Uterine Fibroids Health Center

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Surgical fibroid removal, called myomectomy, is the only fibroid treatment that may improve your chances of having a baby.¹ Because fibroids can grow again, it is best to try to become pregnant as soon as possible after a myomectomy.

For severe fibroid symptoms

If you have fibroid-related pain, heavy bleeding, or a large fibroid that is pressing on other organs, you can consider shrinking the fibroid, removing the fibroid (myomectomy), or removing the entire uterus (hysterectomy). After all treatments except hysterectomy, fibroids may grow back. Only myomectomy is recommended for women who have future childbearing plans.

To shrink a fibroid for a short time, hormone therapy with a gonadotropin-releasing hormone analogue (GnRH-a) puts the body in a state like menopause. This shrinks both the uterus and the fibroids. Fibroids grow back after GnRH-a therapy has ended. GnRH-a therapy can help to:

• Shrink a fibroid before it is surgically removed. This lowers your risk of heavy blood loss and scar tissue from the surgery.
• Provide short-term relief as a "bridge therapy" if you are nearing menopause. (Fibroids naturally shrink after menopause.)

GnRH-a therapy should be used for only a few months because it can weaken the bones. It also may cause unpleasant menopausal symptoms.

To surgically remove fibroids, myomectomy can often be done through one or more small incisions using laparoscopy or through the vagina (hysteroscopy). Sometimes, a larger abdominal incision is needed. Myomectomy preserves the uterus, and makes pregnancy possible for some women.

To shrink or destroy fibroids without surgery, uterine fibroid embolization (UFE) (also called uterine artery embolization) stops the blood supply to the fibroid. The fibroid then shrinks and may break down. UFE preserves the uterus, but pregnancy is not common after treatment. UFE is not usually recommended for women who plan to become pregnant.⁴

Another treatment used to destroy fibroids without surgery is MRI-guided focused ultrasound. This treatment uses high-intensity ultrasound waves to break down the fibroids. Studies show that this treatment is safe and works well at relieving symptoms. But more studies are needed to find out if it works over time.⁴ This treatment may not be available everywhere.

To surgically remove the entire uterus, hysterectomy is available to women with long-lasting or severe symptoms who have no future pregnancy plans. Hysterectomy has both positive and negative long-term effects. For more information, see the topic Hysterectomy.

Uterine Fibroids: Should I Use GnRH-A Therapy?

Uterine Fibroids: Should I Have Surgery?

Uterine Fibroids: Should I Have Uterine Fibroid Embolization?

There are several other ways of removing fibroids or killing fibroid tissue using extreme cold (cryomyolysis), or laser (myolysis). But they are still new enough that risks and long-term benefits are not yet fully known. If your doctor offers one of these procedures, ask how many of the procedures he or she has done, how successful they have been, and what kinds of problems can result. These treatments are not recommended for women who are trying to become pregnant.¹ And these treatments may not be available everywhere.