The first step in receiving the best treatment for your fibroids is a full service fibroid evaluation and consultation. At Mount Sinai, our gynecologic staff will review your full medical history, any past radiologic tests, and perform a full exam. Then we will sit down and discuss your options with you. As part of the evaluation process, we may want you to have additional testing to ensure we are giving you the best available care.
There are many alternatives to treating fibroids, ranging from medication to surgery. Depending on your specific condition, one or a combination of the following treatments may be right for you.
- Supplemental vitamin D and green tea: have been shown with medical research to suppress fibroid growth and reduce symptoms
- Birth control pills: can be used to reduce bleeding symptoms and cramping
- Mirena IUD: an intrauterine device that slowly releases the hormone progesterone to help reduce bleeding
- Uterine fibroid embolization (UFE): performed by interventional radiology, a catheter is used to deliver small particles that block the blood supply to the fibroid causing the fibroid to die
- Myomectomy is the surgical removal of the fibroids. The surgical approach typically depends on the size, number, and location of fibroids. Fibroid removal can be done with an abdominal incision, through the vagina, or using a robotic/laparoscopic approach as described:
- Laparoscopic/robotic myomectomy: using three to five small incisions, the fibroids are removed after being reduced into smaller pieces
- Vaginal myomectomy (hysteroscopic myomectomy): removal of submucosal fibroids through the vagina without incisions
- Abdominal myomectomy: an incision is made at your bikini line, allowing the surgeon to reach the uterus and remove the fibroids while sparring the uterus
- Hysterectomy: removal of the uterus with the possibility of removing your ovaries or cervix. Hysterectomy does not necessarily mean that you have to remove your ovaries. The decision to keep or remove your ovaries is a choice that you and your doctor will make together. Additionally, depending on the type of surgery and your medical history, you may keep or remove your cervix. The different approaches to hysterectomy are abdominal incision approach, vaginal approach, or robotic/laparoscopic approach. There are different types of hysterectomies, such as:
- Vaginal hysterectomy: the uterus and cervix are removed through the vagina
- Supracervical hysterectomy: your uterus is removed but your cervix is left in place
- Total hysterectomy: the uterus, ovaries, and cervix are removed
Regardless of your age, having fibroids should not mean your only choice is hysterectomy. The uterus has as much emotional importance as it does a physical one, and your health care providers should never take its removal lightly. We understand what a difficult decision this can be and can help you make the best choice for you.