New Medical Options for Fibroids
Fibroids are common, and many women can now ease their symptoms with medicine rather than surgery. Newer oral treatments have widened the choices available, as they can control heavy bleeding and other symptoms for longer than the older medicines allowed. This article explains what fibroids are, the treatments now in use, and how a specialist can match an approach to your symptoms.
What are fibroids?
Fibroids are non-cancerous growths that develop in or around the womb. They are very common, and around 1 in 3 women develop them at some point in their life. Many women never know they have fibroids, as they often cause no symptoms at all. Fibroids grow under the influence of oestrogen, so they usually develop during the reproductive years and tend to shrink after the menopause. They range in size from as small as a pea to considerably larger.
What symptoms can fibroids cause?
When fibroids do cause symptoms, heavy or prolonged periods are among the most common. Other signs include pelvic pain or pressure, a swollen lower abdomen, constipation, needing to pass urine more often, and discomfort during sex. Heavy bleeding over time can lower your iron levels and leave you tired, so persistent symptoms are worth assessing. Some women also find that fibroids affect their fertility, depending on the size and position.
How are fibroids treated?
Treatment depends on your symptoms, the size, number and position of the fibroids, and whether you hope to have children. Not everyone with fibroids needs treatment at all, and monitoring is sometimes the sensible choice. Where treatment is helpful, the options span medicines, procedures that preserve the womb, and surgery. A specialist can talk through the benefits, risks and alternatives before anything is agreed.
What medicines are used for fibroids?
Several established medicines can ease fibroid symptoms without an operation. Some are taken around your period to reduce heavy bleeding, while hormonal treatments, including the hormonal intrauterine system, can help lighten periods. A group of injectable medicines called GnRH agonists lowers oestrogen and can shrink fibroids, though these are usually given for a short time before surgery. Their use tends to be limited, as they can bring on menopausal effects such as hot flushes, and fibroids often regrow once the medicine stops.
What are the newer oral treatments for fibroids?
A newer group of daily tablets, called GnRH antagonists, has broadened what medicine can offer. These tablets can reduce heavy bleeding and may shrink the fibroids themselves, and they are usually combined with a small amount of add-back hormone to ease menopausal effects and help protect your bones. That combination allows them to be used for longer than the older injectable medicines. NICE has recommended treatments in this class for moderate to severe fibroid symptoms, and estimated that around 30,000 people could benefit from one such option. For many women they offer an alternative to injections and, in some cases, an alternative to surgery. These are prescription-only medicines, started and overseen by a specialist, and whether they suit you depends on your health and history.
Comparing the main treatment routes
The table below sets out the broad options, so you can see how they differ. A specialist will help you weigh up which one fits your situation.
| Approach | What it involves | Often suited to |
|---|---|---|
| Medicines for bleeding | Tablets taken around your period to reduce blood loss | Milder symptoms, or while you decide on next steps |
| Hormonal treatments | Options including the hormonal intrauterine system, a small device placed in the womb | Heavy bleeding, often with smaller fibroids |
| Newer oral tablets (GnRH antagonists) | A daily tablet, usually with a small amount of add-back hormone, taken for longer periods | Moderate to severe symptoms, when avoiding or delaying surgery |
| Womb-preserving procedures | Uterine artery embolisation, or surgical removal of fibroids (myomectomy) | Wanting to keep the womb or preserve fertility |
| Hysterectomy | Removal of the womb | A definitive option once childbearing is complete |
Can fibroids be treated without surgery?
For many women, yes. Medicines and womb-preserving procedures, such as uterine artery embolisation, can control symptoms without removing the womb. Surgery remains an option when it is the most suitable choice, and a hysterectomy offers a definitive solution once childbearing is complete. The right path depends on your symptoms, your priorities and your plans for the future.
Frequently asked questions
Do all fibroids need treatment?
Not always, as many fibroids cause no symptoms and need only monitoring. Treatment becomes worthwhile when symptoms affect your daily life or your health.
Will fibroids come back after treatment?
Fibroids can regrow, particularly after some medicines are stopped or after womb-preserving surgery. A specialist can explain your individual risk and plan follow-up accordingly.
Can I still have children after fibroid treatment?
Many treatments are chosen specifically to protect fertility, and myomectomy is often preferred for this reason. Share your plans with your specialist, as this guides the choice of treatment.
Do fibroids turn into cancer?
Fibroids are non-cancerous, and a cancerous change is very rare. Any new or unusual symptoms should still be assessed, so that the cause can be confirmed.
How Mr Morris can help
Mr Nicholas Morris is a Consultant Gynaecologist (MBBS FRCOG MEWI) who assesses and treats fibroids across the full range of options. He arranges the scans needed to confirm a diagnosis, explains what your symptoms mean in plain terms, and discusses the medical and surgical choices open to you. Where medicine can control your symptoms, he will talk you through it, and where a womb-preserving procedure or surgery suits you better, he will plan that with you. Appointments are usually available within 24 to 48 hours, in person or online, so you are not left waiting for answers.
To discuss fibroids or book an appointment, please call 020 8371 1510, or email secretary@rapidaccessgynaecology.co.uk. You can also visit rapidaccessgynaecology.co.uk.