Factors women should consider when determining what uterine fibroid treatment is best for them include recovery time, desire for fertility, symptom recurrence rate, need for post-procedure hormone replacement therapy, the risk of early menopause, cost and additional effects on the body. Below are the treatment options available today for women suffering from uterine fibroids.
| Treatment | Description | Advantages | Disadvantages |
|---|---|---|---|
| Hormone treatment | Medications reduce bleeding and decrease fibroid tumor size. | No procedure necessary. Preserves uterus. | Can cause menopause-like symptoms and bone loss. Symptoms return when treatment stops. |
| MR-guided focused ultrasound (MRgFUS) | Ultrasound waves penetrate the abdominal wall and heat fibroid tissue, causing the tumor to shrink. | No incision. One to two day recovery with minimal discomfort. Preserves uterus. | Procedure can take several hours. Usually only appropriate for small fibroids near the surface of the uterus. Insurance may not cover. Fibroids may recur, requiring additional procedures. |
| Uterine fibroid embolization (UFE) | Nonsurgical procedure to block blood flow to fibroids, causing them to shrink. Performed by an interventional radiologist. | Very small incision; no general anesthesia required. One week recovery. Few major complications. Preserves uterus. | Mild fatigue and low grade fever may occur, but can be treated and typically pass quickly. Fibroids may recur, requiring additional procedures. |
| Endometrial ablation | Removal of the lining of the uterus to reduce bleeding. Can only be used in presence of submucosal fibroids < 1 inch in diameter. | Can effectively control bleeding. Preserves uterus. | May not be possible, depending on location or size of fibroids. Will not reduce symptoms related to fibroid bulk. Abnormal uterine bleeding may recur, requiring additional procedures. |
| Myomectomy – hysteroscopic – laparoscopic, including robotic – abdominal |
Surgical removal of fibroid tumors. | Relieves symptoms and preserves uterus. Currently the only procedure recommended for fertility. | Risks associated with surgery and general anesthesia. Two day to six week recovery.** Fibroids may recur, requiring additional procedures. May not be recommended depending on location, size, and number of fibroids. |
| Hysterectomy – vaginal – laparoscopic, including robotic – abdominal |
Surgical removal of the uterus. | Permanently relieves symptoms. | Loss of fertility. Risks associated with surgery and general anesthesia. Two to six week recovery.** Hormonal changes if ovaries are removed. Longer-term side effects have been reported. |
** Depending on how the surgery is performed
Click here to download a patient brochure to use as a guide when discussing treatment options with your doctor.
UFE is not intended for women who desire future pregnancy. However, several studies have shown that women actively trying to become pregnant following UFE were able to do so.
This procedure uses high-intensity focused ultrasound to destroy fibroids. HIFU is a relatively new procedure, with limited availability in the United States. HIFU is non-invasive and done as an outpatient procedure, with six-to-eight hours of treatment time. The effects of HIFU on the ability to become pregnant have not yet been determined. back to chart
Endometrial ablation is the removal of the lining of the uterus to reduce bleeding and can only be used in the presence of submucosal fibroids < 1 inch in diameter. Although endometrial ablation preserves the uterus, it can only control bleeding and will not reduce symptoms related to fibroid bulk, such as pelvic pain, urinary frequency, and constipation. Endometrial ablation may not be possible, depending on location or size of fibroids. Abnormal uterine bleeding may recur, requiring additional procedures. back to chart
Hysterectomy is the surgical removal of uterus and often the ovaries. Hysterectomy usually requires a four-to-six week recovery period, and has a potential association with numerous other long-term physical and psychological effects including incontinence1, loss of sexual pleasure2, and depression3. Following a hysterectomy, a woman may need to consider if hormone replacement therapy (HRT) is necessary to control symptoms of surgical menopause. A woman is no longer able to have children after having a hysterectomy. back to chart
Myomectomy is the surgical removal of fibroids while leaving the uterus in place. Since this alternative to hysterectomy leaves the uterus in place, a woman undergoing myomectomy may still be able to have children. Most myomectomies are invasive and requires a long recovery period. There is also no guarantee that the fibroids will not return. back to chart
Medications called GnRH agonists offer short-term relief from uterine fibroid symptoms. GnRH agonists induce a temporary chemical menopause by reducing estrogen levels causing the fibroids to decrease in size. However, the fibroids usually grow back to their pre-treatment size when the medication is discontinued. back to chart
Click here if you would like a brochure of all fibroid treatment options mailed to you.
2. Psychosexual health 5 years after hysterectomy: population-based comparison with endometrial ablation for dysfunctional uterine bleeding; K McPherson et al; Health Expect 2005 Sep;8(3):234-43
3. Ibid.
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Learn more about Beverly’s personal experience with uterine fibroid tumors.
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Think you or someone you care about has uterine fibroids? For a guide on how to talk to your doctor about diagnosis of uterine fibroid tumors and possible treatment for fibroids.
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Learn more about the number of fibroid tumor treatment options available for women with uterine fibroids.
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