What Are the Treatments for Uterine Fibroids?

Medically Reviewed by Melinda Ratini, MS, DO on July 25, 2023
3 min read

If you have uterine fibroids, you may or may not need treatment. It depends on whether they cause you any problems.

Not all fibroids grow. Even large ones may not cause any symptoms, and most shrink after menopause.

Still, you and your doctor should check on their growth, especially if you develop symptoms like bleeding or pain. You should at least get pelvic exams every year.

You can’t cure fibroids on your own. But you can do things that help you feel better. If you have large fibroids, you may become aware of a mass in your abdomen. If it helps, you can lie down and put a hot pack or hot water bottle on your lower belly several times a day to ease the pain. 

You can take pain relievers like ibuprofen or naproxen. But be sure to follow the instructions on the label so you don’t accidentally take too much. If you and your doctor decide you need to take something for your fibroids, you may want to consider these other options:

  • Hormone therapy. To help prevent more growth of the fibroid, your doctor may recommend that you stop taking birth control pills or using hormone replacement therapy. But in some cases, your doctor may prescribe certain types of birth control pills to help control bleeding and anemia from fibroids.
  • Gonadotropin-releasing hormone (GnRH) antagonists. GnRH is a hormone your body makes. GnRH antagonists put you into menopause for as long as you take them by suppressing estrogen, which stimulates fibroid growth. You take them together with the hormones estrogen and progesterone to reduce side effects. They're not meant to be used long term because they make you more prone to osteoporosis. You take them as a pill. 
  • GnRH agonists. These work in a similar way to GnRH antagonists, but you get them as a shot. They not only reduce heavy periods,  but also can shrink fibroids. They carry the same precautions as GnRH antagonists. When you stop taking them, your fibroids can grow back. They're often used before fibroid surgery.
  • Antifibrinolytic medications. These aren't hormonal drugs, so they don't cause menopause symptoms. Instead, they curb heavy period bleeding by helping your blood to clot quickly. You only take them when you need them. 

An IUD is a birth control device. Some also release the hormone progestin, which can help control the heavy bleeding and cramping that fibroids may cause. An IUD won’t shrink your fibroids, though. And it may not be right for you if your fibroids are in the cavity of your uterus.

There are several possibilities you and your doctor can consider.

  • Fibroid embolization is a procedure in which your doctor injects polyvinyl alcohol (PVA) particles into arteries that feed the fibroid. The PVA blocks the blood supply to the fibroid, which makes it shrink. It’s not surgery, but you may need to spend several nights in the hospital because you might have nausea, vomiting, and pain afterward.
  • Endometrial ablation is a procedure in which doctors destroy the lining of your uterus to cut down on bleeding linked to small fibroids.
  • Myomectomy is surgery to remove fibroids. If you plan to later become pregnant, your doctor may recommend this over other procedures. But it may cause scarring that can lead to infertility. You’ll need to wait 4-6 months after surgery before you try to conceive. Fibroid symptoms usually go away after a myomectomy. But in others, the fibroids come back. Whether it works partly depends on how many fibroids you have and whether your surgeon can remove them all. A myomectomy can be done as abdominal surgery, or your surgeon may use a hysteroscope or laparoscope to remove the fibroids without having to make a large cut on your abdomen. A newer method uses MRI-guided intense ultrasound energy to pinpoint the fibroids and shrink or destroy them.
  • Hysterectomy is surgery to remove your uterus. You won’t be able to get pregnant after this operation. Most people don't need treatment that's this drastic.