Treating your Uterine Fibroids
If you have already been diagnosed with Uterine Fibroids (UF) or you think you have symptoms that could be associated with UF it is now time to talk to your doctor about possible treatment.
Medical treatments
Tablets, patches, rings, implants or even hormonal devices (a small device that is put inside your womb). These are not licensed specifically for UF and do not treat the fibroid directly but can help to reduce heavy bleeding.
Points to consider:
- Once you stop using this, heavy bleeding may return
- You cannot fall pregnant while using this but will be fertile again after use
Who is it for:
- For those whose primary symptom is heavy menstrual bleeding
- For those who want to avoid a medical procedure
- For those who want a treatment option that allows them to maintain fertility
This tablet is approved as a blood-clot regulator, and is not licensed specifically for UF. It does not treat the fibroid directly but can help to reduce heavy bleeding.
Points to consider:
- You can still fall pregnant while taking this medication, therefore must take other contraception, if required
- It is not hormonal and should only be taken short-term when bleeding heavily
- It does not treat the cause of the fibroids but manages bleeding symptoms
Who is it for:
- For those whose primary symptom is heavy menstrual bleeding
- For those who prefer non-hormonal treatment options
- For those who want a treatment option that allows them to maintain fertility
This is an injection, used every 1-3 months, that treats the fibroid directly but can help reduce heavy bleeding. However, it can only be used for up to 6 months to prevent menopause-like symptoms, like hot flushes, and any risk to bone health.
Points to consider:
- Puts you temporarily into a reversible menopausal-like state
- You cannot fall pregnant while using this but will be fertile again after use
- May be recommended as a short-term pre-surgical treatment to shrink fibroids before removal
Who is it for:
- For those planning to undergo surgery and need to shrink their fibroids first
- For those seeking temporary relief from fibroid symptoms without long-term commitment
Tablets recently developed and approved directly for UF that treat the fibroid directly and can help reduce heavy bleeding.
Points to consider:
- Specifically designed to treat uterine fibroid symptoms
- Unlike agonists, which can initially worsen symptoms (flare-ups), there is no such flare-ups with GnRH antagonists
- Effective non-hormonal contraception must be used while on treatment
- Your symptoms may reappear and fibroids start to grow once you stop
Who is it for:
- For those seeking temporary relief from fibroid symptoms
- For those who do not want or cannot take hormones
- For those who can tolerate potential menopausal symptoms during treatment
Tablets recently developed for UF that treat the fibroid directly and can help reduce heavy bleeding. These options are formulated to contain in the one tablet hormones (add-back therapy) along with the antagonist that can help minimise menopause-like side effects and potential bone issues.
Points to consider:
- Add-back therapy helps reduce menopausal-like side effects, such as hot flashes and bone loss, by introducing low doses of estrogen and progestogen
- You cannot fall pregnant while using this when combined in one pill, they provide adequate contraception when used for at least 1 month, but fertility returns, usually quickly, after you stop
- Symptoms may return after stopping treatment, and fibroids could regrow
Who is it for:
- For those who need relief from fibroid symptoms without undergoing surgery
- For those who want to avoid long-term menopausal symptoms, like bone loss and hot flashes
- For those seeking a balance between symptom management and minimizing menopausal side effects
Remember: There may be important differences between options within the same class of treatment, so it’s important to talk to your doctor about these differences
Questions you may want to ask your doctor
How effective is this for UF?
Are there any risks of side effects and how can I best manage this?
Minimally invasive procedures
A procedure that removes a thin layer of the lining of your womb (uterus) using an energy source.
Points to consider:
- This option reduces the amount of menstrual bleeding or stops it entirely
- Requires a local or spinal anaesthetic
- Not suitable if you are considering future pregnancies
- May not treat all fibroid symptoms, as it targets the uterine lining rather than the fibroids themselves
Who is it for:
- For those whose primary issue is heavy menstrual bleeding
- For those not planning to have children in the future
- For those seeking a minimally invasive procedure to reduce symptoms
A procedure that injects small particles (about the size of sand grains) into the blood vessels, that bring blood to the womb (uterus), to cut off blood supply to the fibroids.
Points to consider:
- Can affect pregnancy success after UAE
- The procedure shrinks fibroids but does not remove them
- Repeat procedures may be required
Who is it for:
- For those seeking a non-surgical option to manage fibroids
A procedure that uses focused ultrasound to heat up the fibroids and reduce their size one-by-one.
Points to consider:
- The procedure requires a general anaesthetic
- There are higher risks of complications for future pregnancies
- Minimally invasive, but long-term outcomes regarding fibroid recurrence are still being studied
Who is it for:
- For those seeking a minimally invasive procedure with less recovery time
- For those who do not plan on having future pregnancies
- For those who want to manage fibroid symptoms without surgical removal
Questions you may want to ask your doctor
How effective is this for UF?
How long does the procedure take?
Are there any risks of side effects and how can I best manage this?
Surgery
A surgical procedure that only removes the fibroids and preserves your womb (uterus). There are several different types of myomectomy depending on how it is performed.
- through the vagina (hysteroscopic)
- via small incisions on the abdomen (laparoscopic)
- open surgery (laparotomic)
Points to consider:
- The recovery period is dependent on the type of surgery
- You can preserve your fertility with this surgery
- There is a possibility of new fibroid growth, so future monitoring may be needed
Who is it for:
- For those wanting to preserve fertility and plan for future pregnancies
- For those seeking a surgical option to remove fibroids entirely
This is the surgical removal of your womb and all fibroids along with it.
Points to consider:
- Knowing if you will be able to keep your ovaries and if not accepting the requirement to undergo hormone replacement therapy due to subsequent forced menopausal status
- A long recovery period with restricted activity is necessary
- This is a definitive treatment with no risk of fibroid recurrence but has significant physical and emotional implications, including inability to undergo a future pregnancy.
Who is it for:
- For those who no longer wish to preserve fertility and want a permanent solution
- For those whose fibroids cause severe symptoms that haven’t been managed by other treatments
Questions you may want to ask your doctor
How long does the procedure take and how long will I have to stay in hospital?
Are there any risks to my womb or general health?
How permanent is this procedure?
4 things to remember
- The treatment table here aims to provide a useful overview of all the treatment approaches currently available – but remember your doctor is the best person to talk to about this
- We have included some questions you may want to ask your doctor when discussing the different options so you can select a treatment that’s right for you. Remember there could be important differences between treatments – even those within the same treatment class – so it’s important to know and talk about these with your doctor
- Treating your UF can affect your current and future fertility – so it is important to consider and talk to your doctor about this too
- Any treatment will be associated with risks or side effects and your doctor is the best person to talk to about this
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