Uterine fibroids develop in or around the uterus, often during a woman’s reproductive years. Many women who are diagnosed with these benign growths worry about whether surgery is necessary. The good news is that several non-surgical treatment options exist, allowing women to manage their symptoms while avoiding the risks associated with surgery.
Here are three to consider.
Medical Management & Drug Therapy
How It Works
Medical therapy focuses on relieving the symptoms of fibroids rather than removing them. Your doctors may prescribe hormonal medications to regulate your menstrual cycle, reduce heavy bleeding and shrink your fibroids.
Commonly used medications include gonadotropin-releasing hormone (GnRH) agonists, oral contraceptives, and progesterone-releasing intrauterine devices (IUDs). Non-hormonal medications like tranexamic acid may also be used to manage heavy menstrual bleeding.
What to Expect
Most women begin to notice symptom relief within weeks to a few months of starting treatment. For example, GnRH agonists can quickly shrink fibroids and reduce bleeding, but they are typically used short-term due to their side effects.
Birth control pills and IUDs may take longer to show full benefits but are ideal for long-term use.
Benefits
Medical therapy is non-invasive, often well-tolerated, and may serve as a temporary or long-term solution. It is especially suitable for women approaching menopause, when fibroids usually shrink naturally.
Drug therapy can also be a valuable interim solution for women who wish to delay surgery or childbearing.
Risks & Side Effects
While generally safe, drug therapies can have side effects. GnRH agonists may cause symptoms similar to menopause, including hot flashes, vaginal dryness, and bone density loss if used long-term.
Hormonal therapies may also increase the risk of blood clots or lead to mood changes. Please attend regular follow-ups with your doctor to monitor your response and change your treatment as needed.
Uterine Artery Embolisation (UAE)
How It Works
Uterine artery embolisation (UAE) is a minimally invasive radiologic procedure that blocks the blood supply to the fibroids, causing them to shrink and die. A tiny catheter is pushed into a blood vessel in the groin or wrist, and small particles are injected to block the uterine arteries feeding the fibroids.
What to Expect
The procedure spans about 1 to 2 hours and is performed under local anaesthesia with sedation. Most women go home the same day or after an overnight stay.
Recovery time is generally short, with most women returning to normal activities within a week. However, cramping and mild to moderate pain are common in the first few days post-procedure.
Benefits
UAE is effective at reducing fibroid size and symptoms, particularly heavy bleeding and pressure. You can avoid the risks of general anaesthesia and open surgery and preserve your uterus.
For those who are not ideal surgical candidates, UAE offers a safe and effective alternative.
Risks & Side Effects
While generally safe, UAE carries some risks. Post-embolisation syndrome, which is a collection of flu-like symptoms, including fever and fatigue, is fairly common in the first week. There’s also a small risk of infection and unintended damage to nearby tissues, or premature ovarian failure, especially in women nearing menopause. However, these can be managed through regular consultations with your doctor.
MRI-Guided Focused Ultrasound
How It Works
MRI-guided focused ultrasound is a non-invasive treatment that uses high-intensity sound waves to heat and destroy fibroid tissue. MRI imaging guides the focused ultrasound beams to the precise location of the fibroids, allowing targeted destruction without harming surrounding tissues.
What to Expect
This is done on an outpatient basis, usually lasting 2–4 hours. No incisions are required. You lie on an MRI table while the machine targets the fibroids with ultrasound energy. Most women can return to normal activities within one to two days, making this one of the quickest recovery options available.
Benefits
This procedure is completely non-invasive and does not require anaesthesia or hospitalisation. This treatment preserves the uterus and may be a good option for women who are not ready for surgery and who wish to maintain their fertility.
Risks & Side Effects
Some women may experience temporary skin burns, nerve irritation, or minor abdominal discomfort.
Choosing the Right Treatment
The most appropriate treatment depends on the intensity of your symptoms, your age, whether you wish to become pregnant in the future, and your personal preferences. Non-surgical methods work well for many women, especially those with mild to moderate symptoms or those who want to avoid surgery.
You should talk to your gynaecologist to weigh the benefits and risks of each approach.
When Is Surgery More Suitable?
Surgery may be more appropriate if fibroids are large, rapidly growing, or causing significant pressure on the bladder or bowel. It may be ideal if you have tried non-invasive options but not found relief and if your fibroids are affecting your fertility and pregnancy.
Surgical options include myomectomy, a procedure to remove fibroids while preserving the uterus, and hysterectomy, which involves permanent removal of the uterus.
When to Seek Medical Intervention
In assessing your health, you should consult a doctor if you experience any of the following:
- Heavy or chronic menstrual bleeding that affects daily activities
- Severe or persistent pelvic pain
- A feeling of pressure or fullness in the lower abdomen
- Difficulty urinating or frequent need to urinate
- Constipation or difficulty with bowel movements
- Sudden or worsening symptoms that may indicate complications
- Plans for pregnancy, especially with a known history of fibroids
A doctor can help prevent any complications and guide you toward an appropriate treatment based on your health profile.
Consult Dr TC Chang for Fibroids Removal
Uterine fibroids can impact a woman’s health and well-being, but surgery is not always the only answer. Today, women have more choices than ever when managing fibroids. However, when symptoms are severe, you may need a procedure to remove fibroids in your uterus.
If you’re considering treatment for fibroids and want to explore all your options, consult Dr TC Chang, a gynaecologist with experience in managing complex fibroids. Dr Chang can help you understand your condition, assess your treatment goals, and recommend a personalised plan. With the proper care, living well with fibroids is entirely possible.