Treatment Options

The treatment for fibroids varies from woman to woman. Prior to making our recommendations, we perform a comprehensive examination using advanced imaging tools such as MRIs and ultrasounds to determine the size, location and growth pattern of a patient's fibroids. We also evaluate information about the woman's overall health, age and reproductive plans when advising about treatment.

The Fibroid Center offers cutting-edge surgical and non-surgical therapies, including laparoscopic and hysteroscopic minimally invasive surgery, and uterine fibroid embolization. Additionally, our center evaluates patients wanting a second opinion and offers counseling for women with fibroids who are planning to become pregnant.

Surgical Treatment Options

Myomectomy – This surgical procedure involves removing the fibroids but not the uterus. This is often the best choice for women who wish to become pregnant in the future. It may be done in several ways:

• an open myomectomy - the fibroids are removed through an abdominal incision
• a laparoscopic myomectomy* – the surgeon makes several small incisions in the abdomen, through which a camera and surgical tools are inserted to remove the fibroids
• a hysteroscopic myomectomy* – no incisions are made; a small camera is inserted through the vagina into the uterine cavity. Electricity flowing through a thin wire attached to the end of the camera enables the surgeon to cut and remove the fibroids.

*A laparoscopic or hysteroscopic myomectomy is possible only when the fibroids are in certain locations and relatively small.

Endometrial Ablation - Endometrial ablation is a procedure in which the uterine lining is “thinned” with a special instrument. The thinner lining results in less menstrual bleeding. This procedure is an option for women with small fibroids that protrude into the uterine cavity. This procedure is not advised for women who want to become pregnant in the future.

Hysterectomy - A hysterectomy is a surgical procedure to remove the uterus. In some cases, the cervix, fallopian tubes and ovaries are removed as well. The uterus may be removed through the abdomen through a large incision, through the abdomen through small incisions with the help of a camera (laparoscopic-assisted hysterectomy) or through the vagina. Women who undergo a hysterectomy can no longer bear children.

Non-Surgical Treatment Options

Uterine fibroid embolization - Uterine fibroid embolization is a procedure in which an interventional radiologist uses tiny particles to block the blood supply to the fibroids, causing them to shrink. This procedure is performed through a tiny incision in the groin. It is suitable only for fibroids in certain locations, and may not be suitable for women who may wish to become pregnant. To learn more about how the procedure is performed, click here.

Other Options

Observation - For women who do not have any symptoms from fibroids, no treatment is necessary. As long as the fibroids are not causing severe anemia or unbearable pain, it is reasonable to “watch and wait,” especially for women approaching menopause. Symptoms generally decrease after “the change of life.” Women who do not have symptoms, but who know they have fibroids, should have regular gynecologic exams.

Pain Relievers - There are several medicines that may be helpful to women who are bothered by their fibroids. Non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Advil) and naproxen (Aleve) can help with pain and bleeding caused by fibroids.

Hormones - Fibroids grow in response to estrogen, one of the female hormones, so many treatments target estrogen levels. For example, progestins such as Aygestin, Provera and Depo-Provera may slow fibroid growth and decrease menstrual bleeding. Birth control pills also may be helpful in decreasing bleeding and pain. A class of drugs called GnRH agonists can temporarily stop menses and cause shrinkage of fibroids however these medications are generally only used before surgical treatment of fibroids or as a “bridge” to menopause in older women.

Change of Diet, Exercise - No definite links have been found between diet and fibroid formation. There is an association between obesity and fibroids, suggesting that a diet and exercise plan that maintains a normal weight may help prevent or reduce fibroid symptoms.

Complementary and Alternative Medicine - This includes the use of herbal or vitamin supplements, acupuncture, reflexology, etc. Although many therapies claim to help with uterine fibroids, none have been well-studied.