What is the treatment for fibroids?

Talk with your doctor about the best way to treat your fibroids. She or he will consider a number of things before helping you choose a treatment. Some of these things include:

  • whether or not you have symptoms from the fibroids
  • if you might want to become pregnant
  • the size of the fibroids
  • the location of the fibroids
  • your age

If you have fibroids, but do not have any symptoms, you may not need any treatment. But your doctor will check during your regular exams to see if they have grown.

Medications  - If you have fibroids and have mild symptoms, your doctor might only suggest pain medication. Over-the-counter anti-inflammatory drugs, such as ibuprofen, or other painkillers such as acetaminophen can be used for mild pain. If pain becomes worse, your doctor can prescribe a stronger painkiller.

Other drugs used to treat fibroids are called gonadotropin releasing hormone agonists (GnRHa), example, Lupron. These drugs can decrease the size of the fibroids. Sometimes they are used before surgery, to shrink the fibroids, making them easier to remove. Side effects can include hot flushes, depression, not being able to sleep, decreased sex drive, and joint pain. These drugs only offer temporary relief from the symptoms of fibroids; once you stop the therapy, the fibroids often grow back.

Surgery -If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:

  • Myomectomy - a surgery to remove fibroids without taking out the healthy tissue of the uterus. There are many ways a surgeon can perform this procedure. It can be major surgery (with an abdominal incision) or minor surgery (hysteroscopic myomectomy). The type, size, and location of the fibroids will determine what type of procedure will be done. A myomectomy is done when you want to preserve future fertility. Talk with your doctor about the different types of surgery and which one is appropriate for you.

  • Hysterectomy - a surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. This surgery is used when a woman's fibroids are large, or if she has heavy bleeding, and is either near or past menopause and does not want children. There are various types of hysterectomy that differ in how invasive they are. Sometimes, if the fibroids are large, a woman might need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the surgeon might be able to reach the uterus through the vagina, instead of making a cut in the abdomen.

  • Endometrial ablation – the endometrial lining of the uterus is destroyed. This surgery avoids an abdominal incision. This type of surgery controls very heavy bleeding, but afterwards a woman cannot have children.

  • Myolysis – a procedure in which an electrical needle is inserted into the uterus through a small incision in the abdomen to destroy the blood vessels feeding the fibroids.

Uterine Fibroid Embolization (UFE)-A relatively new treatment, uterine fibroid embolization (UFE) is a treatment that cuts off the blood supply to the uterus and the fibroids so they shrink. UFE is proving to be an alternative to hysterectomy and myomectomy. The recovery time is also shorter, and there is a lower risk of needing a blood transfusion than for some surgeries. Many women can have UFE and go home the same day. There is a small risk of infection in the treated fibroid, but these are usually managed with antibiotics. Recent studies also suggest that most fibroid tumors are not likely to re-grow after UFE, although more long-term data is needed.

Not all fibroids can be treated with UFE. All patients must first be evaluated with ultrasound or MRI to make sure the fibroids will respond well to this treatment. Doctors called interventional radiologists perform UFE. The best candidates for UFE are women who:

  • have fibroid tumors that are causing heavy bleeding
  • have fibroid tumors that are causing pain or pressing on the bladder or rectum
  • don’t want to have a hysterectomy
  • don’t want to have more children

Sometimes after UFE, the particles that are put into the fibroids to cut off their blood supply travel to the ovaries. In a few women, the ovaries then stop working for a short time or permanently. Although researchers know that UFE may affect how ovaries function, they are unsure of how exactly UFE affects fertility. If you want to have children in the future, you should talk with your doctors about the definite risk of UFE causing you to go into early menopause. In general, most fertility doctors do not recommend UFE to those who want to have children in the future. Too few women have gotten pregnant after UFE for researchers to know if there is an increased risk of pregnancy complications.

Information provided by:  The National Women's Health Information Center which is Sponsored by the Office on Women's Health in the U.S. Department of Health and Human Services