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magee fibroids

Fibroid Treatment Services

Fibroids are benign (noncancerous) tumors that grow in or on the wall of the uterus. Many people with fibroids have no symptoms. But fibroids can sometimes cause issues like pain and heavy bleeding during your period.

If you have issues with fibroids, UPMC’s experts offer treatments to ease your symptoms.

What Are Fibroids?

Fibroids are benign (noncancerous) tumors that grow in or on the walls of the uterus. Any person with a cervix can get uterine fibroids, but they're most common in people over the age of 30.

Fibroids can be as small as a pea or larger than a grapefruit. The larger a fibroid is, the more likely it is to cause symptoms.

Most people with fibroids don’t have symptoms, and even large fibroids may not cause issues.

But if you have the following symptoms, you may have fibroids:

  • Heavy bleeding, cramping, and/or blood clots during your period.
  • Pain during sex.
  • Bleeding between periods.
  • Periods that last longer than a week.
  • Fullness in your lower belly (pelvic area).
  • Frequent urination.
  • Lower back pain, especially during your period or during sex.

Tell your doctor if you're experiencing symptoms consistent with fibroids.

How Do You Check For Uterine Fibroids?

You can’t check for fibroids at home.

Doctors often discover fibroids during routine pelvic exams. During a pelvic exam, your doctor uses their fingers to check the inside of your vagina and outside of your pelvic area. If they find a painless lump on or around your uterus, they’ll suggest you get additional tests to see if it’s a fibroid.

Tests to diagnose fibroids

Doctors use several tests to diagnose fibroids, including:

  • Ultrasounds — Which use sound waves to look at and around your uterus.
  • MRIs — Use a magnetic field and radio waves to create 3D images of your uterus. MRIs can show doctors the location of your fibroids.
  • Hysterosonography — A doctor inserts a thin, flexible catheter (tube) through your vagina and cervix into your uterus. They also inject sterile saline (salt water) into your uterus through the tube. Then, they use an ultrasound probe to capture images of the inside of your uterus.
  • Hysteroscopy — A doctor inserts a long, thin scope into your uterus through your vagina and cervix to see inside your uterus.

What Fibroid Treatment Options Do You Offer?

Uterine fibroids aren’t cancer, and they don’t cause cancer. There are cancerous tumors that look like fibroids, but these are very rare. Fibroids can interfere with pregnancy, but many women with fibroids conceive and have pregnancies without complications. Fibroids then often shrink after menopause, when levels of hormones like estrogen drop.

Some fibroids do cause symptoms that are hard to live with. If you have fibroids, UPMC offers many treatments that can help you get relief.

There’s no one “best” treatment for fibroids.

Your doctor will make a recommendation based on your symptoms and:

  • The size and location of your fibroids.
  • Your age and how close you might be to reproductive changes like child-bearing or menopause.
  • Your health history.
  • Whether you want to get pregnant in the future — If you do, your doctor may recommend you don't use certain treatments like a hysterectomy, which is surgery to remove the uterus.

Nonsurgical treatments for fibroids

Watchful waiting for fibroids

If your fibroids aren’t causing issues, your doctor may recommend watchful waiting. That’s when your doctor checks your uterus during routine pelvic exams to see if your fibroids have grown. Let your doctor know if you have new symptoms between appointments. 

Medication for fibroids

Doctors treat mild fibroid symptoms using medications, including:

  • Over-the-counter pain drugs — Both ibuprofen and acetaminophen can help ease pain, but ibuprofen can also reduce bleeding during your period.
  • Birth control medications or hormonal medications — These include low-dose birth control pills, progestin injections, and an IUD (intrauterine device) that contains progestin, a hormone. Birth control that contains hormones can reduce bleeding during your period. Some birth control methods can stop your periods entirely, but they don’t shrink fibroids or keep them from growing. Other hormonal medications can have similar effects.
  • Gonadotropin-releasing hormone (GnRH) antagonists/agonists — These medications decrease your levels of estrogen and progesterone, which are hormones that help fibroids grow. GnRH medications can also reduce bleeding during your period. Some GnRH medications may help shrink the size of your fibroids, but doctors often don’t recommend using them for a long time, and they stop working when you stop using them. Doctors usually recommend these treatments if you have anemia and need to increase your blood levels. Doctors sometimes use GnRH medications to shrink fibroids before surgery.
  • Tranexamic acid — This oral medication reduces bleeding during your period. Tranexamic acid doesn’t contain hormones or affect your body’s hormone levels, and it doesn’t shrink fibroids either. It can be used as an intravenous treatment for emergent bleeding in the ER or the OR as well.

Uterine fibroid embolization (UFE)

UFE is a minimally invasive procedure that's also known as uterine artery embolization, or UAE.

During UFE, doctors insert a catheter into an artery in your groin to block blood flow to your fibroids. This approach can help shrink your fibroids, but it doesn’t get rid of them. Some women still have symptoms after UFE. 

This procedure is not typically recommended for women who want to have a future pregnancy, but women who have undergone these procedures have achieved pregnancy.

Surgical treatments for fibroids

At UPMC, we use minimally invasive surgeries as often as possible to treat fibroids. These surgeries reduce recovery time and lower the risk of complications like infection. 

Laparoscopic radiofrequency ablation

Laparoscopic radiofrequency ablation is also known as “Acessa.” During this procedure, doctors make small cuts in your pelvic area and use a tool that releases thermal energy to shrink uterine fibroids. Acessa is usually recommended if you haven’t gone through menopause but don’t want to get pregnant in the future. It does not remove the fibroids.

Myomectomy

During a myomectomy, a doctor removes fibroids from your uterine wall without removing your uterus. This is the most common treatment offered to people having problems with fibroids who need surgery but want to maintain fertility (the ability to have a future pregnancy). Fibroids can grow back several years after you have a myomectomy, so it’s not a permanent solution.

Doctors perform myomectomy in three ways: 

  • Laparoscopically/robotically — Doctors make small cuts in your pelvic area to reach your uterus.
  • Hysteroscopically — Doctors enter your uterus through your vagina and cervix.
  • Abdominally — Doctors make larger cuts in your abdomen to reach your uterus. Doctors only do this if you have a lot of fibroids or your fibroids are very large.

Hysterectomy

With a hysterectomy, doctors remove your uterus. Sometimes, they may also remove other organs or tissues, like your ovaries and fallopian tubes.

Without a uterus, fibroids can’t grow back, and you can’t have a period. Hysterectomy is a permanent solution for fibroids, but you can’t get pregnant afterward.

What Are the Risks and Complications of Uterine Fibroid Treatment?

The risks of fibroid treatment depend on which treatment you receive. Your health history and the size of your fibroids may also play a role.

In general:

  • A hysterectomy may lead you to start menopause early.
  • Any type of surgery, even the minimally invasive kind, incurs a risk of bleeding, infection, and development of scar tissue.
  • Medications may cause minor side effects, like stomach issues or mood changes.

Myomectomy can cause large blood loss during surgery and scar tissue development in the muscle of your uterus and other places in your abdomen. If your doctor makes a deep cut in your uterine wall and you plan to get pregnant in the future, your ob-gyn may recommend a cesarean section as the safest way to deliver your baby. Scar tissue in the abdomen can cause other problems later in life.

In the rare case that you have a cancerous tumor that looks like a fibroid, a myomectomy may increase the risk of spreading that cancer. Still, this risk remains very low.

What Should I Expect Before, During, and After My Fibroid Treatment?

Before your fibroid treatment

If you’re having a procedure or surgery to remove your fibroids, your doctor will talk to you about how to prepare. For example, you might need to stop taking certain medications.

During your fibroid treatment

What you experience during fibroid treatment will depend on:

  • The type of procedure or surgery you receive.
  • The location and size of your fibroids.
  • Your health history.

For most surgeries and procedures, you will undergo sedation or general anesthesia through an IV, so you sleep through the procedure.

Most surgeries take a couple of hours.

After your fibroid treatment

Your recovery will also depend on the type of treatment you received, the size and location of your fibroids, and your health history. It’s normal to experience some pain for a few days after surgery. Your doctor will give you medications to ease the pain.

You’ll need a ride home from the hospital after your procedure or surgery. You’ll feel tired and will need to rest for at least several days afterward. With some surgeries, like a myomectomy and hysterectomy, you may need several weeks or more to recover.

Talk to your doctor about what to expect.

Women's Virtual Health Care

Are you interested in a video visit with one of our women's health experts? You can now see a fibroid specialist from anywhere in Pennsylvania through UPMC virtual care.


Schedule a video visit.


Last reviewed by Gretchen E. H. Makai, MD on 2024-09-05.