What Are My Treatment Options for Uterine Fibroids?
Including Uterine Fibroid Embolization
Published January 2022
Uterine fibroids are fibrous, solid, noncancerous tumors of the uterus. They are also known as uterine leiomyomas or myomas. They're common and may not require treatment.
"If you are diagnosed with uterine fibroids and have no symptoms, there might be no need for treatment," says Dr. Chaudhari. "Your physician may simply monitor their growth at your annual exams or more frequently if needed."
Your physician may recommend treatment if you:
- Have fibroid-related heavy menstrual bleeding, pain or pressure that interferes with your daily life
- Are trying to get pregnant, and the fibroids are located in an area that may impact getting or staying pregnant
Myomectomy is a surgical procedure to remove fibroids while keeping the uterus in place.
- Myomectomy may reduce both bleeding and pressure symptoms.
- The goal of myomectomy is to keep the uterus for future fertility. But, in some cases, the procedure can impact the ability to get pregnant or stay pregnant, or impact the type of delivery that is recommended.
- There are several different ways to perform a myomectomy: through small keyhole abdominal incisions, or larger open abdominal incisions.
- The "best" way depends on where your fibroids are located, how big they are and how many you have.
- Discuss all of your options with your gynecologic surgeon.
- Recovery from this procedure varies based on the type of procedure you need.
- New fibroids can grow back after surgery. Between 10% and 25% of patients who undergo myomectomy will need a second fibroid surgery during their reproductive years, and the timing of repeat surgeries varies.
- Myomectomy is considered the gold standard for patients who want to get pregnant in the future, but may not be right for everyone.
Uterine Fibroid Embolization (UFE)
UFE shrinks fibroids by blocking some of the blood supply to the uterus.
- UFE can decrease symptoms of pressure and bleeding.
- It is performed by an interventional radiologist:
- They guide a thin catheter through an artery using imaging technology.
- A gel made of polyvinyl alcohol beads is injected into the arteries that supply blood to your uterus.
- The gel sticks to the blood vessel wall, causing a clot to form that blocks the blood supply.
- After the procedure, with the blood supply blocked, the fibroids shrink by about 30% to 50%.
- This procedure preserves your uterus. It is sometimes recommended by gynecologists for patients who want to get pregnant in the future. However, it is not approved by the Food and Drug Administration for women who want to get pregnant.
- Some patients begin menopause after UFE, especially if they are older than 45.
- Recovery usually takes one to two weeks. Most patients return to full activity at two weeks.
- New fibroids can begin to grow after the procedure. About 15% to 20% of patients need a second procedure or surgery for their fibroids five years after initial treatment if they have not yet reached menopause.
A hysterectomy is a surgical procedure to remove the uterus.
- This is a permanent treatment because it removes the uterus and fibroids and prevents new fibroids from growing.
- Since your uterus is removed, you are not able to carry a pregnancy after a hysterectomy.
- Hysterectomy may be performed through the vagina, keyhole abdominal incisions or a larger open incision. The approach depends on the size of your uterus and your anatomy.
- Recovery varies based on the type of procedure performed. Most patients return to work at four weeks and all regular activities at six weeks.
Which Treatment Is Right for Me?
Talk to your gynecologist about what procedures and treatments may be right for you and your fibroids.