Treatments for Uterine Fibroids

Talk with your health care provider 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 are having symptoms from the fibroids, if you might want to become pregnant, how large the fibroids are, and your age.

If you have fibroids, but do not have any symptoms, you may not need any treatment. But your health care provider will check during your regular exams to see if they have grown. If you have fibroids and have mild symptoms, your health care provider might only suggest pain medication. Over-the-counter anti-inflammatory drugs (like Advil or Motrin) or other painkillers (like Tylenol) can be used for mild pain. If pain becomes worse, a health care provider can prescribe a stronger painkiller.

Other drugs used to treat fibroids are called gonadotropin releasing hormone agonists (GnRHa). 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. Anti-hormonal agents, such as a drug called mifepristone, also can stop or slow the growth of fibroids. It is important to know that these drugs only offer temporary relief from the symptoms of fibroids; once you stop the therapy, the fibroids often grow back.

If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them.

• Myomectomy is 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. The type, size, and location of the fibroids will determine what type of procedure will be done. Talk with your health care provider about the different types of this surgery.

• Hysterectomy is a surgery to remove the uterus, and 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 different types of this surgery that differ in how invasive they are. Sometimes, if the fibroids are large, a woman might need the type of this surgery 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.

Other ways to treat fibroids are being developed, and your doctor might offer them as treatment options to you. But because these methods are not yet "standard" treatment options, your health insurance might not cover them. Cryomyolysis is a treatment in which your doctor shrinks the fibroids by placing a freezing agent on them. Uterine Fibroid Embolization (UFE) is a treatment that cuts off the blood supply to the uterus and the fibroids so they shrink.

If you are thinking about getting UFE to treat your fibroids, talk to your gynecologist. In general, patients have not reported a lot of problems from having UFE. In the short-term, patients have said that the size of the fibroids and uteri shrunk and menstrual bleeding and other symptoms from the fibroids improved. But it is important to know that there could be problems, like hysterectomy or death. And there is not enough information to know if UFE is safe for women who want to become pregnant in the future. The American College of Obstetricians and Gynecologists still considers UFE investigational for women who may want to become pregnant. They believe more information is needed to figure out if UFE is safe for these women.