What Is the Treatment for Uterine Fibroids? How to Choose the Best Option for You

As many as 80% of women have fibroids by age 50. And Black women are more likely than white women to have them. Many people who have fibroids have no symptoms. But for some, they can cause pain and heavy bleeding.

If you have uterine fibroids, you may be wondering what treatments are available. So we'll walk you through the details of the medications and procedures that can help. That way, you can choose the option that's best for you.

What are uterine fibroids?

Uterine fibroids are non-cancerous growths that develop inside or on top of the uterus. They're most common between ages 30 and 50. But some women develop fibroids during menopause.

Symptoms can include:

• Heavy bleeding, which can lead to anemia

• Longer and more frequent periods

• Painful periods

• Bleeding between periods

• Pain in the stomach, pelvic, or low back

• Pain during sex

• Changes in urinary urgency or frequency

Fibroids inside the uterus can make it harder to become pregnant. They can also cause complications during pregnancy, including miscarriage.

What are the treatment options for uterine fibroids?

Treatment for uterine fibroids includes medications, hormone therapy, and surgical procedures. The best treatment options will vary from person to person.

Factors that affect your treatment choices include:

• Your age

• Your overall health

• What symptoms you have and how severe they are

• Whether you want to get pregnant in the future

Below, we'll go into each of the three treatment options.

Medications

Medications for fibroids can do a few different things. They can slow the growth of fibroids, manage symptoms like pain or heavy bleeding, or do a combination of both.

For pain, here are some medication options:

• OTC:Over-the-counter (OTC) pain medications like ibuprofen or acetaminophen may be helpful.

• Prescription: Prescription medications may be necessary for some people. A combination drug called Myfembree is sometimes prescribed. It can treat both pain and heavy bleeding.

And here are some medication options for bleeding:

• Myfembree: Myfembree, mentioned above, is a type of hormonal treatment that helps with heavy bleeding. It works by blocking hormones that cause ovulation and menstruation.

• Antifibrinolytic medications: These are used for particularly heavy bleeding. They work by helping blood to clot. Tranexamic acid (Cyklokapron) is an example of an antifibrinolytic.

• Iron, vitamin B12: If ongoing bleeding leads to low blood counts (anemia), iron and vitamin B12 supplements may be recommended.

• Birth control:Low-dose birth control pills, as well as rings and patches, may be used to control heavy bleeding.

• Progesterone-like injections: Examples of these are medroxyprogesterone (Depo-Provera), which can also help with heavy bleeding.

• IUDs:Intrauterine devices (IUDs) that release progestin, like Mirena, are another option for fibroid treatment. They control heavy bleeding and pain.

Finally, here is an option to shrink fibroids:

• Gonadotropin-releasing hormone agonists:These medications can help. They also stop the body from making hormones that cause periods (estrogen and progesterone). These medications may be effective on their own. They're also sometimes prescribed to shrink fibroids before surgery to remove them.

Procedures

Procedures or surgery may be an option for people with heavy menstrual bleeding and pain that doesn't respond to medications. Some procedures may also be an option for women who have fibroids that make it difficult to become pregnant.

There are a few different types of procedures that can treat fibroids.

Myomectomy

A myomectomy is a surgical procedure that involves removing the fibroids from the uterus. This option is typically used when someone wants to become pregnant in the future.

There are a few different ways to perform a myomectomy. For example, it can be done through an incision in the stomach. Or a fibroid can be removed through the cervix. The approach usually depends on the location and size of the fibroids.

There's a chance that fibroids will grow back months, or even years, after this procedure.

Hysterectomy

A hysterectomy is a surgical procedure to remove the uterus. While this procedure will prevent fibroids from returning, it also means you won't be able to get pregnant.

Focused ultrasound

A magnetic resonance-guided focused ultrasound is another treatment option. It uses MRI and sound waves to treat uterine fibroids. It's a nonsurgical technique that destroys fibroid tissue in a specific area. You can still become pregnant after having this procedure.

Radiofrequency ablation

Radiofrequency ablation is a minimally invasive procedure that uses radio waves and heat to destroy fibroid tissue. It may reduce your symptoms and the number of fibroids you have. Fibroids typically shrink within a few weeks to a few months. However, it may be more difficult to become pregnant after this procedure.

Embolization

Uterine artery embolization is a procedure that cuts off blood supply to fibroids. Here's how the procedure goes:

• A thin tube is inserted into a blood vessel in the thigh.

• The tube is then threaded up toward the blood vessels that feed the fibroids.

• Next, small particles are injected into those blood vessels, which block the blood supply to the fibroid.

• The fibroids will begin to shrink within a few weeks to a few months.

This may be a suitable choice for people who have heavy bleeding, don't want kids in the future, and want to avoid a hysterectomy.

Can fibroids be cured?

The only cure for uterine fibroids is to remove the uterus entirely with a hysterectomy. The other treatment options can help decrease symptoms, shrink fibroids, or remove fibroids. But symptoms can return and fibroids can grow back later.

Do uterine fibroids always need to be treated?

Some people with uterine fibroids have no symptoms. When this happens, your gynecologist may suggest watching for changes in symptoms. In other cases, a person may have mild symptoms that can be managed without prescription medications or procedures.

While you may not have any symptoms for months or even years after fibroids first appear, this can change over time. Talk to your gynecologist if your symptoms worsen so that your treatment plan can be revised.

This includes ongoing discussion about whether you want to become pregnant in the future. Depending on the size and location of the fibroids, it may be difficult to become pregnant without medical treatment first.