Is heat therapy using hot packs contraindicated in patients with uterine myoma (fibroids)?

From the Guidelines

Heat therapy using hot packs is generally contraindicated in patients with uterine myoma (fibroids). Patients with fibroids should avoid applying direct heat to the lower abdomen or pelvic area as heat can increase blood flow to the region, potentially exacerbating symptoms and promoting fibroid growth. Heat therapy works by dilating blood vessels and increasing circulation, which may stimulate estrogen production and blood supply to the fibroids, potentially causing them to grow larger or bleed more heavily. This is particularly concerning since fibroids are estrogen-dependent growths, and increased blood flow could worsen symptoms like heavy menstrual bleeding, pelvic pain, and pressure.

Some key points to consider:

• Fibroids are the most common benign tumor in women of reproductive age, affecting more than 66% of women by 50 years of age 1.
• The symptoms of fibroids can be managed with medical therapy, such as oral contraceptive medication or gonadotropin-releasing hormone (GnRH) agonists or antagonists, but these agents have several drawbacks, including the potential for bone loss and the return of symptoms after discontinuation 1.
• The use of heat therapy may be beneficial for muscle tension elsewhere in the body, but it should be applied only to areas distant from the pelvis and abdomen to avoid exacerbating fibroid symptoms.
• Instead, patients with symptomatic fibroids experiencing pain may consider using cold packs for pain relief, taking appropriate pain medications as recommended by their healthcare provider, or exploring medical treatments specifically designed to manage fibroid symptoms.
• The most recent guidelines for the management of uterine fibroids, published in 2023, emphasize the importance of individualized treatment approaches and the need for further research on the optimal management of fibroid symptoms 1.

From the Research

Heat Therapy and Uterine Myoma

• There is no direct evidence in the provided studies that heat therapy using hot packs is contraindicated in patients with uterine myoma (fibroids) 2, 3, 4, 5, 6.
• The studies focus on various treatment options for uterine myomas, including medical and surgical management 2, new treatment strategies 3, pain relief using continuous epidural anesthesia 4, and the effects of aromatase inhibitors and gonadotropin-releasing hormone agonists on uterine leiomyoma volume and hormonal status 5.
• One study discusses radiofrequency thermal ablation for uterine myomas, which involves the use of heat to treat the condition, but this is a different application of heat therapy than using hot packs 6.
• Overall, there is no clear indication that hot packs are contraindicated for someone with myoma, but there is also limited research on the specific use of hot packs for this condition.

Treatment Options for Uterine Myoma

• Various treatment options are available for uterine myomas, including medical and surgical management 2.
• New treatment strategies have evolved over the past 20 years, offering alternative options for patients 3.
• Pain relief can be achieved through continuous epidural anesthesia in pregnant women with uterine myoma 4.
• Aromatase inhibitors and gonadotropin-releasing hormone agonists can reduce uterine leiomyoma volume and improve hormonal status 5.
• Radiofrequency thermal ablation is an alternative treatment option for uterine myomas, especially for women over 45 years old with a single myoma 6.