Fibroid tumors are noncancerous growths (tumors) in the uterus. In most cases, treatment is not needed at all. Treatment is only considered if the fibroid is growing rapidly or if you have symptoms such as:

• Abdominal enlargement
• Abdominal pain
• Excessive vaginal bleeding
• Pelvic pressure
• Pain with intercourse

In the past, most women who had fibroids with symptoms required surgery to correct the problem; recent research, however, has led to many new treatments that do not require surgery.

Medication: The following medicines are used to decrease the size of fibroids in preparation for surgery, or to decrease the symptoms caused by fibroids:

• GnRH agonists such as leuprolide (Lupron). These drugs stop the body from making the hormones that cause women to have their periods. As a result, fibroids shrink and symptoms decrease. GnRH agonists only shrink fibroids to 30-50% of their original size, and fibroids will regrow when women stop taking the medicine. For this reason, GnRH agonists are used only to help decrease bleeding as a woman prepares for surgery.
• Birth control pills can also decrease bleeding caused by fibroids. If a woman does not have risk factors that prevent her from taking hormones, this may be a good option for treating the symptoms caused by fibroids.
• NSAIDS are over-the-counter medicines that can decrease the amount of menstrual bleeding, as well as treat minor to moderate pain caused by fibroids.

Surgical Treatments

• Myomectomy: removal of the fibroid or fibroids that are causing symptoms. This can be done through an incision in the abdomen (abdominal myomectomy), or through the vagina without an incision (hysteroscopic myomectomy).
• Hysterectomy: partial or complete removal of the uterus. This can be done through an incision in the abdomen (abdominal hysterectomy), through the vagina (vaginal hysterectomy), or through instruments placed through several small incisions in the abdomen (laparoscopic hysterectomy)
• Endometrial Ablation: This treatment uses electrical energy or heat energy to destroy the lining of the uterus. It reduces the amount of bleeding a woman has with her periods.

Uterine Artery Embolization (UAE): UAE shrinks fibroids by cutting off their blood supply. A catheter is threaded from the groin up into the uterine artery. The blood vessels supplying the fibroids are identified and material is used to block blood flow to the tumor. This procedure is usually done in women who are not planning to get pregnant again.

Katsumori T, Kasahara T. Uterine artery embolization versus hysterectomy in the treatment of symptomatic uterine fibroids (EMMY trial). Am J Obstet Gynecol. 2006;195:1190.

Evans P, Brunsell S. Uterine fibroid tumors: diagnosis and treatment. Am Fam Physician. 2007;75:1452-1453.

Gupta JK, Sinha AS, Lumsten MA, Hickey M. Uterine artery embolization for symptomatic uterine fibroids. Cochrane Database Syst Rev. 2006;25.

Lethaby A, Vollenhoven B. Fibroids (uterine myomatosis, leiomyomas). Clin Evid. 2005;14:2264-2282.