No treatment for fibroids is best for all women who have this problem. Every woman should discuss the treatment options with her doctor. The treatment that is best for any individual woman will depend on a variety of factors.
Are the fibroids causing problems? Fibroids that are not causing problems may need no treatment at all. A woman should be checked by her doctor every few months to see if the fibroids are growing. If the fibroids begin to cause problems, it's time to consider treatment options.
What problems are the fibroids causing? The best treatment choice may be different if fibroids are causing severe pain than if a woman's major problem is heavy bleeding. Treatment that shrinks fibroids (embolization, treatment with a GnRH agonist drug) often relieves pain. Heavy bleeding may be treated by combination therapy with a GnRH agonist and a low-dose hormone.
Do you want to have more children? Fibroids in the uterus usually do not prevent a woman from becoming pregnant. However, a woman cannot become pregnant or carry a baby after having a hysterectomy (removal of the uterus). A myomectomy preserves the uterus but may make it more difficult to become pregnant.
Do you want to avoid having major surgery? A hysterectomy is major surgery, requiring two to five days in the hospital and about six weeks to recover fully. Some women-and some doctors-feel that a hysterectomy is undesirable for a problem such as fibroids that is not life-threatening. However, a myomectomy is also major surgery, requiring about the same length of time in the hospital and about the same recovery time as a hysterectomy.
Women who want to avoid major surgery may wish to consult a doctor who has experience in one or more of the new procedures that in some cases offer alternatives to hysterectomy or myomectomy.
Are you close to menopause? Fibroids shrink naturally after menopause when estrogen levels in the body decline. If a woman who is close to menopause has pain caused by fibroids, a doctor may prescribe GnRH agonists. Treatment with these drugs for a few months will shrink her fibroids, which should relieve her pain until the fibroids begin to shrink naturally after menopause.