Fibroid Treatment Options: From Medication to Surgery

July is Fibroids Awareness Month, so it is a good time to look at the choices available if fibroids are affecting your life. Fibroids are very common, non-cancerous growths in or around the womb, and many women never know they have them. Not every fibroid needs treating, but when they cause heavy periods, pain or pressure, fibroid treatment can make a big difference.

Do you need fibroid treatment?

If your fibroids are not causing symptoms, you usually do not need any treatment at all. Fibroids often shrink after the menopause, when hormone levels fall. Your gynaecologist may simply suggest keeping an eye on things, with a repeat scan if needed. Our fibroids page explains the symptoms, types and how they are diagnosed.

When symptoms do appear, the right fibroid treatment depends on the size, number and position of your fibroids, your symptoms and your age. Importantly, it also depends on whether you would like to keep your womb or have children in the future. We always talk these factors through together.

Medication for fibroids

Medicines are often the first step in fibroid treatment, particularly for heavy bleeding. Options include:

• Tranexamic acid and anti-inflammatory medicines: taken during your period to reduce bleeding and pain.
• Hormonal treatments: such as the combined pill or a hormonal coil, which can lighten periods when the fibroids do not distort the womb cavity.
• GnRH analogues: injections that shrink fibroids temporarily, often used for a few months before surgery.

Medical fibroid treatment can control symptoms well, but most medicines do not remove fibroids permanently, and symptoms may return when you stop. NICE guidance on heavy menstrual bleeding sets out how these options should be offered.

Procedures that keep your womb

If you would like to keep your womb, there are several procedures to consider. Fibroids that bulge into the womb cavity can often be removed through the cervix during a hysteroscopy, with no cuts on the tummy. Larger fibroids in the womb wall can be removed by an operation called a myomectomy.

A myomectomy can often be carried out by key-hole surgery for fibroids, which means smaller scars and a quicker recovery than open surgery. It is usually the preferred fibroid treatment for women who hope to become pregnant. Uterine artery embolisation, which blocks the blood supply to the fibroids so that they shrink, is another option for some women.

Hysterectomy as fibroid treatment

A hysterectomy, which removes the womb, is the only fibroid treatment that guarantees fibroids will not come back. It may be the right choice if your symptoms are severe, other treatments have not worked and you have completed your family. Many hysterectomies can now be done by keyhole surgery, and you can read more about total laparoscopic hysterectomy on our website.

Choosing the right option for you

Every option has benefits and risks, and what suits one woman may not suit another. At your consultation, we will look at your scan results, talk about what matters most to you and explain the likely outcomes of each approach. The Royal College of Obstetricians and Gynaecologists also has helpful patient information to read before your appointment.

Some women try medication first and move on to a procedure later, while others choose surgery straight away. Your fibroid treatment can change as your circumstances and plans change, and that is perfectly normal. Regular reviews help make sure the approach still suits you.

There is no need to put up with heavy, painful periods or pressure symptoms. If you would like to discuss fibroid treatment with Mr Abu, please contact our team to book a consultation. Together, we can find the approach that fits your life.