Medical treatment may be given before the surgery and during the surgery. Gonadotropin-releasing hormone (GnRH) agonists (such as Lupron) are frequently used for preoperative treatment of fibroids.
These drugs have been used for both myomectomy and hysterectomy and have proven very effective in stopping uterine bleeding and causing uterine shrinkage.
The American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin states that GnRH agonists (like Lupron) are the only drugs available that result in clinically significant uterine shrinkage and amenorrhea. On the positive side, these medications do the following:
Decrease the size of the fibroids
Decrease the bleeding
Shorten the hospital stay
Shorten operating time
Decrease postoperative pain
On the other hand, these drugs are expensive and have significant side effects.
Also of note, intraoperative medication, such as vasopressin, when injected into the uterine muscle, significantly decreases blood loss during myomectomy.