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A one-a-day tablet could ease the fear of hysterectomy and offer the hope of starting a family to thousands of young women blighted by a painful, fertility limiting womb condition (stock image)
A one-a-day tablet could ease the fear of hysterectomy and offer the hope of starting a family to thousands of young women blighted by a painful, fertility limiting womb condition.
The new development in the treatment of fibroids – non-cancerous blood-filled lumps that grow in or around the uterus – could save them from ever needing surgery.
The drug, Esmya, was approved in 2012 for use to shrink fibroids before surgery to remove them.
But a watershed ruling by the European Commission, which follows stunning clinical trial results, means sufferers can now be prescribed Esmya long-term, whether they go on to have surgery or not.< /p>
Gynaecologists believe it could transform the way uterine fibroids are treated.
Around 40 in every 100 women develop fibroids at some time in their life, most often aged between 30 and 50. Many don't know they have fibroids until they have a routine gynaecological examination, but for others symptoms may be debilitating – including heavy, long and painful periods, bleeding between periods, a feeling of 'fullness' in the lower part of the stomach, pain or discomfort during intercourse, fertility problems and miscarriage.
In some cases growths can be so large they press on nearby organs, such as the bladder, bowel or kidney, causing further complications.
The cause of fibroids isn't known, though they are more common in women who haven't had children.
If symptoms can't be controlled with medication, fibroids can be removed by keyhole surgery.
Women with large fibroids may undergo a uterine artery embolisation, in which a radiologist blocks the blood vessels that supply the fibroids, causing them to shrink.
In the most severe cases a myomectomy – open surgery to remove the fibroids followed by reconstruction of the uterus – or a hysterectomy – complete removal of the uterus – may be carried out.
Martin Powell, a consultant gynaecologist at the Nottingham Treatment Centre, said: 'Prescribing Esmya for long-term control of fibroids gives women a choice.
'Finally we have a viable treatment that can shrink their fibroids and reduce the bleeding, rather than having to undergo major surgery.
'It is particularly significant for those women who want children and therefore wish to avoid surgery that could damage their fertility or, in the case of a hysterectomy, prevent them being able to start a family.'
Nitu Bajekal, a consultant gynaecologist at the Royal Free London NHS Foundation Trust in Hampstead and co-founder of Women For Women's Health UK, says by not having surgery, patients are avoiding the risk of damage to nearby organs, infections and the need for a blood transfusion.
One woman to benefit is Rachel Richardson, a vet from Whiteshill in Gloucestershire, who was hoping to start a family with her musician husband Matt when she discovered she had fibroids in May 2010. She is pictured with 14-month-old Julian
One woman to benefit is Rachel Richardson, a vet from Whiteshill in Gloucestershire, who was hoping to start a family with her musician husband Matt when she discovered she had fibroids in May 2010.
A routine scan revealed she had three large fibroids – the largest the size of a rugby ball – and several smaller ones.
Rachel, had a myomectomy to remove the three largest. After six months of trying to get pregnant, Rachel tried IVF unsuccessfully.
She later became pregnant naturally only to miscarry at 11 weeks. Subsequently, her problems became debilitating. Rachel, 38, explains: 'I was very anaemic due to heavy bleeding by this stage and I didn't have much energy left to do anything other than go to work.
'There was talk of a hysterectomy, which was a horrendous thought because Matt and I really wanted children. We were both really upset.'
A scan revealed another large fibroid, and Esmya was recommended. Rachel says: 'Within days of taking Esmya, the bleeding stopped. I took it for three months from August 2013 and it did a brilliant job shrinking the fibroids. It was life-changing and I didn't have any side effects.'
In January 2014 Rachel underwent a second IVF, which proved successful, and that September she had her son Julian, now 14 months old. She knows her fibroids are growing again, and is planning to go back on Esmya to shrink them now that she has stopped breast-feeding.
She says: 'This treatment gave us a choice when all the signs were pointing to a hysterectomy. If it wasn't for Esmya, Matt and I wouldn't have our baby now, and for that we'll always be very grateful.'
Source: Saved from surgery that risks infertility... by a daily tablet: One-a-day pill to ease the fear of hysterectomy for thousands of young women
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