You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.
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This decision aid is for women who have decided to treat their uterine fibroids. Many fibroids don't need treatment.
If you've decided to treat your uterine fibroids, you may also need to make a decision about GnRH-A hormone therapy or a decision about surgery.
Uterine fibroids are growths in the uterus. They are not cancer. Fibroids can grow on the inside of the uterus, within the muscle wall of the uterus, or on the outer surface of the uterus. They can change the shape of the uterus as they grow. This can make it hard for you to get pregnant, or it can cause problems during a pregnancy.
Over time, the size, shape, location, and symptoms of fibroids may change.
As women get older, they are more likely to have uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no symptoms. But fibroids can cause bad pain, bleeding, and other problems.
The cause of fibroids is not known. But the hormones estrogen and progesterone can make them grow. A woman's body makes the highest levels of these hormones during her childbearing years. After menopause, when hormone levels decrease, fibroids often shrink or disappear.
Uterine fibroids usually need treatment when they cause:
Depending on the reasons you need treatment, one type of treatment may work better for you than another.
Uterine fibroid embolization is a procedure that blocks blood flow to fibroids in the uterus. It's not surgery. Fibroids treated with this procedure shrink by about half.footnote 2
The doctor (a radiologist) puts a thin, flexible tube called a catheter into a blood vessel in your upper thigh (femoral artery). Then the doctor injects a substance called contrast material into the catheter. He or she uses an X-ray on a video screen to see the arteries and guide the catheter to the arteries that supply blood to the fibroid. Small particles are injected into those uterine arteries through the catheter. These particles build up in the arteries and block blood flow to the fibroid. The rest of the uterus usually isn't harmed, because it's supplied by other arteries.
Uterine fibroid embolization can be used to control heavy, long-lasting menstrual bleeding when:
Embolization usually works well to treat fibroids. Short-term studies show that:footnote 1
But the results don't always last: In one study, nearly 1 out of 4 women who had embolization needed another one or a hysterectomy within the next couple of years.footnote 4
The chance of a problem after embolization is low. But the risks include:
Although some women can get pregnant after this procedure, experts don't yet fully know the risks to pregnancy.
If you're thinking of having this procedure, look for a radiologist who has done it many times with few problems.
Your doctor might recommend this procedure if:
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These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
I have had pain before and during my period for years. In the past year or so I started having really heavy bleeding, and my periods were lasting longer than usual. I tried nonprescription and prescription medicines to control the bleeding. Nothing was working. My doctor suggested a procedure called uterine fibroid embolization. I had the procedure, and my doctor was able to treat the fibroids. It didn't hurt too much, and I was surprised at how quickly I recovered. It has been 6 months now, and I no longer have those days of heavy bleeding. I am glad I had uterine fibroid embolization.
Marlena, age 43
Over the past 3 or 4 years, my periods have been getting heavier and heavier. My doctor did a bunch of tests and thought that uterine fibroids may be causing my symptoms. He suggested that I have a procedure called uterine fibroid embolization to control my bleeding. The procedure sounded scary, so I asked if waiting a few months would be dangerous. He said waiting would be fine. After a few months, my periods eased up. I am glad I decided to wait and see if my bleeding decreased before having the procedure.
Angie, age 44
About 3 years ago, my menstrual periods really changed for the worse. I began having cramps, and my periods were heavy with clotting and lasted for 2 weeks. I thought, "No way was that a totally normal period," and I made an appointment with my doctor. I tried a bunch of different medicines and nothing seemed to make much difference. After lots of further testing and discussion I had uterine fibroid embolization. I figure that since I don't want any more kids, any risk of losing my fertility is okay. The procedure was quick, and I was completely recovered in about 3 days. I had some pretty severe cramping afterwards, but it only lasted for about 12 hours and got better with ibuprofen. The embolization worked but I still have some odd cycles in that I bleed too many days per month, I get clotting some cycles, and some of my periods are heavier. My doctor says I may have to have another embolization, but I think it will be worth it.
Raquel, age 32
A couple of years ago I started having heavy, painful periods. My doctor said she thought I might have something I had never even heard of called uterine fibroids. Apparently they are pretty common as you get older. My doctor outlined all the different treatments I could try, including something called uterine fibroid embolization, if it ever got really bad. She said that I might consider starting with birth control pills and that I could try ibuprofen for a few days right before my period starts and then for several days during my period, to help control the bleeding. The embolization sounded pretty risky—I don't know if I could ever do that. Lucky for me, the birth control pills and ibuprofen have helped a lot. In fact, my doctor says that means the bleeding was more of a menstrual problem than a fibroid problem!
June, age 38
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have uterine fibroid embolization
Reasons to choose another treatment
I don't want to have surgery or take hormones.
I would rather have surgery or take hormones.
I don't plan to get pregnant.
I would like to be able to get pregnant after treatment.
I want a shorter recovery.
I don't mind taking time to recover after surgery.
I'm not close to menopause.
I'm close to menopause.
I'm not worried about possible risks such as infection or pain.
I'm concerned about possible side effects from the procedure.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having embolization
NOT having embolization
Check the facts
Decide what's next
Certainty
1. How sure do you feel right now about your decision?
Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
| Author | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica MD - Family Medicine |
| Primary Medical Reviewer | Elizabeth T. Russo MD - Internal Medicine |
| Primary Medical Reviewer | Divya Gupta MD - Obstetrics and Gynecology, Gynecologic Oncology |
This decision aid is for women who have decided to treat their uterine fibroids. Many fibroids don't need treatment.
If you've decided to treat your uterine fibroids, you may also need to make a decision about GnRH-A hormone therapy or a decision about surgery.
Uterine fibroids are growths in the uterus. They are not cancer. Fibroids can grow on the inside of the uterus , within the muscle wall of the uterus , or on the outer surface of the uterus . They can change the shape of the uterus as they grow. This can make it hard for you to get pregnant, or it can cause problems during a pregnancy.
Over time, the size, shape, location, and symptoms of fibroids may change.
As women get older, they are more likely to have uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no symptoms. But fibroids can cause bad pain, bleeding, and other problems.
The cause of fibroids is not known. But the hormones estrogen and progesterone can make them grow. A woman's body makes the highest levels of these hormones during her childbearing years. After menopause, when hormone levels decrease, fibroids often shrink or disappear.
Uterine fibroids usually need treatment when they cause:
Depending on the reasons you need treatment, one type of treatment may work better for you than another.
Uterine fibroid embolization is a procedure that blocks blood flow to fibroids in the uterus. It's not surgery. Fibroids treated with this procedure shrink by about half.2
The doctor (a radiologist) puts a thin, flexible tube called a catheter into a blood vessel in your upper thigh (femoral artery). Then the doctor injects a substance called contrast material into the catheter. He or she uses an X-ray on a video screen to see the arteries and guide the catheter to the arteries that supply blood to the fibroid. Small particles are injected into those uterine arteries through the catheter. These particles build up in the arteries and block blood flow to the fibroid. The rest of the uterus usually isn't harmed, because it's supplied by other arteries.
Uterine fibroid embolization can be used to control heavy, long-lasting menstrual bleeding when:
Embolization usually works well to treat fibroids. Short-term studies show that:1
But the results don't always last: In one study, nearly 1 out of 4 women who had embolization needed another one or a hysterectomy within the next couple of years.4
The chance of a problem after embolization is low. But the risks include:
Although some women can get pregnant after this procedure, experts don't yet fully know the risks to pregnancy.
If you're thinking of having this procedure, look for a radiologist who has done it many times with few problems.
Your doctor might recommend this procedure if:
| Have embolization | Don't have this procedure | |
|---|---|---|
| What is usually involved? |
|
|
| What are the benefits? |
|
|
| What are the risks and side effects? |
|
|
These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.
"I have had pain before and during my period for years. In the past year or so I started having really heavy bleeding, and my periods were lasting longer than usual. I tried nonprescription and prescription medicines to control the bleeding. Nothing was working. My doctor suggested a procedure called uterine fibroid embolization. I had the procedure, and my doctor was able to treat the fibroids. It didn't hurt too much, and I was surprised at how quickly I recovered. It has been 6 months now, and I no longer have those days of heavy bleeding. I am glad I had uterine fibroid embolization."
— Marlena, age 43
"Over the past 3 or 4 years, my periods have been getting heavier and heavier. My doctor did a bunch of tests and thought that uterine fibroids may be causing my symptoms. He suggested that I have a procedure called uterine fibroid embolization to control my bleeding. The procedure sounded scary, so I asked if waiting a few months would be dangerous. He said waiting would be fine. After a few months, my periods eased up. I am glad I decided to wait and see if my bleeding decreased before having the procedure."
— Angie, age 44
"About 3 years ago, my menstrual periods really changed for the worse. I began having cramps, and my periods were heavy with clotting and lasted for 2 weeks. I thought, "No way was that a totally normal period," and I made an appointment with my doctor. I tried a bunch of different medicines and nothing seemed to make much difference. After lots of further testing and discussion I had uterine fibroid embolization. I figure that since I don't want any more kids, any risk of losing my fertility is okay. The procedure was quick, and I was completely recovered in about 3 days. I had some pretty severe cramping afterwards, but it only lasted for about 12 hours and got better with ibuprofen. The embolization worked but I still have some odd cycles in that I bleed too many days per month, I get clotting some cycles, and some of my periods are heavier. My doctor says I may have to have another embolization, but I think it will be worth it."
— Raquel, age 32
"A couple of years ago I started having heavy, painful periods. My doctor said she thought I might have something I had never even heard of called uterine fibroids. Apparently they are pretty common as you get older. My doctor outlined all the different treatments I could try, including something called uterine fibroid embolization, if it ever got really bad. She said that I might consider starting with birth control pills and that I could try ibuprofen for a few days right before my period starts and then for several days during my period, to help control the bleeding. The embolization sounded pretty risky—I don't know if I could ever do that. Lucky for me, the birth control pills and ibuprofen have helped a lot. In fact, my doctor says that means the bleeding was more of a menstrual problem than a fibroid problem!"
— June, age 38
Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.
Reasons to have uterine fibroid embolization
Reasons to choose another treatment
I don't want to have surgery or take hormones.
I would rather have surgery or take hormones.
I don't plan to get pregnant.
I would like to be able to get pregnant after treatment.
I want a shorter recovery.
I don't mind taking time to recover after surgery.
I'm not close to menopause.
I'm close to menopause.
I'm not worried about possible risks such as infection or pain.
I'm concerned about possible side effects from the procedure.
My other important reasons:
My other important reasons:
Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.
Having embolization
NOT having embolization
1. Uterine fibroid embolization could be a good choice for me, because I don't plan to have more children.
2. I can recover more quickly after embolization than after surgery.
3. Embolization will fix my fibroids for good.
1. Do you understand the options available to you?
2. Are you clear about which benefits and side effects matter most to you?
3. Do you have enough support and advice from others to make a choice?
1. How sure do you feel right now about your decision?
2. Check what you need to do before you make this decision.
| By | Healthwise Staff |
|---|---|
| Primary Medical Reviewer | Sarah Marshall MD - Family Medicine |
| Primary Medical Reviewer | Kathleen Romito MD - Family Medicine |
| Primary Medical Reviewer | Martin J. Gabica MD - Family Medicine |
| Primary Medical Reviewer | Elizabeth T. Russo MD - Internal Medicine |
| Primary Medical Reviewer | Divya Gupta MD - Obstetrics and Gynecology, Gynecologic Oncology |
Current as of: February 11, 2021
Author: Healthwise Staff
Medical Review:Sarah Marshall MD - Family Medicine & Kathleen Romito MD - Family Medicine & Martin J. Gabica MD - Family Medicine & Elizabeth T. Russo MD - Internal Medicine & Divya Gupta MD - Obstetrics and Gynecology, Gynecologic Oncology
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