If your fibroids aren't bothering you, you don't need to do anything about them. Your doctor may check them during your regular visits to see if they have gotten bigger.
But if you have a fibroid problem, there are several treatments to consider. What treatment you choose may depend on how bad your symptoms are, if you want to get pregnant, and how close you are to menopause.
Medicines are used to relieve symptoms like heavy menstrual bleeding or painful periods. These medicines include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs). They can improve menstrual cramping and reduce bleeding.
- Birth control hormones (pill, patch, or ring). They lighten menstrual bleeding and pain while preventing pregnancy.
- An intrauterine device (IUD) that releases small amounts of progestin into the uterus. It may reduce heavy menstrual bleeding.
- A progestin shot (Depo-Provera) every 3 months. It may lighten your bleeding.
- Tranexamic acid. This is a medicine that can reduce bleeding by helping blood to clot.
- Gonadotropin-releasing hormone analogue (GnRH-a) therapy. This shrinks the fibroids. It may be used to shrink fibroids before surgery. It can also help with symptoms.
- Iron supplements. They can help correct anemia caused by fibroid blood loss.
Procedures and surgery
If you have fibroid-related pain, heavy bleeding, or a large fibroid that is pressing on other organs, there are treatments you can try that shrink or remove your fibroids. After all treatments except hysterectomy, fibroids may grow back or new fibroids can grow. If you plan to get pregnant, talk with your doctor about which treatment is right for you.
- Shrinking or destroying fibroids without surgery.
- Uterine fibroid embolization stops the blood supply to the fibroid. The fibroid then shrinks.
- MRI-guided focused ultrasound uses high-intensity ultrasound waves to destroy the fibroids.
- Surgery to remove fibroids.
This surgery is called myomectomy. It preserves the uterus. This means you may be able to get pregnant in the future.
- Surgery to remove the entire uterus.
This surgery is called hysterectomy. It may be an option if you have no future pregnancy plans.
For infertility and pregnancy problems
Fibroids don't often affect fertility. But if a fibroid distorts the wall of the uterus, it can prevent a fertilized egg from implanting in the uterus. Surgery to remove the fibroid may improve your chances of getting pregnant.
When nearing menopause
If you are nearing menopause and can tolerate your symptoms, you can try to control them with home treatment and medicine. After menopause, your estrogen and progesterone levels will drop. This causes most fibroids to shrink and symptoms often improve.
- Endometrial Ablation
- Uterine Fibroids: Should I Have Surgery?
- Uterine Fibroids: Should I Use GnRH-A Therapy?