Uterine fibroids: When to treat them and how to choose the right option

Choosing the right treatment option for uterine fibroids can depend on various factors. Find out more about when to treat them, and how to know what’s the best management strategy for you, here.

What are uterine fibroids?

Uterine fibroids are non-cancerous growths, and grow in or around the uterus. They vary in size and number, often occurring during a woman’s childbearing years. While many fibroids cause no symptoms and go undetected, others can lead to heavy periods, pelvic pain and fertility issues.

When should fibroids be treated?

Treatment is typically considered when fibroids cause:

• Heavy or prolonged periods: Fibroids can lead to excessive menstrual bleeding, which may result in anaemia or fatigue.
• Pelvic pain or pressure: Large fibroids can press on surrounding organs, leading to discomfort, frequent urination or constipation.
• Fertility problems: In some cases, fibroids can interfere with conception or increase the risk of miscarriage.
• Rapid growth: A sudden increase in fibroid size may require closer monitoring or intervention.
• Complications during pregnancy: Some fibroids can complicate pregnancy or childbirth, necessitating treatment before or during pregnancy.

Choosing the right treatment option
 

Several treatment options are available depending on the size, location and symptoms of fibroids. Your gynaecologist will work with you to determine the best approach based on your specific condition and health goals. Common options include:

• Watchful waiting: If fibroids are small and not causing significant symptoms, regular monitoring may be all that's needed.
• Medications: Hormonal therapies, such as gonadotropin-releasing hormone (GnRH) agonists, can temporarily shrink fibroids and manage symptoms like heavy bleeding. Non-hormonal options like tranexamic acid can also help reduce bleeding during periods.
• Minimally invasive procedures: Techniques like uterine artery embolization (UAE), which blocks blood flow to the fibroid, or radiofrequency ablation, which shrinks the fibroid, offer less invasive alternatives to surgery.
• Myomectomy: For women who wish to preserve fertility, myomectomy is a surgical procedure that removes fibroids while leaving the uterus intact. This can be performed through traditional open surgery or minimally invasive methods.
• Hysterectomy: In cases where other treatments have failed, or if a woman no longer wishes to preserve her uterus, a hysterectomy (removal of the uterus) can provide a permanent solution.

How to choose the right option
 

The right treatment depends on factors such as:

• Symptom severity
• Fibroid size and location
• Desire for future fertility
• Overall health and age

Working with your healthcare provider to discuss the risks and benefits of each option ensures that you choose the most suitable treatment based on your individual needs and long-term health goals.