Non-Surgical Treatment Options
Watchful waiting: A minority of fibroids will naturally shrink over time. Most uterine fibroids will either stay the same size or grow.
Oral contraceptives (birth control pills): These contain hormones (estrogen, progesterone, or a combination) that can help reduce heavy periods caused by uterine fibroids.
Lupron: This hormone treatment stops menstrual periods and shrinks uterine fibroids. Lupron is usually used as a temporary treatment before surgery.
Intrauterine device (IUD) with levonorgestrel: Mirena is an IUD that releases a hormone that reduces heavy periods.
Pain relievers: Motrin or Aleve can reduce the pain caused by uterine fibroids.
Iron: Heavy periods caused by uterine fibroids can lead to iron-deficiency anemia. Iron tablets can help the body replace the blood lost during menstruation.
Surgical Treatment Options
Myomectomy: Surgery to remove uterine fibroids while leaving the uterus in place. Myomectomy is often done for women wishing to have children. New uterine fibroids may grow, requiring a later procedure in up to a third of women after myomectomy.
Hysterectomy: Surgery to remove the entire uterus and all uterine fibroids. Hysterectomy cures uterine fibroids and prevents them from ever returning. Women with symptoms from uterine fibroids who don’t want a future pregnancy often undergo hysterectomy.
Surgeons perform myomectomy and hysterectomy through different techniques. These can determine time in the hospital, healing time, and scarring.
- Open abdominal surgery: A surgeon makes a 5-inch to 7-inch incision either up and down or side to side across the belly. The fibroids (and/or the uterus) are removed through this incision.
- Vaginal approach: The surgeon makes a cut in the vagina and removes the uterus through this incision. The incision is closed, leaving no visible scar on the abdominal wall.
- Laparoscopy: Several small cuts are made in the belly, and a lighted camera and surgical tools are inserted through these incisions. In a single site laparoscopic procedure, just one small cut is made through the belly button. The surgeon operates from outside the body and removes the fibroids or fibroids and uterus through these small incisions or through a vaginal incision, viewing the operation on a video screen.
- Robot-assisted laparoscopy: This procedure is similar to laparoscopy, but the surgeon controls a sophisticated robotic system of surgical tools from outside the body. Advanced technology allows the surgeon to use natural wrist movements and view the surgery on a three-dimensional screen.
- A less invasive type of myomectomy uses a hysteroscope -- the long, thin lighted tube mentioned above -- to enter the uterus through the vagina and cervix and remove submucosal fibroids. Fibroids can then be removed by a tool inserted through the hysteroscope.