeon to check the organs in a woman's lower abdomen to see if there are any signs of disease. In most cases, the surgeon is looking for signs of
endometriosis, polycystic ovary syndrome, or uterine fibroids. If one of these conditions is present, the surgeon will use a different method to remove it.
In laparoscopy, the surgeon inflates the abdomen slightly with a harmless gas. After making a small cut in the abdomen, the surgeon then uses a small viewing device with a light in it, called a laparoscope, to look at the reproductive organs, the intestines, and other organs in the lower abdomen. Because laparoscopy involves making a small cut in the abdomen, it is considered a type of laparotomy, which is any surgery that cuts into the abdomen. The Medem™ Web site provides more detailed patient information on
.
In hysteroscopy, the surgeon inserts a camera on a long tube through the
directly into the inside of the
. This procedure is commonly used to find uterine fibroids on the lining of the uterus. If the surgeon finds fibroids during the hysteroscopy, he or she will likely do a myomectomy to remove them. The Medem™ Web site provides more detailed patient information on
.
Myomectomy
Surgeons use this procedure to treat uterine fibroids. Myomectomy allows the surgeon remove only the fibroid, while leaving the healthy areas of the uterus in place. The specific type of procedure depends on where the fibroids are located:
Laparoscopic myomectomy is done during laparoscopy, if the fibroids are outside the uterus.
Hysteroscopic myomectomy is done during hysteroscopy, if the fibroids are inside the uterus
Abdominal myomectomy is if the fibroids are inside the uterus. This type of surgery involves a cut into the abdomen (laparotomy) and a cut into the uterus to find and remove the fibroids.
The Society of Interventional Radiology provides more detailed patient information about
.
Laparotomy
This word describes any surgery that involves a cut into the abdomen. Some types of laparotomy include: laparoscopy, abdominal myomectomy, and abdominal hysterectomy.
Hysterectomy
Hysterectomy is abdominal surgery that is used to treat a variety of gynecological conditions, including endometriosis, uterine fibroids, and pelvic floor disorders. During a hysterectomy, surgeons remove a woman's
, which means she will not be able to have a child once she has the procedure done. The results of this surgical procedure cannot be reversed. If you are considering hysterectomy, you should know as much about the procedure, its short-term effects, and its long-term effects before making your decision. You should discuss any issues or questions with your health care provider.
In general, recovery time for hysterectomy is about two months. However, new options for hysterectomy may make the procedure less invasive, which might decrease recovery time. Current options for hysterectomy include:
Abdominal hysterectomy is a procedure that involves a cut into the abdomen (laparotomy) to remove the uterus. In most cases, this procedure is highly invasive and requires a great deal of recovery time. However, some surgeons are using several small cuts to do the procedure, which makes the procedure much less invasive.
Vaginal hysterectomy is less invasive. The surgeon reaches the uterus through the
, instead of making a cut into the abdomen.
The National Library of Medicine provides more detailed patient information about
.
Bilateral Salpingo-Oophorectomy or Total Hysterectomy
This procedure is a type of abdominal surgery (laparotomy) that removes a woman's
,
, and ovaries all at the same time. Having this procedure means that a woman will never again be able to have a child.
Because a total hysterectomy is major surgery, it requires about a two-month recovery time. Health care providers may recommend this treatment for a woman with a condition such as
endometriosis
or
PCOS, whose symptoms are severe, and who does not wish to preserve her ability to get pregnant.
