Treatments & Options

The size and location of your fibroids, along with your medical history, will determine the options available to you. No matter how old or young you are, you can be sure that in most cases you have more than one choice for a cure. Don't settle for less. You do not need a hysterectomy.

Every woman's situation is unique. It is important for each woman to get a complete evaluation and carefully review all of her options before deciding what treatment is best for her. The uterus is not a useless organ after the last pregnancy: it plays a preventive role in heart disease and supports other organs in the body. In the interest of preserving it, women have to know about alternatives and be aware of them.

Fibroids are the most common cause for hysterectomy. Improved surgical procedures minimize the risks and costs of a hysterectomy, but it remains a radical and unnecessary operation. Women who experience fibroid related symptoms are usually between 30 and 45 years old, and premenopausal. Only 15% of all hysterectomies are necessary.

Click on any of the links below for details on treatment options.

Remember that these procedures are skill dependent operations and should be performed by highly trained board certified physicians. They are covered by insurance companies. The outlined treatment options are insurance covered.

Myomectomy

There are several types of myomectomy, an operation that removes fibroids and leaves the reproductive organs completely intact, and mostly functional.

Myolysis

Myolysis is a controversial procedure. The fibroids are not removed, rather, the blood supply to the myoma is reduced by coagulation of the vessels (through electric coagulation, cryoscopy, or laser). This causes the fibroids to shrink in size. This treatment can cause adhesions, weakness in the uterine wall, or future uterine rupture during pregnancy. Potential cancer can be missed. This procedure is still being studied for thorough evaluation.

Hysterectomy

With or without removal of the ovaries, Hysterectomy is the most radical approach to the treatment of fibroids. In the absence of a cancerous condition a supra-cervical hysterectomy - which leaves the cervix in place - can be a better choice.

Uterine Artery Embolization

Process by which the blood flow to the uterus is interrupted. A catheter is inserted into the leg vein and follows it into the uterine artery. A chemical (poly-vinyl alcohol) is then injected into the uterine artery (process of embolization), which interrupts blood flow to both the womb and any fibroids within it. This is intented to cause myomas to shrink, stunt their source of nourishment, and prevent them from growing in the future.

Embolization is performed by an interventional radiologist. The evaluation for uterine artery embolization includes an ultrasonogram of the fibroids to determine their size and location. This procedure is not indicated for large fibroids (over 10cm.), pedunculated and submucous fibroids. Also, women who are considering pregancy are not candidates for uterine artery embolization. Premature menopause, ovarian failure, and infection are infrequent complications.

Drug Treatments

Hormone therapy can slow fibroid growth before surgery.

No Treatment

Yes, doing nothing is also an option and often a good recommendation if symptoms are not severe.