Uterine Fibroids: What Treatments Are Available
Uterine fibroids—noncancerous growths in the uterus—are common, but many women may not realize they have them or know that multiple treatment options are available.
“The size of a fibroid can range from a pea to a softball, and they can cause many symptoms, or they can be asymptomatic,” says Farinaz Selfi, MD, a Yale Medicine gynecologic surgeon.
Symptoms can include heavy menstrual bleeding, severe menstrual cramps, urinary frequency, bloating, back pain, infertility, and recurrent miscarriages.
“Women may experience anemia from heavy blood loss and think that this is normal menstrual bleeding, but it is not,” Dr. Selfi says.
Women now have many uterine fibroid treatment options, including hormonal therapy by taking a low-dose birth control pill to manage symptoms. For small fibroids, a hysteroscopy (inserting a hysteroscope into the vagina to remove the fibroids) can be done in a short outpatient procedure.
For larger fibroids, women can have a laparoscopic myomectomy, in which a surgical instrument is inserted through the navel to remove the fibroid. This can also be done with the assistance of a robot. “The beauty of the robotic procedure is that we can then access different parts of the uterus through small incisions,” Dr. Selfi says. “This is also an outpatient procedure, and the patient can go home the same day.”
The above options preserve a woman’s fertility, but for those who have completed their families or aren’t interested in having children, a hysterectomy (removal of the uterus) will definitively alleviate their symptoms, Dr. Selfi says.
Women can also choose to have uterine artery embolization, which is noninvasive and offers a faster recovery than surgery, says Hamid Mojibian, MD, a Yale Medicine interventional radiologist.
“We enter the artery through the groin or from the wrist, and Yale is one of the few places that can do this,” Dr. Mojibian says. In this procedure, small particles are injected into the bloodstream around the fibroid, causing it to shrink. Yale also offers a new uterine fibroid treatment method called laparoscopic radiofrequency ablation, in which heat is used to significantly shrink the fibroid.
“At Yale, our interventional radiologists, gynecologists, and primary care physicians all work together to help make the best treatment plan for our patients,” Dr. Mojibian says.
