The best treatment option for fibroids depends on several factors, including the severity of symptoms, the size and location of the fibroids, the age and reproductive status of the patient, and the patient’s overall health and preferences. Here are some treatment options for fibroids:
- Watchful waiting: Many fibroids do not cause symptoms, and in these cases, watchful waiting may be the best approach. This involves monitoring the fibroids over time to see if they grow or cause symptoms.
- Medication: Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. They don’t eliminate fibroids, but may shrink them. Medications include:
- Gonadotropin-releasing hormone (GnRH) agonists. Medications called GnRH agonists treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary menopause-like state. As a result, menstruation stops, fibroids shrink and anemia often improves. Your doctor may prescribe a GnRH agonist to shrink the size of your fibroids before a planned surgery or to help transition you to menopause.
- Progestin-releasing intrauterine device (IUD). A progestin-releasing IUD can relieve heavy bleeding caused by fibroids. A progestin-releasing IUD provides symptom relief only and doesn’t shrink fibroids or make them disappear. It also prevents pregnancy.
- Tranexamic acid (Lysteda, Cyklokapron). This nonhormonal medication is taken to ease heavy menstrual periods. It’s taken only on heavy bleeding days.
- Other medications. Your doctor might recommend other medications. For example, oral contraceptives can help control menstrual bleeding, but they don’t reduce fibroid size. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, may be effective in relieving pain related to fibroids, but they don’t reduce bleeding caused by fibroids. Your doctor may also suggest that you take vitamins and iron if you have heavy menstrual bleeding and anemia
- Uterine fibroid embolization (UFE): This is a minimally invasive procedure that blocks the blood vessels that supply blood to the fibroids, causing them to shrink and die. UFE is performed by an interventional radiologist.
- Radiofrequency ablation. In this procedure, radiofrequency energy destroys uterine fibroids and shrinks the blood vessels that feed them. This can be done during a laparoscopic or transcervical procedure. A similar procedure called cryomyolysis freezes the fibroids
- Myomectomy: Myomectomy is a surgical procedure that involves removing the fibroids while leaving the uterus intact. This procedure is often recommended for women who want to have children in the future.
- Hysterectomy: Hysterectomy is a surgical procedure that involves removing the entire uterus. This procedure is usually recommended for women who do not wish to have children in the future or who have severe symptoms that do not respond to other treatments.
- Endometrial ablation. This treatment, performed with a specialized instrument inserted into your uterus, uses heat, microwave energy, hot water or electric current to destroy the lining of your uterus, either ending menstruation or reducing your menstrual flow.
The choice of treatment will depend on a variety of factors, and it’s important to discuss the options with your healthcare provider to determine the best approach for your individual situation.