“Won’t My Fibroids Go Away On Their Own?” Weighing the Wait-And-See Option

If you’ve done any Internet research on fibroids at all, you’ve probably encountered some mention of a woman’s fibroids disappearing on their own after menopause. It’s most likely a true story. Indeed, as the body’s natural production of estrogen declines in menopause, the estrogen-fueled fibroid tumors, also called leiomyomas, will follow suit—at least, in theory.

There are a number of reasons why a woman would continue to see the persistence or even growth of her fibroids after menopause: the reintroduction of estrogen with hormone replacement therapy or malignant changes in the tumor (cancer known as leiomyosarcoma) are two possible explanations for the continuation of symptoms. Hormone replacement, in particular, is commonly necessitated when a woman’s menopausal symptoms impact her quality of life, but the need isn’t foreseeable in pre-menopausal years. In such cases, fibroids that may have otherwise gone away naturally could continue to present problematic symptoms far later in life than anticipated.

Still, the natural disappearance of fibroids is a viable possibility. For many women, this raises the question, if fibroids will potentially shrink or even disappear on their own after menopause, should a pre-menopausal woman take steps to have them treated, or should she simply wait and see? The urgency for treatment typically depends on the severity of symptoms, according to Dr. Donald Galen, OB-GYN and former Surgical Director at the Reproductive Science Center of the San Francisco Bay Area.

The degree to which women experience common fibroid symptoms like heavy menstrual bleeding, pelvic pain and pressure, and urinary frequency varies substantially. For many women, fibroid symptoms are more than inconvenient: they can interfere with all aspects of her life and relationships. When symptoms are debilitating, a woman may want to consider treating her fibroids sooner, rather than later. With many available treatment options, including minimally invasive options like Acessa Procedure, treating any existing fibroids will improve her quality of life.

Women whose symptoms are less severe, on the other hand, may choose to delay treatment. “If symptoms are minimal,” Dr. Galen explains, “it is reasonable to follow these patients and as they progress in menopause…their fibroids and symptoms should progressively diminish and thus no other treatment may be needed.” Stressing the importance of the patient’s participation in the decision-making progress, he adds, “this decision is made by the woman, with counseling from her physician as to all available risks, treatments, alternatives, etc.”


  1. Burbank, Fred. Fibroids, Menstruation, Childbirth and Evolution: The Fascinating Story of Uterine Blood Vessels. Tucson, AZ: Wheatmark, 2009. 135. Print.
  2. American Society for Reproductive Medicine, “What Are Fibroids”, Resources, ReproductiveFacts.org: 2011. Retrieved April 6 2015, from http://www.reproductivefacts.org/FACTSHEET_What_are_Fibroids/


What are common methods of fibroid removal?

Fibroids are tumors or lumps of smooth tissue that grow outside or within the uterine wall of women. Most fibroids are non-cancerous, but they can cause bloating, pelvic pain, difficulty urinating and constipation. Some women may also experience heavy bleeding due to uterine fibroids and run the risk of becoming anemic. Nearly 20 to 80 percent of women develop uterine fibroids by the age of 50. Women experiencing moderate to severe symptoms may wish to have the uterine fibroids removed and have the option to undergo any of the following procedures for fibroid removal, depending upon their preferences and the severity of their condition:

Endometrial Ablation—Pros and Cons

Endometrial ablation is a procedure to remove the lining of the uterine wall, and thereby reduce or eliminate menstrual bleeding. It is not specifically designed or approved to treat fibroids but some endometrial ablation devices are approved to be used in the presence of fibroids. To perform endometrial ablation, the surgeon inserts a heated balloon or a tool into the uterus to either heat or freeze the lining. This procedure is minimally invasive, which is a benefit, but it is only recommended for women who have completed childbearing.

Myomectomy—Pros and Cons

Myomectomy is a procedure that removes only the fibroids from the uterus. Myomectomy can be performed by any one of the following three ways: hysteroscopy, laparotomy or laparoscopy. Nearly 80 to 90 percent of women experience relief from symptoms of uterine fibroids after this procedure. However, sometimes this procedure involves making an incision in the uterine wall to remove the larger fibroids. Smaller fibroids may not be removed if it involves another incision in the uterus and increases risk. If small fibroids are not removed, they may grow, become problematic, and patients may be , subjected to another procedure in the future.

Hysterectomy–Pros and Cons

Hysterectomy is a surgical procedure that is recommended for women who are either struggling with very large fibroids or have a multitude of fibroids (too many to treat or remove individually). A hysterectomy involves the complete or partial removal of the uterus and is the only way to prevent the reoccurrence of uterine fibroids. It is also recommended at times for women experiencing heavy bleeding due to uterine fibroids, as this might be the only way the doctors can stop the dangerous bleeding. While this procedure does prevent uterine fibroid regrowth, it is also highly invasive and requires recovery time, with the post-operative recuperation varying between one to two months in some cases.

The Acessa System – Pros and Cons

The Acessa Procedure is a minimally-invasive technique that treats uterine fibroids. The Acessa System has been cleared by the FDA with this specific indication for treating uterine fibroids. Radiofrequency ablation is performed during the Acessa procedure where a small array of needles points directly apply energy to each uterine fibroid. As a result, the fibroids are treated and the surrounding uterine tissue remains healthy and intact. This procedure makes use of laparoscopic ultrasound probe technology to detect fibroids as small as 2mm in diameter. The Acessa Procedure is minimally invasive and patients can go home the same day. Some patients experience minor abdominal discomfort requiring non-steroidal anti-inflammatory medication after the procedure, patients can generally return to work within 3-5 days. There are many risks involved in laparoscopic procedures to learn more you should consult an Access-trained gynecologist.


  1. http://www.nichd.nih.gov/health/topics/uterine/conditioninfo/treatments/pages/surgical-treatments.aspx
  2. http://womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html?from=AtoZ


Is a hysterectomy the only way to treat fibroids?

Depending on their size and number, uterine fibroids can cause symptoms that range from bothersome to severe. These benign tumors, which can grow in your uterine wall, inside your uterus or on the external portion of your uterus, are relatively common in menstruating women and may require treatment in the event that heavy bleeding, cramps, frequent urination or swelling occur due to their presence. If you have this condition and are considering fibroid surgery, you may be under the impression that a hysterectomy is the only solution to your problem. The good news is that these uterine tumors can be treated in other ways that are less surgically invasive.

Hysterectomy Risks and Benefits

One reason why your doctor may recommend a hysterectomy is that this type of surgery for fibroids provides a permanent cure for the condition. Because the uterus is removed during a hysterectomy procedure, uterine fibroids do not have a place in which to grow back, and any symptoms caused directly by the fibroids should cease. However, due to the nature of this surgical procedure, a hysterectomy is generally not the first course of action unless uterine fibroids are causing major health issues. Some of the complications associated with a hysterectomy include a prolonged recovery period – typically 4 to 8 weeks – if the ovaries are removed during hysterectomy, hormone fluctuations brought about by early menopause, pelvic discomfort and bladder problems.

Uterine Fibroid Embolization

The procedure known as uterine fibroid embolization is another treatment method that your doctor may offer. This option is technically not a fibroid surgery as it is performed via catheter by a radiologist. The purpose of a uterine fibroid embolization is to cut off the blood supply to the tumors so that they will shrink significantly or disappear. The catheter used in this process is fed from your thigh into your uterine artery, upon which time an injected solution blocks the fibroids’ blood source. Embolization is a non-invasive uterine fibroid treatment that provides many women with symptom relief and does not involve a difficult recovery. Potential complications include the onset of premature menopause, infection and the need for subsequent procedures in the event that fibroids return.

Myomectomy Procedures

A myomectomy is a surgery for fibroids that involves removal of the tumors themselves while leaving the uterus in place. You may consider this option if you are hesitant to experience the menopausal symptoms that arise due to a hysterectomy but are suffering from pain due to fibroids. Myomectomies can be performed in several ways, either abdominally, laparoscopically (“keyhole surgery”) or hysteroscopically (through the vagina). Less invasive types, such as hysteroscopic myomectomies, may be outpatient, while other types require a brief hospital stay. The most common risks associated with this procedure for treating uterine fibroids include blood loss, formation of scar tissue and the need for a hysterectomy down the line.

The Acessa Procedure

The Acessa procedure is a new treatment option for uterine fibroids that has great promise due to its innovative technology, non-invasive nature and high success rate. The FDA-cleared Acessa Procedure is comprised of a handpiece with electrodes on the tip and a generator. Both of these are involved in the utilization of radiofrequency energy that shrinks or destroys each fibroid one at a time. During the procedure, a laparoscopic ultrasound probe is used to locate all of the fibroids. Though the procedure does require general anesthesia and two small laparoscopic incisions, Acessa is outpatient and involves little downtime. Acessa targets each fibroid directly so that surrounding uterine tissue stays healthy and functional. There are many risks involved in laparoscopic procedures, such as post-operative infection; to learn more you should consult an Access-trained gynecologist.


  1. http://www.webmd.com/women/uterine-fibroids/uterine-fibroids-topic-overview
  2. http://www.webmd.com/women/uterine-fibroids/uterine-fibroids-treatment-overview


Are large fibroids treated differently than small fibroids?

Uterine fibroids can develop in about 80 percent of women throughout the course of their lifetime. These fibroids often grow spontaneously without warning, and for some women the fibroids cause life-affecting symptoms that require medical treatment. When diagnosed with any medical condition, it is important to understand your treatment options fully in order to help you make informed choices about your health. If you have been diagnosed with fibroids, there are several treatment options available that can relieve symptoms and restore you to full health.

What are These Growths?
Uterine Fibroids are typically non-cancerous growths or tumors that are located in the walls of the uterus. These fibroids can cause both painful and discomforting symptoms. Symptoms such as pelvic pain and prolonged vaginal bleeding often lead women to seek treatment for the fibroid removal.

Treatment for Fibroids
There are a range of options available for the treatment of fibroids. Small fibroids (smaller than a dime) are typically not a major health concern nor do they tend to cause symptoms that are severe enough to seek treatment. As a result of the benign nature of these small fibroids, they are often not treated but rather simply monitored by a physician for continued growth. For larger fibroids that are causing pain, heavy bleeding or are pushing against other internal organs, there are medications and surgical options available that may shrink or eliminate the fibroids and their resulting unpleasant symptoms.

Medications available for fibroids are designed to shrink their growth temporarily and are not always considered a long-term or permanent treatment. The advantage of medication is that it is the least invasive approach and can alleviate many uterine fibroid symptoms; the disadvantages include some unpleasant side effects and, oftentimes, the fibroid tumors will grow back once the medications are discontinued. As a result, medications are generally considered a short-term solution to relieve fibroid symptoms temporarily while the patient waits for uterine fibroid removal.

Removing uterine fibroids can be done in a variety of ways depending upon the size, number, and location of the tumors. Some fibroids require invasive surgery to completely extract the tumors from the womb. The advantages of fibroid removal surgery (myomectomy) are complete extraction and relief from the unpleasant and uncomfortable symptoms of fibroid tumors. However, not all fibroids can be removed in this manner and in some cases, the entire uterus may be removed (hysterectomy). If a patient undergoes fibroid removal surgery, she will require a two to six week recovery period after the procedure.

In some cases, a woman can opt for a less invasive uterine fibroid treatment. The Acessa procedure is one such option. The Acessa System uses equipment that has received FDA clearance to treat uterine fibroid tumors. This method of fibroid treatment is designed to destroy the fibroids without damaging surrounding tissue. The advantages of the Acessa procedure are that it is less invasive than conventional fibroid surgery and is a same-day outpatient procedure with a shorter (3-5 days) recovery time.

Although very common in most women, fibroid tumors can affect one’s health and cause painful symptoms that interact negatively with one’s quality of life. The good news is that fibroid tumors are easily treated with numerous effective options. As such, these tumors do not have to remain a nuisance to a woman’s overall health and feelings of well-being.


  1. http://www.webmd.com/women/uterine-fibroids/uterine-fibroids-topic-overview
  2. http://www.webmd.com/women/uterine-fibroids/uterine-fibroids-treatment-overview

How Fibroids Leave Their Mark: Fibroid Removal and Scarring Risk

For women who struggle with symptoms of uterine fibroids—pelvic pain, heavy menstrual bleeding, painful periods, and/or frequent urination— a variety of surgical treatments offer potential relief. Of course, virtually any kind of surgery carries some risk for post-operative complications. Scarring is one issue of significant concern to many women who are looking at fibroid removal procedures. And unsightly visible scars aren’t the only scars to warrant concern: internal scars, called adhesions, present their own set of symptoms, which – in extreme cases – can be more problematic than those that motivated the surgery in the first place.

They may not be a painful consequence, but abdominal scars can be unsightly. However, for women facing a fibroid removal surgery who are haunted by visions of a friend’s post-C-section tummy, there’s some good news: long-term, visible scarring is rare with most fibroid removal procedures. Dr. Donald Galen, MD and former Surgical Director at the Reproductive Science Center of the San Francisco Bay Area, explains, “severe scarring from elective surgery is very uncommon.”

In part, the infrequency of major scarring is due to the size of incisions that most methods entail. The external incisions required for laparoscopic surgeries are typically small, ranging from 5-12mm (i.e. less than 1/2 inch) in length. Hysterectomies may require longer abdominal incisions, since they, by definition, involve complete or partial removal of the uterus. Still, the approximate length of incisions varies by method. Some hysterectomies can be performed using minimally-invasive surgical techniques. “The benefits of minimally-invasive surgery for hysterectomy are that only two to three 0.5-1 inch incisions are necessary, [which enables] rapid healing and minimal visible scarring,” says Dr. Galen.

What can patients do to inhibit the formation of abdominal scarring after surgery? Not much, unfortunately. According to Dr. Galen, “Many methods, such as topical steroids, massage, [and] Mederma, have been…used to try and minimize external scarring. These [topical treatments] may help minimize scar formation, however, the more important ingredients seem to be the patient’s own genetic makeup and race, as well as the type and size of sutures used for closure.”

Internal scars, called adhesions, are another potential consequence of fibroid removal surgeries, and ones that can pose a risk to the patient’s health. Abdominal adhesions can result in pelvic pain, cramping, bowel obstructions, and even infertility.1

Adhesions form when the body’s attempt to heal internal incisions goes awry. During the healing process, a layer of new scar tissue forms over damaged tissue. If this new tissue attaches to other organs or locations within the abdomen, it is called an “adhesion”.
Logic dictates that, the greater the number of incisions, the higher the risk for developing adhesions after surgery. For this reason, different fibroid removal procedures present different levels of risk in terms of adhesion formation. A laparoscopic myomectomy, for example, requires a surgeon must make one or more incisions in the uterus; the incisions create the circumstances for adhesions to form.2 Dr. Galen describes the typical case, saying, “when myomectomy is performed… there are usually considerable post-op adhesions that form from the incisional sites on the exterior of the uterus to other abdominal structures such as bowel, anterior abdominal wall, and bladder.”

Less invasive options for fibroid removal, like the Acessa procedure (radiofrequency volumetric thermal ablation or “RFVTA”), present little risk of adhesions: the Acessa procedure utilizes heat from a probe to destroy fibroids, thereby avoiding the need for uterine incisions and the potential for subsequent internal scarring.
Women diagnosed with uterine fibroids should consult with a physician to determine the best course of treatment. While minimal scarring and adhesion risk is obviously preferential, different surgical fibroid treatments are appropriate in different cases. The number, location, and size of fibroids, along with other factors, will ultimately determine which method(s) of treatment is medically advised.


  1. “Abdominal Adhesions”, MedicineNet.com, http://www.medicinenet.com/script/main/art.asp?articlekey=143560. Retrieved September 23, 2014.
  2. Macer, James A. For uterine-sparing fibroid treatment, consider laparoscopic ultrasound-guided radiofrequency ablation. OBG Management, Nov. 2013:Vol.25(11).
  3. Endoscopic Surgery for Gynaecologists, page 31, edited by Chris Sutton and Michael Diamond, Published by W.B. Saunders Co. Ltd, Philadelphia, PA, 1993

Is fibroid treatment elective?

Hearing a diagnosis of fibroids might feel overwhelming, but it doesn’t have to be. Fibroids are far more common than you might think, and there are exciting new treatment options available for women who suffer from the effects of uterine fibroids.

What are Fibroids?

Fibroids are firm, generally benign, tumors that grow inside of, and on the surface of, the uterus. Also known as uterine fibromas, leiomyomas or myomas, these compact masses are made of fibrous connective tissue and smooth muscle cells. Approximately 70%-80% of women will develop fibroid tumors during her reproductive years, but the impact this will have on her overall health varies from woman to woman.

The exact cause of fibroids is not known, though current theory is that they develop due to a combination of an aberrant muscle cells and the presence of estrogen; the two join together to produce a tumor. Most fibroids, up to 99 percent of all detected fibroids, are not cancerous and will never become cancerous. But they can still cause health problems if they are not treated.

Fibroids range in size from that of a pea to tumors large enough to be felt by the patient and her physician; about the size of a soft ball or grapefruit. In the case of tumors large enough to be a source of pain or other symptoms, fibroid treatment is the best option for remedying the uncomfortable situation. Where the fibroids are tiny enough not to cause health problems, they are unlikely even to be detected and treatment may be unnecessary.

What Happens if Larger Fibroids are Left Untreated?

Uterine fibroids that grow large enough to be detected can cause a wide range of troublesome symptoms, including lower back pain, abnormally heavy or long periods, bleeding between periods, pain or frequent urination due to the tumor pressing on pelvic organs or the bladder, or pain during sexual intercourse. If left untreated, the increased blood loss due to heavy periods and between-period bleeding can lead to anemia, which can have serious consequences. In those cases, it is wise to consult your physician as to the best fibroid treatment for you.

Fibroid Treatment Options

There are several options for treatment. The mildest and least invasive is simple painkillers, which are commonly used in cases where the tumors are tiny and causing few complications. The most radical and invasive fibroid treatment is a hysterectomy, which is major abdominal surgery to remove the uterus carrying with it all the risks that entails. Hormone therapies are also available, such as estrogen reduction and anti-progestin therapies, though these tend to come with unpleasant side effects.

One fibroid therapy, called radiofrequency ablation, uses an FDA-cleared small array needle device to target and shrink fibroids without damaging the surrounding tissue. This is an outpatient procedure with a four- to five-day recovery time and minimally invasive. Many patients achieve successful results with radiofrequency ablation and are back to living their normal daily lives without the discomfort of uterine fibroids.


  1. http://acessaprocedure.com/acessa-procedure.php
  2. http://umm.edu/health/medical/ency/articles/uterine-fibroids
  3. http://www.uchospitals.edu/online-library/content=P00560

Gone for Good? The Real Risk of Recurrence Following Fibroid Removal

Once removed or destroyed, a fibroid does not grow back, though new fibroids may develop. A study by Hanafi provides deeper insight into the role the number fibroids plays in determining the likelihood of their future appearance. Results showed an 11 percent rate of recurrence in patients who had only one fibroid removed and a significantly larger instance of recurrence —74 percent— in patients who had multiple fibroids removed through myomectomy.3

Another treatment option is radiofrequency ablation (RFVTA), which utilizes the Acessa System. The Acessa procedure uses ultrasound for identification of all fibroids throughout the surgery, along with heat from a small probe to shrink the individual fibroids, leading to their reabsorption. The procedure does not require uterine incisions, so recovery time is minimal. A multi-center study on the Acessa method revealed that —in the three years following the procedure—11% percent of patients required surgical re-intervention for fibroid-related symptoms.4

A third surgical method for the removal of fibroids is Uterine Fibroid Embolization (UFE), also known as Uterine Artery Embolization (UAE). Performed by an interventional radiologist, the procedure works by blocking blood flow to the individual fibroids, causing them to die. UFE has proven generally successful in improving patients’ quality of life, and recovery time for the procedure is typically short, though patients often experience significant post-operative pain and require short-term hospitalization. The reintervention rate with UFE is particularly high: studies have demonstrated that nearly 37% of patients required surgical re-intervention within three years of receiving UFE.5

Hysterectomy, or removal of the uterus, is the most common surgical procedure to treat uterine fibroids. It is the only fully curative method, (because without the uterus, fibroids cannot occur), but it is highly invasive, involves a longer recovery period, and carries the risk of serious side effects.6 Moreover, removing of the uterus initiates early menopause, so it is an unfavorable option for women who wish to preserve their uterus.

Patients who have been diagnosed with uterine fibroids or are experiencing symptoms associated with fibroids should consult with a medical professional in order to determine the best course of treatment.


  1. http://health.usnews.com/health-conditions/sexual-health/fibroids/treatment
  2. Yoo, E. et al. Predictors of leiomyoma recurrence after laparoscopic myomectomy, Journal of Minim. Invasive Gynecology. Nov-Dec 2007; 14(6): 690-7
  3. Hanafi, M. Predictors of leiomyoma recurrence after myomectomy, Obstetrics and Gynecology. April 2005; 105(4): 877-81
  4. http://www.fda.gov/downloads/AdvisoryCommittees/CommitteesMeetingMaterials/MedicalDevices/MedicalDevicesAdvisoryCommittee/ObstetricsandGynecologyDevices/UCM404148.pdf
  5. Mara, M. “Uterine fibroid embolization versus myomectomy in women wishing to preserve fertility: preliminary results of a randomized controlled trial,” European Journal of Obstetrics & Gynecology and Reproductive Biology, June 1, 2006 i9i
  6. Cardozo, E.R. et al. “The estimated annual cost of uterine leiomyomata in the United States,” American Journal of Obstetrics & Gynecology, December 12, 2011.

Treating Fibroids without Invasive Surgery


The Acessa Procedure is a minimally invasive, laparoscopic procedure to treat fibroids that involves general anesthesia, typically allowing a woman to go home the same day. This is appealing to many women who desire a quick recovery time and a less invasive approach to removing or controlling fibroids in the uterus. The Acessa System consists of a generator that allows the doctor to easily monitor bleeding and temperature during the procedure, and a hand piece and electrode that effectively shrink the fibroids.

The Acesa Procedure is ideal for treating fibroids because it is designed to eliminate fibroids of any size. The hand piece is used as a guide for finding and isolating the fibroids. The electrode is deployed as necessary to shrink each fibroid individually. This is done using MRI technology that seeks out the fibroids. It’s generally very successful at targeting the masses that need attention.


There are many reasons why a woman would choose to undergo the Acessa Procedure to treat her fibroids. The procedure offers a quick recovery time when compared to traditional surgical methods. The tools used treat only the fibroids, without endangering any surrounding tissue or internal organs. The Acessa Procedure results in a low recurrence of fibroids, which is good news for women who have undergone several treatments for them in the past. Finally, the Acessa Procedure has a high rate of satisfaction among women who have undergone the procedure.

Of course, the Acessa Procedure might not be right for every woman. In addition, because the procedure is fairly new, it may take more time to get preauthorization of the procedure from your insurance carrier. The best thing to do is for women interested in the Acessa Procedure to speak to their gynecologist about the appropriateness of the method for their specific case of fibroids.

Left untreated, fibroids can result in anemia due to blood loss and other challeges. Fibroids that can interfere with daily life should be treated appropriately.


  1. http://www.mayoclinic.org/diseases-conditions/uterine-fibroids/basics/complications/con-20037901
  2. http://health.usnews.com/health-conditions/sexual-health/fibroids/treatment

Clinical Pros and Cons with a Hysterectomy


One of the main pros of having a hysterectomy is relief from cancer. For a woman with cancer in her reproductive system, removing the affected organs can stop cancer symptoms and give a woman peace of mind again. In some cases, a hysterectomy can be lifesaving.

A hysterectomy is also beneficial for women who experience heavy bleeding during menstruation or due to fibroids. While the procedure is generally considered a last resort, it can stop the symptoms if other methods prove unsuccessful.


There are many factors to consider before choosing to undergo a hysterectomy. Because it is major surgery, there is a long recovery period, of at least six weeks in many cases. Infection is another side effect of surgery to think about. Because women who have a hysterectomy have their uterus removed, they are unable to become pregnant, and some may face emotional issues associated with this loss. Some women may have symptoms related to changes in hormonal balance and hormone therapy must be used to counteract the loss of reproductive organs.

A 2009 study published in the journal, Obstetrics and Gynecology reports that women who have their ovaries removed face a higher incidence of developing other health problems that lead to death, including heart disease and lung cancer. The study also indicates that removal of the ovaries doesn’t have much impact on survival, so it may become an unnecessary procedure in most instances. That doesn’t mean that a hysterectomy isn’t the right choice, but simply that preserving the ovaries is the best option for most women.

It’s best to discuss the pros and cons of a hysterectomy with a doctor extensively and consider the procedure for some time rather than making an impulsive decision to have it done. That way, a woman can be absolutely sure the choice is the right one for her.


  1. http://www.hystersisters.com/vb2/view_trials.htm
  2. http://www.medicalnewstoday.com/releases/146710.php
  3. http://www.womenshealth.gov/publications/our-publications/fact-sheet/hysterectomy.html#g
  4. http://www.healthstatus.com/health_blog/wellness/the-pros-and-cons-of-hysterectomy/2/

When is Treatment for Fibroids Necessary?

Symptoms Requiring Fibroid Treatment

When heavy bleeding, clotting, and extended menstruation happens as a result of fibroids, it can leave patients homebound for days. Anemia is often a consequence and can result in tiredness, syncope, and headaches. When menstrual symptoms caused by fibroids reduce your quality of life, even for a few days a month, it is worthwhile to begin assessing treatment options. In the past, hysterectomy was the most common fibroid treatment but, with today’s advanced procedures, patients can keep their uterus after undergoing same-day surgery. Contraceptive pills and GnRH antagonists are other options that are used temporarily when surgery is not yet needed.

When Fibroids Interrupt Quality of Life

Some patients, particularly those with large growths, experience a feeling of pelvic pressure that makes certain exercises, movements and positions too uncomfortable to tolerate. This symptom is more common than localized pain, which happens when a fibroid’s cells begin to die, causing calcium build-up.

Frequent urination is among the most frequently experienced problems for those with fibroids and is caused by the pressure of the growths on the bladder. It can interrupt sleep, leaving patients feeling tired during the day. When fourth stage sleep is interrupted, the body does not heal itself, which may cause muscle pain and a general feeling of malaise. When there is pressure on the bladder, it can lead to frequent urinary tract infections. When fibroids put pressure on the rectum or vagina, they can cause discomfort, constipation, and painful intercourse.

Muscle pain, usually in the lower back, can be caused when larger growths put pressure on nerves and muscles. Since pain can be neurological or muscular, a range of different types of pain may be experienced, from cramping to shooting nerve pain that radiates to other areas. Back pain occurs in 80% of people at some point in their lives, so it should be investigated before assuming that it is a direct result of fibroids.

An enlarged abdomen and uterus sometimes occurs when the body makes room for fibroid growth. This is easily mistaken for menstrual bloating, but in some patients, the expansion is large enough to mimic a pregnancy. This symptom can also be caused by adenomyosis, where ectopic glandular tissue grows in the endometrial tissue. To rule this out, a physical exam and ultrasound will need to be done. Unlike fibroids, ultrasounds and MRIs are adequate diagnostic tests for adenomyosis.

Only one fifth of fibroid patients experience symptoms requiring treatment, and those experiencing physical effects usually have a number of symptom-free years before experiencing problems. Menopause often comes with fewer fibroid symptoms or removes them entirely. Previous treatments carried risk as well as extensive hormonal changes and were thus put off by sufferers wishing to avoid long recoveries or delay menopausal symptoms. Today, ablation techniques and laparoscopic procedures leave hormonal balance intact and are accompanied by short recovery periods, allowing all who are suffering symptoms to receive treatment.


  1. http://www.womenshealth.gov/publications/our-publications/fact-sheet/uterine-fibroids.html
  2. http://www.aafp.org/afp/2000/0615/p3611.html
  3. http://www.babycentre.co.uk/a7187/what-you-need-to-know-uterine-fibroids
  4. http://www.ucsfhealth.org/conditions/fibroids/signs_and_symptoms.html
  5. http://women.webmd.com/uterine-fibroids/uterine-fibroids-treatment-overview