Choosing a Treatment for Uterine Fibroids

Uterine fibroids are benign (not cancerous) growths that develop from the muscle tissue of the uterus. They can stay small for years, grow slowly, or suddenly get bigger.

Carrie, who is 51 and lives in Minnesota, had fibroids for years without many symptoms. When her fibroids were first diagnosed in 2002, she discussed treatment options with her ob-gyn. Carrie decided she could cope without treatment, and her ob-gyn used yearly transvaginal ultrasounds to track the size and locations of the fibroids.

Around 2010, Carrie’s symptoms got worse. She knew it was time to decide on a treatment. In this edited interview, Carrie shares her story of how it went.

ACOG: Why did you decide on treatment for your fibroids?

Carrie: One of the challenges of this condition is that it can sneak up on you. You don’t realize how bad things are because you adapt. For many women, the main symptom is abnormal uterine bleeding. For me, it was chronic low-grade pelvic pain, mostly a crampy, dull ache like menstrual pain.

Increasingly, though, my pain got worse. I had a feeling of fullness in my abdomen and my clothes didn’t fit. But most worrying was that some of the fibroids pressed on nerves that affected my right leg. I was losing feeling in my right toes. I love to travel and I’m an outdoor enthusiast, and I began feeling more and more unsteady on my feet.

ACOG: What treatment did you choose and why?

Carrie: My ob-gyn and I talked about all the options and their benefits and risks. I didn’t want a hysterectomy. I wanted to preserve my uterus for several reasons. One was that I was 41 at the time and engaged. My partner and I hadn’t decided whether we wanted to try to have children, and we were realistic about the chances given our ages. But we wanted to keep our options open.

When I learned about uterine artery embolization [UAE], it felt like a good choice for me. With UAE, an interventional radiologist injects tiny spheres into the blood vessels that go to your uterus. This cuts off the blood supply to the fibroids and they shrink over time.

It’s usually an outpatient procedure. The radiologist told me the pain afterward would be like having a bad period, and I felt I could handle that. I knew it was possible to get pregnant after UAE, though not guaranteed. After talking it over with my partner, I decided UAE was the best option for me.

ACOG: What were your goals for the procedure?

Carrie: To shrink the fibroids to the point where I wasn’t experiencing the pelvic pain and sense of fullness, and for my clothes to fit again. I also wanted to have a reasonable recovery.

ACOG: What was the procedure like?

Carrie: The procedure itself was pretty easy. I was prepped and given a sedative. It was over in a couple of hours and I had no pain. Afterward, though, my blood pressure dropped. The doctor admitted me to the hospital overnight to monitor my heart function.

ACOG: What happened after you went home?

Carrie: The pain medication I was prescribed made me sick to my stomach, so I couldn’t take it. My partner spoke with the doctor’s office, and they recommended ibuprofen instead. I had several extremely painful days. It took about 2 weeks for me to feel normal again.

ACOG: Once you got past the pain and recovery, did your symptoms improve?

Carrie: Yes. The tingling in my foot stopped in the first month. Within a couple months my uterus got back down to a more reasonable size and my pants fit better. I didn’t have as much pelvic pain. Overall, I felt I had good symptom relief. I had a follow-up ultrasound 4 months after the UAE that showed the fibroids were a lot smaller.

Now, almost 10 years later, I’m starting to have more pelvic pain again. My ob-gyn thinks it’s due to the fibroids growing again. I’ve decided to wait and see if there’s a positive change with menopause, which sometimes causes fibroids to shrink.

ACOG: What advice would you give to other women considering treatment for uterine fibroids?

Carrie: Talk with whoever is going to be taking care of you after the procedure and have a plan for how you’re going to manage recovery, including pain control.

Now, before a procedure, I ask the doctor about his or her approach to pain management. We make sure I have medications that I know I can take. And my partner knows that if I’m in pain, he can speak up for me as well.

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This information is designed as an educational aid for the public. It offers current information and opinions related to women's health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOG’s complete disclaimer.