Since most fibroids stop growing or may even shrink as you approach menopause, your healthcare provider may simply suggest "watchful waiting." With this approach, your healthcare provider monitors your symptoms carefully to make sure that there are no significant changes and that the fibroids are not growing.
If your fibroids are large or cause significant symptoms, treatment may be necessary. Treatment will be discussed with you by your healthcare provider based on:
- How old you are
- Your overall health and past health
- How sick you are
- How well you can handle specific medicines, procedures, or therapies
- How long your condition is expected to last
- Your opinion or preference
- Your desire for pregnancy
In general, treatment for fibroids may include:
- Hysterectomy. This is the surgical removal of the entire uterus. Fibroids remain the number one reason for hysterectomies in the U.S.
- Conservative surgical therapy. Conservative surgical therapy uses a procedure called a myomectomy. With this approach, fibroids are removed, but the uterus stays intact. This may allow a future pregnancy.
- Gonadotropin-releasing hormone agonists (GnRH agonists). This approach lowers your estrogen level. This triggers a "medical menopause." Sometimes GnRH agonists are used to shrink the fibroid, making surgery easier.
- Anti-hormonal medicines. Certain medicines oppose estrogen (such as progestin and Danazol), and seem to work to treat fibroids. Anti-progestins, which block the action of progesterone, are also sometimes used.
- Uterine artery embolization. Also called uterine fibroid embolization, uterine artery embolization (UAE) is a newer technique. The arteries supplying blood to the fibroids are identified, then embolized (blocked off). The embolization cuts off the blood supply to the fibroids, thus shrinking them. Healthcare providers continue to look at the long-term implications of this procedure on fertility and regrowth of the fibroid tissue.
- Anti-inflammatory painkillers. This type of medicine is often effective for women who have occasional pelvic pain or discomfort.
In some cases, the heavy or prolonged periods, or the abnormal bleeding between periods, can lead to iron-deficiency anemia. This also requires treatment.