Surgery is a reasonable treatment option when:
- Heavy uterine bleeding and/or anemia has continued after several months of therapy with birth control hormones and a nonsteroidal anti-inflammatory drug (NSAID).
- Fibroids grow after menopause.
- The uterus is misshapen by fibroids and you have had repeat miscarriages or trouble getting pregnant.
- Fibroid pain or pressure affects your quality of life.
- You have urinary or bowel problems (from a fibroid pressing on your bladder, ureter, or bowel).
- There is a possibility that cancer is present.
- Fibroids are a possible cause of your trouble getting pregnant.
Surgical treatment options include:
- Myomectomy, or fibroid removal. This may improve your chances of having a baby if the fibroid is inside the uterus and prevents a fertilized egg from implanting in the uterus. Removing fibroids in other locations of the uterus may not improve your chances of becoming pregnant.
- Hysterectomy, or uterus removal. This is only recommended for women who have no future pregnancy plans. Hysterectomy is the only fibroid treatment that prevents regrowth of fibroids. It improves quality of life for many women. But it can also have negative long-term effects. For more information, see the topic Hysterectomy.
Myomectomy or hysterectomy can be done through one or more small incisions using laparoscopy, through the vagina, or through a larger abdominal cut (incision). The method depends on your condition, including where, how big, and what type of fibroid is growing in the uterus and whether you hope to become pregnant.
What to think about
If you are hoping for a future pregnancy, myomectomy is your one surgical option.
Heavy, prolonged, and painful periods caused by uterine fibroids will stop naturally after you reach menopause. If you are nearing menopause and your symptoms are tolerable, consider controlling symptoms with home treatment and medicine until menopause. Uterine fibroid embolization (UFE) may also be a reasonable option for you, although it has some risks.