Uterine Fibroid Treatment Options: Surgical and Non-Surgical Approaches
If uterine fibroids (also called uterine leiomyomas) are disrupting your life with heavy bleeding, pelvic pain, or constant pressure, you’re not alone. These noncancerous growths affect millions of women, and while they’re common, the symptoms are anything but normal.
The good news is that while several treatment options have been developed over the years, minimally invasive procedures are now taking the foreground. Finding the right approach depends on your symptoms, goals, and lifestyle. Whether you’re looking to manage symptoms, preserve fertility, or eliminate uterine fibroids entirely, understanding modern treatment options can help you take the next step toward relief and a better quality of life.
1. Watchful Waiting
The advent of minimally invasive procedures like uterine fibroid embolization has made watchful waiting largely antiquated or unnecessary for most women with symptomatic fibroids.
Traditionally, doctors recommended watchful waiting if fibroids were small or symptoms were mild, reasoning that surgery was too invasive for minor issues. However, today’s minimally invasive treatments have changed this calculus entirely. Modern procedures like UFE are so low-risk—requiring only an outpatient visit, a tiny pinprick in the wrist, and allowing patients to return home three hours later essentially free of fibroid symptoms—that even women with milder symptoms can benefit from early intervention.
Women who are truly asymptomatic will naturally choose to wait without seeking treatment. However, if you’re experiencing even mild symptoms and searching for solutions, it’s worth knowing that the risk profile of minimally invasive procedures has shifted dramatically away from traditional surgery. What once required waiting until symptoms became unbearable now has a safe, effective solution available.
This approach of monitoring the uterine fibroids over time through routine checkups and pelvic ultrasound to track fibroid size and any changes in fibroid symptoms may still be recommended for women nearing menopause, when uterine fibroids naturally shrink due to decreased hormone levels.
2. Medications
While certain medications can help control heavy bleeding, reduce pelvic pain, and even slow fibroid growth, it’s important to understand that they are usually only a temporary solution. Medications won’t completely remove uterine fibroids—they simply mask the symptoms. Once you’re on these medications, you often can’t come off them, committing you to long-term medication use without actually solving the underlying problem. They can be an option, especially if you’re looking to delay or avoid fibroid removal surgery.
Two main types of medications are used for treating uterine fibroids: hormonal and non-hormonal.
Hormonal Medications
Uterine fibroids thrive on hormones, particularly estrogen and progesterone. So hormonal medications can help provide symptom relief.
While they don’t remove uterine fibroids, these medications can make them smaller or more manageable. Doctors often recommend them if you’re not ready for fibroid surgery or need short-term relief before a permanent fibroid treatment.
Common hormonal medications include:
- Gonadotropin-releasing hormone (GnRH) agonists: These medications, like leuprolide, temporarily induce a menopause-like state by lowering estrogen and progesterone levels to help shrink fibroids before surgery. However, long-term use can lead to serious complications like bone density loss.
- GnRH antagonists: This newer option also helps lower estrogen levels but without the menopause-like side effects of traditional GnRH agonists.
- Birth control pills or patches: Combination hormonal contraceptives can regulate your menstrual cycle, reduce menstrual bleeding, and alleviate menstrual cramps, but they don’t stop fibroid growth.
- Levonorgestel-releasing intrauterine system: This intrauterine device (IUD) releases a small amount of progestin to help control abnormal uterine bleeding, though it’s not effective for shrinking large fibroids.
Non-Hormonal Medications
If hormonal treatments aren’t right for you—or you prefer to avoid their side effects—non-hormonal medications can help manage fibroid symptoms like heavy bleeding, pelvic pain, and frequent urination. While these won’t shrink fibroids, they can improve your quality of life by controlling symptoms temporarily.
Common non-hormonal options include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen help relieve pelvic pain and reduce menstrual flow, but they don’t affect fibroid size.
- Tranexamic acid: This medication helps treat heavy menstrual bleeding by preventing excessive blood loss during menstrual periods.
- Iron supplements: If excessive bleeding from uterine fibroids has led to anemia, iron supplements can help restore healthy blood levels.
3. Uterine Fibroid Embolization (UFE) – The Modern Minimally Invasive Solution
If you’re looking for an effective, minimally invasive procedure to treat uterine fibroids without surgery, a procedure called uterine fibroid embolization (UFE) could be the right choice. UFE represents the advancement in fibroid treatment that has made older approaches less necessary—it’s ideal for women experiencing heavy bleeding, pelvic pain, or fibroid-related symptoms but who want to avoid a hysterectomy or myomectomy and preserve fertility.
UFE works by cutting off the blood flow to fibroids, causing them to shrink over time. During the procedure, a doctor inserts a catheter into the uterine artery through a small incision in the wrist or groin, then injects tiny particles that block the blood vessels supplying the uterine fibroids. This causes the fibroid tissue to shrink and die off gradually.
UFE has a high success rate of approximately 90-95%. Most women see a dramatic improvement in their symptoms and can go home the same day and return to normal activities within a week.
Why UFE Stands Out Among Treatment Options
Unlike surgical procedures that require individually targeting each fibroid, UFE treats all fibroids simultaneously—including those too small to be visible on imaging. This makes it particularly effective for women with multiple fibroids, which is common. The procedure:
- Requires no general anesthesia
- Involves minimal downtime (most women return to normal activities within a week)
- Treats all fibroids at once, regardless of size or location
- Addresses both visible fibroids and those below the imaging threshold
- Has allowed thousands of women to have successful pregnancies afterward
However, UFE is not suitable for every patient, especially those with certain types of submucosal fibroids. A consultation with a fibroid specialist can help determine if UFE is right for you.
4. Myomectomy (Surgical Removal of Fibroids)
If you want to remove uterine fibroids while preserving your uterus, a myomectomy may be an option. This fibroid removal surgery extracts fibroids while leaving the uterus intact, so it is a preferred choice for women who still want the option to conceive. A myomectomy can significantly relieve fibroid symptoms, but it doesn’t prevent new uterine fibroids from developing in the future.
A myomectomy is best suited for women with symptomatic uterine fibroids, particularly those with severe symptoms that don’t improve with medication. It’s also an option if your uterine fibroids are affecting fertility.
Depending on the fibroid size, location, and number, the procedure can be performed in several ways:
- Open surgery
- Minimally invasive laparoscopic radiofrequency ablation (RFA)
- Robotic-assisted techniques
Important considerations: While this surgery effectively removes fibroids, recovery time varies. Open surgery requires several weeks of healing, while minimally invasive approaches lead to faster recovery. Additionally, larger fibroids or submucosal fibroids embedded deep in the uterine wall may be more challenging to remove completely. Unlike UFE, which treats all fibroids simultaneously, surgical approaches must target each fibroid individually, which can be time-consuming and may miss smaller fibroids.
5. Hysterectomy
A hysterectomy offers a permanent solution for women who are done with childbearing. This surgical treatment removes the uterus entirely, eliminating the possibility of fibroid regrowth. It’s the only fibroid treatment that guarantees fibroids won’t return. That makes it an option for women who have exhausted other treatments without success.
While this surgery effectively removes uterine fibroids, it also ends the ability to carry a pregnancy. Depending on the approach—vaginal, laparoscopic, or open abdominal surgery—recovery can range from a few weeks to several months. Though effective, a hysterectomy is a major surgery with risks of infection, hormonal changes if the ovaries are removed, and a longer healing process compared to minimally invasive procedures.
Why Choose UFE for Fibroid Treatment?
At VIP Fibroid Center, we understand how uterine fibroids can impact your life. You deserve a treatment plan that prioritizes your health and comfort. Our board-certified physicians specialize in advanced, minimally invasive procedures like uterine fibroid embolization to help you find relief without unnecessary surgery.
With a compassionate team, state-of-the-art technology, and a patient-first approach, we’re here to guide you every step of the way. Contact us today to explore your best fibroid treatment options so you can live life without fibroid-related symptoms holding you back.