A hysterectomy is the removal of the uterus or just a part of it, by surgical methods. There are several reasons why a woman’s uterus may need to be removed, and an enlarged uterus that is caused by fibroids or adenomyosis is just one of these reasons. Fibroids are benign growths within the wall of the uterus. Adenomyosis is the thickening of the uterus. Both these conditions cause the uterus to enlarge.
Uterine cancer is another reason for an enlarged uterus and will warrant the removal of the uterus. A hysterectomy can either be done as an open procedure or as a minimally invasive procedure. The method of surgery will depend on the reason for the surgery to be done and also the patient’s health in general. A hysterectomy is only considered if the patient has had children (parous).
Treatment Options For Enlarged Uterus
Hormonal imbalance is known to play havoc on the body. It is also known to be one of the reasons for an enlarged uterus. Here, the delicate balance of the estrogen and progesterone hormones is disturbed. There is an escalation of estrogen and a deficiency of progesterone; this causes the uterine wall to thicken. Hormone therapy to elevate the progesterone level in the body and decrease the estrogen level is the course of treatment.
For the progesterone to work and to decrease the levels of estrogen and thereby the size of the uterus as well, large doses of progesterone must be administered. This is because when taken orally, most of the progesterone is destroyed by the liver. Your doctor be able guide you regarding the dosage and the duration of the treatment. When getting off progesterone, it is important to remember that the drug must be tapered off very slowly.
Freezing And Cauterization
If the patient suffers from a problematic fibroid that is causing the uterus to enlarge, the fibroid can be removed by cryomyolysis which is the freezing of the fibroid. This is a laparoscopic procedure, and a probe is used to freeze the tissue of the fibroid. While this is definitely a mode of treatment for an enlarged uterus, it is not widely practiced because of the other more effective modes of treatment. Cauterization is the removal of the tumor by heat of a laser and is a laparoscopic procedure as well.
Endometrial ablation is the removal of the lining of the endometrium as well the problematic fibroid. This method of treatment cannot be considered when fertility must be preserved, although women are known to become pregnant several years later.
An endometrial ablation is the preferred mode of treatment when a hysterectomy cannot be considered. Women who opt for an endometrial ablation must be fully aware that they may never be able to become pregnant after the procedure.
Wait And Watch
Very often, doctors prefer to adopted the ‘wait and watch’ mode of treatment. If the initial findings do not point to cancer or any other life-threatening disease, the best method of treatment can prove to be waiting for a while and watching if the uterus reverts to normal size.
This is possible if the reason behind the enlarged uterus is a large fibroid. Fibroids do not disappear but are known to shrink to a negligible size. When this happens, the uterus returns to normal size and no further treatment is necessary.