If you’ve been diagnosed with uterine fibroids, your first instinct may be to have them surgically removed through hysterectomy or myomectomy. A doctor may have even mentioned surgery as your only option. There are other, less invasive measures, however, that may help reduce or break down your fibroids, minimize symptoms, and maximize your quality of life. Discover what options may be available to you prior to considering surgery.

Why Shouldn’t I Just Go Straight to Surgery?

While it’s true that hysterectomy will remove the fibroids and all associated symptoms, it will also remove your uterus and your ability to have children in the future. Hysterectomy may also lead to other long-term health issues, such as higher risk of:

• Cardiovascular disease, hypertension, and stroke
• Pelvic prolapse and pelvic organ fistula
• Certain cancers such as urinary tract and thyroid cancer
• Urinary and bowel incontinence
• Vasomotor symptoms
• Frailty
• Depression
• Decline in cognitive function

Myomectomy is a surgical procedure that allows you to keep your uterus but does not prevent fibroids from growing back. Data suggests that over a third of women who undergo myomectomy experience recurring fibroids.

If you don’t want to, or simply can’t, go straight to surgery, or you don’t want to risk your fertility in your reproductive years, there may be other avenues you can explore.

Uterine Fibroid Embolization 

During uterine fibroid embolization (UFE), tiny particles are inserted into the artery to choke off a  fibroid’s blood supply and shrink it until it disappears. Inserted through a catheter in the leg or wrist, and guided by x-ray imaging, these particles stick to the wall of the artery and create clots that prevent blood from reaching the fibroid(s).

The type of doctor that performs UFE is called an interventional radiologist. “You would need to go to a radiology department that could do this procedure,” says Linda Fan M.D., an assistant professor of obstetrics, gynecology, and reproductive sciences at Yale School of Medicine in New Haven, Connecticut. “This is a good option for bleeding but not bulk symptoms” such as pelvic and abdominal pressure, urinary urgency, and constipation.

The incision is less than an inch long, and can be covered with a small bandage. The procedure generally requires a short hospital stay of one day or less for a full recovery.

Advantages of UFE include:

• Faster recovery
• Minimally invasive
• Virtually no relapse
• Preservation of uterus
• Immediate symptom improvement
• Quick procedure and small incision

There are few risks to UFE. Some of the rare examples include fibroid expulsion, as well as injury to and infection of the uterus.

Other minimally-invasive procedures that can help relieve symptoms include: MRI-guided focused ultrasound (MRgFUS) and radiofrequency ablation.

Medication and Hormone Therapy

Certain types of medications and hormone therapy can help to reduce fibroids symptoms, including:

• Progestin-releasing intrauterine devices (IUDs) to reduce pain and bleeding from heavy periods. This treatment does not eliminate the fibroids, just certain symptoms.
• Myfembree® (relugolix, estradiol, and norethindrone acetate) can also reduce heavy bleeding.
• Gonadotropin-releasing hormone agonists (GnRH-a) to shrink your fibroids. These meds have certain risks, including putting your body into a “menopause-like” state and recurrence of fibroid growth after you stop using them. 

Do not use any of these hormonal treatments if you are pregnant.

While many say proper diet and exercise can help eliminate or reduce fibroids, and there is certainly no downside to it, there is no scientific proof that diet and/or exercise alone are effective. Nevertheless, you can empower yourself to manage your fibroids and increase your quality of life by working closely with your doctor, asking questions, and even seeking a second opinion if you don’t feel comfortable with the options your doctor has provided.

*Mans, Keydra (2022, April 11). If You’re Considering Surgery for Fibroids, Try These Options First. https://www.healthcentral.com/slideshow/uterine-fibroid-non-surgical-options