Uterine fibroids are benign fibrous tumors in the uterus that are fed by estrogen. They are extremely common- about 70% of Caucasian women and 80% of African-American women have fibroids by age 50. Most of them don’t cause any symptoms and women are surprised to find they have a fibroid. In many cases though, fibroids can cause heavy bleeding that can lead to anemia and quality-of-life issues. At that point, you would probably consider treatment. There are several treatments for fibroids, depending on the number, size and location of the fibroids, including:

• Hormone therapy: Since fibroids are fed by estrogen, progesterone can be used to counteract your body’s natural estrogen and shrink the fibroid.
• Progestin-releasing IUD: Effective in women with small fibroids, the progestin in the Mirena IUD has been shown to substantially reduce menstrual bleeding. In one study, 85% of all women with menorrhagia treated with a Mirena IUD had their bleeding reduced to normal amounts after 3 months. By 12 months, a full 40% of the women didn’t have periods at all.
• Myomectomy: Surgically removing the fibroid is one option to preserve the uterus while getting rid of the fibroid. It’s moderately effective…in a study of 196 women who had menorrhagia due to fibroids, 68% reported satisfaction with the myomectomy after 73 months. 32% of the women considered the results unsatisfactory. Another report followed 285 women treated with hysteroscopic mymectomy: additional surgery was required for 9.5% of them after 2 years and 26.7% after 8 years.
• Endometrial ablation: In women who are done with childbearing, but who wish to preserve their ovaries and natural hormones, an endometrial ablation is often an effective treatment for small fibroids. One year after the procedure, 95% of women with fibroids have a reduction in bleeding to normal levels; many women have no menstrual bleeding at all.
•  Uterine artery embolization: While UAE appears to be an effective treatment for many women for fibroids, it’s affect on premature ovarian failure, fertility and pregnancy is not clear. Complications of the procedure may lead to a hysterectomy, so if you are adamantly opposed to a hysterectomy, this would not be a good option for you. This procedure works by cutting off the blood supply to the fibroid. It typically requires an overnight stay in the hospital for pain management.
•  Hysterectomy: A woman with large fibroids or with multiple fibroids that haven’t responded to more gentle treatment may require a hysterectomy for definitive treatment. This is a major surgical procedure with the usual accompanying risks. The physician may just take out the uterus, or may take out the uterus and the ovaries. The latter would put you immediately into menopause along with the pesky symptoms and health risks that go with it. This should be the last resort for women as it is the most invasive and can put women at risk for cardiovascular disease and osteoporosis if her hormones are not replenished.

No one answer is right for every woman. Your treatment of fibroids should be personalized to fit your specific medical history, lifestyle, financial situation, and beliefs and comfort level. Talk to your physician about dealing with uterine fibroids. You don’t have to just “live with it”.