Managing Uterine Fibroids: Alternatives to Hysterectomy

William H. Parker, MD

Disclosures

July 20, 2012

In This Article

The Modern Management of Fibroids

Fibroids are benign uterine tumors that have been reported in up to 75% of all women.[1] The many treatment options available for women with uterine fibroids include:

  • Observation;

  • Medical therapy;

  • Myomectomy;

  • Uterine artery embolization;

  • Focused ultrasonography; and

  • Hysterectomy.

Most women with fibroids can choose "watchful waiting" without harm. Predicting the growth of fibroids or the onset of new symptoms is impossible. A National Institutes of Health study found that although the average annual increase in fibroid volume was 9%, the range of change in fibroid size was very wide, from a 25% shrinkage to a 138% growth in a single year.[2]Furthermore, a nonrandomized study of women with fibroids and uterine size of 8 weeks or greater who chose watchful waiting found no significant changes in 77% of women in the self-reported amount of bleeding, pain, or degree of bothersome symptoms at the end of 1 year.[3]Watchful waiting can be considered in late perimenopause because after menopause, bleeding will stop and fibroids will shrink.

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