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Welcome! If you are a woman experiencing fibroid symptoms, it is important you know that treatment for fibroids is not a one-size-fits-all approach, and you have many treatment options available to you, ranging from noninvasive to hysterectomy. Below is a list of current treatment options for you to consider. Please keep in mind that it is in your best interest to speak to a health care provider as soon as possible about your symptoms, as the earlier your diagnosis of fibroids, the more treatment options you will have, which will enable you to choose a treatment based on your own health, lifestyle and professional needs, and family preferences. Feel free to print out this page and take this list of options with you to your next doctor appointment.
- Hormonal Therapy treatments involve the use of hormones to shrink fibroids or control fibroid related bleeding. This is often a first-line therapy for women who are diagnosed with fibroids. For example, gonadotropin-releasing agonists (GNRHa) such as Lupron inhibit estrogen secretion, producing temporary menopause; birth control pills can help regulate periods; and, Mirena can be used to treat heavy bleeding in the presence of fibroids up to 5cm. However, if therapy is discontinued, fibroids often grow back within four to six months. Women are unable to conceive while on most hormonal therapy.
- Non-hormonal Therapies are newer options that include a class of drugs called “antifibrinolytics” (e.g., tranexemic acid) recently adopted in the U.S. to decrease heavy bleeding.
- Watchful Waiting is recommended when fibroids are not currently causing any symptoms and means that the woman is not being treated with any specific therapy but is being monitored for any new changes or symptoms. “Watchful waiting” is suitable for women whose fibroid symptoms are mild, who are not family-complete, or who are nearing menopause. Women may consider adopting lifestyle changes recommended by their physicians to alleviate discomfort.
- Focused ultrasound is a newer, noninvasive, no-incision technology that uses waves of ultrasound energy to heat and destroy fibroid tissue. MRI images are used to guide treatment and supply temperature feedback. This outpatient procedure allows for a very quick return to normal activities. A recent nationwide Fibroid Relief survey of nearly 1,000 women found that when women were presented with treatment descriptions, the majority (60%) rated focused ultrasound as their top treatment choice.
- Uterine Fibroid (or Artery) Embolization (UFE or UAE) involves surgery to block the uterine artery with small particles to decrease blood supply to the fibroid. This option can be used to treat most fibroids and avoids risks of major surgery. UFE/UAE relieves heavy bleeding in 90% of women and relieves pain in 85%. The procedure enables return to normal activity in 3 to 10 days.
- Myomectomy procedures – which can be either hysteroscopic, laparoscopic, abdominal or robotic – involve surgical removal of fibroids from the uterus. A hysteroscopic myomectomy removes one or more fibroids (mostly within the uterine cavity) using a hysteroscope through the cervix. A laparoscopic myomectomy removes fibroids (typically up to 6 cm in size depending on location) on the outside of the uterus via a small incision in the abdominal wall. An abdominal myomectomy requires incisions in the abdomen and in the uterus to access the fibroid. Reproductive potential can be spared if the uterus is retained and the reproductive organs remain intact. Myomectomy controls symptoms in about 80% of cases. Complete success is less likely in patients with many fibroids.
- Hysterectomy — including laparoscopic, vaginal, abdominal or robotic — involves removing the uterus entirely, eliminating any possibility of fibroid recurrence. More than half of respondents (55%) in our recent survey said they feared they would need a hysterectomy. Uterine ﬁbroids are the leading cause of hysterectomy in the United States and can result in loss of reproductive potential and many possible side effects including early menopause and urination and defecation disorders. Contrary to popular belief, hysterectomy is NOT the most common treatment option for fibroids.