Uterine fibroids are very common. At least 20% of women will have a fibroid at some point in their lives, with some estimates reaching 70% or higher. This means that millions in the U.S. live with uterine fibroids every day. And while some may not experience any symptoms at all, you may be among those who deal with extremely heavy periods, pelvic pain or discomfort – or a range of other uterine fibroid symptoms .
So, the big question on your mind may be: What are my uterine fibroid treatment options?
Luckily, there are several treatment options available that work for every type of fibroid, and the best combination of treatments will depend on several factors. Your doctor will work with you to determine the treatment option based on your age, the symptoms you are experiencing, your pregnancy goals, and the size and location of your fibroids. Keep reading to learn more about your uterine fibroid treatment options.
Conservative uterine fibroid treatments
It’s very important for your doctor to understand the severity of your symptoms because this will help determine how and when to treat your fibroids. There are several ways to remove or shrink uterine fibroids, but if your symptoms are nonexistent or mild, your doctor may recommend a more conservative treatment plan.
Watchful waiting is just like it sounds. A doctor may suggest simply waiting to see how or if your fibroids progress in size, multiply or if your symptoms worsen. During this waiting period, your doctor will periodically evaluate your symptoms. As fibroids are not cancerous, this typically presents no health risks – although it is important to talk to your doctor if your symptoms worsen.
Hormonal intrauterine device (IUD)
An IUD is primarily used for longer-term pregnancy prevention, but hormonal IUDs can also be used to help reduce fibroid-related symptoms like heavy bleeding and painful periods.
Uterine fibroid medications
While medications won’t cause fibroids to go away completely on their own, some – like oral birth control or nonsteroidal anti-inflammatories – can reduce the severity of some fibroid symptoms, like pain and heavy bleeding during periods. Other medications that may be recommended include:
Over-the-counter (OTC) pain relievers
For mild pain or discomfort, taking nonprescription anti-inflammatory medicines like ibuprofen may provide enough relief to help manage your symptoms – particularly painful cramps during your period.
Tranexamic acid (Lysteda, Cyklokapron)
Tranexamic acid is a medication that can be taken each month during your period on days of heavy bleeding to reduce menstrual flow.
Gonadotropin-releasing hormone (GnRH) agonists
Estrogen and progesterone may cause uterine fibroid growth. So, blocking these hormones can help shrink uterine fibroids.
Depending on your age and if fibroid surgery is part of your treatment plan, your doctor may recommend GnRH agonists for a short amount of time. This medication puts your body in a temporary menopausal state by blocking estrogen and progesterone. In the short-term, this medication can be very effective at shrinking fibroids. It’s not recommended for prolonged use as it can cause bone loss and other side effects.
Noninvasive uterine fibroid treatments
Depending on your symptoms and pregnancy goals, your doctor may recommend a noninvasive treatment option that requires no incision and can be performed as outpatient care.
MRI-guided focused ultrasound
This uterine fibroid treatment brings two therapies together: focused ultrasound and magnetic resonance imaging (MRI). During this procedure, a high-intensity focused ultrasound (HIFU) pinpoints the fibroid and destroys the growth cells without damaging surrounding tissue by raising the temperature of the targeted area. MRIs are used to guide and control the treatment, allowing doctors to be precise and effective in targeting uterine fibroids.
Minimally invasive treatments
Certain minimally invasive procedures can dissolve uterine fibroids without surgically removing them, which can also reduce risks of complications. To help relieve or minimize uterine fibroids and their symptoms, or increase your chances of pregnancy, your doctor may recommend the following minimally invasive treatment options.
Uterine artery embolization
Uterine fibroids need a blood or “nutrient” source to grow. A uterine artery embolization is a minimally invasive procedure that cuts off the blood supply to a fibroid, causing it to shrink and for symptoms to ease.
This uterine fibroid treatment is often recommended when the growths are causing pain or fullness in your abdomen or during sexual intercourse, as well as infertility, anemia and certain other symptoms. But it’s not usually recommended for large fibroids.
This process uses radio waves to create a current that heats a small area of nerve tissue. The heat destroys that area of the nerve, stopping it from sending pain signals to your brain. This treatment is especially helpful if your fibroids cause you general pain or produce very painful cramping during your periods.
An endometrial ablation doesn’t shrink fibroids like other procedures, rather it helps reduce heavy menstrual bleeding that may be caused by them. During this treatment, your doctor will insert a specialized instrument into your uterus to remove your uterine lining called the endometrium, which is responsible for blood flow. With the endometrium removed, you will likely experience normal or light menstrual bleeding.
For those who hope to become pregnant in the future, this treatment is not recommended. The endometrium is where a fertilized egg implants itself, eventually forming a connection with the placenta to supply a baby with what it needs to grow.
Uterine fibroid surgery
If your symptoms are severe, or the amount, size or location of your fibroids is concerning, your doctor may recommend surgery in addition to other less invasive treatments. Severe symptoms may include anemia from heavy fibroid bleeding, or problems with your urinary tract or bowel.
Surgery may also be recommended if you have multiple fibroids, or very deep or large fibroids. Typically, imaging tests like an MRI are done to evaluate the size of the growths to determine if surgery is a good option.
Types of uterine fibroid surgeries
When discussing uterine fibroid surgery with your doctor, your pregnancy goals are a key factor. Your doctor will use this information to guide your treatment plan. Because while a myomectomy can help your chances of becoming pregnant in the future, a hysterectomy is a permanent treatment option that will prevent you from ever getting pregnant.
This surgery takes out fibroids while preserving the uterus. It’s often used to remove submucosal fibroids, which are those that are attached to the uterine lining, and often recommended for those experiencing signs of infertility and hoping to become pregnant in the future.
A myomectomy can be done through laparoscopy or laparotomy. During a laparoscopy, your surgeon will make a small incision in the abdomen, inflate the area with a harmless gas, and insert a laparoscope (a slim instrument with a camera) to remove the fibroids. A laparotomy is a more major surgery that uses a larger abdominal incision to access the fibroids. This is ideal for treating every type of fibroid but is especially helpful for large or low-visibility fibroids.
Laparoscopy and laparotomy are two surgical procedures that are also used in endometriosis treatment.
When there are a lot of large masses present or uterine fibroids continue to grow back after other treatments, your doctor may recommend a full or partial hysterectomy to remove the uterus along with the growths. This is the only way to cure fibroids entirely, but it’s the most invasive surgery option.
For those hoping to become pregnant, this procedure is not recommended since it removes the womb.
Uterine fibroid surgery recovery: What to expect
Most uterine fibroid treatment surgeries are performed as an outpatient procedure, which means most people are able to go home to recover on the same day as a surgery. One or more overnight stays at a hospital are sometimes needed if you have certain underlying conditions or your insurance requires it.
The first week or so after surgery, your incision area will likely feel sore. But the typical recovery time after having uterine fibroid removal surgery is 4-6 weeks, which means your incisions should be healed by then. However, it’s important to follow your doctor’s post-surgery instructions such as refraining from lifting, pushing or pulling heavy objects.
Risks with uterine fibroid surgery
Uterine fibroid surgery is generally considered safe. But like all surgical procedures, there are always some risks. Typically, the possibility of infection is the biggest concern, but your care team takes every possible step to minimize this risk. This is also why it’s important to follow post-surgery care instructions.
Other possible risks can include scar tissue, regrowth of fibroids and the prevention of future pregnancy. If you have specific questions about the risks of uterine fibroid surgeries, talk to your doctor.
Get a personalized uterine fibroid treatment plan
While a diagnosis of uterine fibroids can be scary, it can also become the light at the end of the tunnel. It opens the door to understanding your body and gives you the opportunity for treatment.
If your symptoms are mild, your primary care doctor or OB-GYN can guide you through a more conservative treatment plan. But if minimally invasive or surgical treatments may be needed, an OB-GYN can provide that more advanced care.
Whether you’re looking for relief from your symptoms or hoping to become pregnant, your uterine fibroids don’t have to stop you from living the life you want.