Uterine Fibroids: Should I Have Surgery?

Top of the pageDecision Point

Uterine Fibroids: Should I Have Surgery?

You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Uterine Fibroids: Should I Have Surgery?

Get the facts

Your options

  • Have surgery to take out just your fibroids or to take out your
    uterus.
  • Don't have surgery. You can choose another treatment, such as over-the-counter pain medicine, hormones, or fibroid embolization.

This decision aid is for women who
have decided to treat their uterine fibroids. Many fibroids do not need treatment.

If you've decided to treat your uterine fibroids, you may also need to make a decision about embolization or a decision about GnRH-A hormone therapy.

Key points to remember

  • You might want to choose surgery if fibroids
    are making it hard for you to get pregnant or if you have other symptoms that
    affect your quality of life, and other treatments have not worked for you.
    There are two surgical treatments for fibroids: taking fibroids out of the
    uterus (myomectomy) and removing the uterus (hysterectomy).
  • After
    menopause, fibroids usually get smaller or go away. If
    you are close to menopause, you could take
    nonsteroidal anti-inflammatory drugs (NSAIDs) (such as
    ibuprofen or naproxen) for pain or have
    fibroid embolization. You also could try birth control hormones, get a certain
    type of
    IUD, or take
    hormone therapy (GnRH-a) for a short time if you have bad
    symptoms.
  • If you want to have a baby, taking out just the fibroids
    may improve your chance of getting pregnant. But this type of surgery can lead to a problem with the
    placenta. It also can make a
    cesarean delivery more likely.
  • Taking out
    the uterus is the only cure for uterine fibroids. But it's not a good choice if
    you want to have children (or more children). You can't get pregnant after your
    uterus is taken out.
  • Both types of surgery have short-term risks, such as blood loss
    and infection. Both surgeries also can cause scar tissue, which can cause
    pelvic pain and
    infertility.
FAQs

What are uterine fibroids?

Uterine fibroids are
growths in or on the
uterus. They are not cancer. Fibroids can grow on the
inside of the uterus,
within the muscle wall of the uterus, or on the
outer surface of the uterus. They can change the shape of the uterus as they
grow. This can make it hard for you to get pregnant.

Over time, the size, shape, location, and
symptoms of fibroids may change.

As women get older, they are more likely to have
uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no
symptoms. But fibroids can cause bad pain, bleeding, and other
problems.

The cause of fibroids is not known. But the hormones
estrogen and
progesterone can make them grow. A woman's body makes
the highest levels of these hormones during her childbearing years. After
menopause, when hormone levels decrease, fibroids often shrink or
disappear.

When do fibroids need to be treated?

Uterine
fibroids usually need treatment when they cause:

  • Anemia from
    heavy fibroid bleeding.
  • Ongoing low back pain or a feeling of
    pressure in the lower belly.
  • Trouble getting pregnant.
  • Problems during
    pregnancy, such as
    miscarriage or preterm labor.
  • Problems with the urinary tract or bowels.
  • Infection,
    if the tissue of a large fibroid dies.

Depending on the reasons you need treatment, one type of
treatment may work better for you than another.

What should you know about surgery to take out just the fibroids?

Myomectomy, which is surgery to take
out just the fibroids, can decrease pain and other symptoms. It also may make
it possible for you to get pregnant.

Surgery can be
done:

  • Through the vagina and into the uterus using
    a lighted scope.
  • Through a large cut in the
    belly.
  • Through several small cuts in the belly using a lighted
    scope. This is called a
    laparoscopy.

How well myomectomy works

Taking out fibroids decreases menstrual bleeding and pelvic pain from
fibroids. It may improve your chances of having a
baby.

Chance that fibroids can come back

Fibroids tend to grow back, unless you have your
uterus taken out. New fibroids also can grow. Fibroids return in up to half
of women who have surgery to take out just the fibroids. They are more likely
to come back if you had many fibroids.footnote 1 Talk to your doctor about whether your type of fibroid is
likely to grow back.

Risks of myomectomy

Cutting into the uterine wall during this
surgery can cause problems in a future pregnancy. There could be a problem with
the way the
placenta grows, such as
placenta abruptio or
placenta accreta. During labor, the uterus might not
work like it should.
This could
mean that you would need a
cesarean delivery.

What should you know about surgery to take out the uterus?

Hysterectomy, which is surgery to take
out the uterus, cures fibroids. But it's usually the last choice for treatment,
because it's major surgery and it makes you unable to get pregnant. Having this
surgery means that you will no longer have menstrual periods. The
ovaries and fallopian tubes also may be taken out at
the same time.

This surgery
gives most women relief from their symptoms.

Talk to your doctor
if you are not close to
menopause (about age 50) and you're thinking about
having your uterus and ovaries taken out. Experts say that women live longer
when they keep their ovaries until at least age 65. This may be because women
who have their ovaries have fewer hip fractures and are less likely to get
heart disease.footnote 2

How well hysterectomy works

This
surgery:

  • Relieves pain from fibroids.
  • Stops
    anemia from heavy and irregular vaginal
    bleeding.
  • May fix leakage of urine if it was caused by
    fibroids.

Chance that fibroids can come back

Fibroids do not grow back after your uterus is taken
out.

Risks of hysterectomy

Most women don't have problems from this surgery. But possible long-term
problems include:

  • Scar tissue that can cause pelvic pain.
  • Early menopause caused by a slow, early decline of the
    ovaries.
  • Weakness of the pelvic muscles and ligaments that support the
    vagina, bladder, and rectum. This can cause bladder or bowel problems.
  • Trouble urinating.
  • Pelvic pain. If you had pain before surgery, taking out your
    uterus may not relieve your pain.

What are the risks of having either surgery?

Most
women do not have problems after either surgery to treat fibroids. But problems
can include:

  • A fever. A slight fever is common after any
    surgery.
  • Rare problems, such as:
    • Infection.
    • Blood clots in the
      legs or lungs.
    • Scar tissue (also called adhesions).
    • Injury to other organs, such
      as the bladder or bowel.
    • A collection of blood at the surgical
      site.
    • Continued
      heavy bleeding. Some vaginal bleeding within 4 to 6
      weeks after you have the uterus removed is normal.
    • Problems from the medicine
      used to make you sleep during surgery.
    • Severe blood loss that causes you to need more blood
      (transfusion).

Why might your doctor recommend surgery to treat fibroids?

Your doctor might suggest that you have surgery to
take out just your fibroids if:

  • You want to treat your fibroids in a way that
    may make it possible for you to get pregnant later.

Your doctor might suggest that you have surgery to
remove your uterus if:

  • You have bad symptoms and:
    • Other treatments have not helped.
    • You're not
      near
      menopause.
    • You don't plan to have children
      (or more children).
    • There is a risk of cancer.

Compare your options

Compare

What is usually involved?

What are the benefits?

What are the risks and side effects?

Have surgery to take out
fibroids or your uterus

Have surgery to take out
fibroids or your uterus

  • You may take the hormone
    GnRH-a before surgery to shrink your fibroids.
  • You may have outpatient surgery, which means you would go home
    the same day. Or you may spend 1 to 4 days in the hospital after
    surgery.
  • Recovery can take from a few days to 6 weeks, depending on
    the type of surgery you have.
  • If you have your uterus taken out,
    you won't be able to get pregnant.
  • Either surgery can ease your pain
    and other symptoms.
  • Surgery to take out just your fibroids (myomectomy) may make it
    possible for you to get pregnant.
  • Surgery to take out your uterus (hysterectomy) will cure your fibroids.
  • Both surgeries have
    risks, some of which are rare. Risks include bleeding, infection, and scar
    tissue.
  • Cutting into the uterus to take out just the fibroids
    could cause a problem with how the uterus works in a future pregnancy.
  • Pelvic pain that you had before either surgery may not get
    better.
  • If you have just the fibroids taken out but not the uterus,
    the fibroids can grow back.
Don't have either
surgery

Don't have either
surgery

  • You may take hormones (GnRH-a) to
    shrink the fibroids.
  • You can take
    nonsteroidal anti-inflammatory drugs (NSAIDs), take birth control hormones, or get a
    certain type of
    IUD to reduce pain and bleeding.
  • You may
    have other procedures such as fibroid embolization, endometrial ablation or magnetic resonance guided ultrasound.
  • You may choose to
    have surgery later if you change your mind.
  • You may be able to control
    your symptoms without surgery.
  • If you have bad symptoms and are close to menopause, you may be
    able to control your symptoms long enough to go through
    menopause.
  • You won't have the risks of surgery.
  • Your pain or
    other symptoms could get worse.
  • If fibroids are making it hard for
    you to get pregnant, NSAIDs and hormones won't help you get
    pregnant.
  • NSAIDs can cause bleeding and other problems in some
    people. Talk to your doctor before taking them.
  • Hormones can have serious side effects, such as menopause
    symptoms and bone-thinning.
  • Fibroid embolization can have side
    effects such as infection and pain.

Personal stories about surgery to treat uterine fibroids

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

Uterine
fibroids made me miserable for a week to 10 days every month. Since my husband
and I did not want any more children, I decided it was time to take action. Not
only was the pain getting to me, but I was losing enough blood that I had
anemia I couldn't beat. I was tired all the time! I knew a hysterectomy was the
only sure cure for the pain caused by uterine fibroids. My doctor talked with
me about the discomfort and risks of a hysterectomy. She also said she might
have to remove my ovaries. I had a hysterectomy, and my ovaries were removed.
The first 2 weeks after the surgery were pretty rough, but my family and I
managed. I now take estrogen every day. It's been a year since my surgery, and
I feel great.

Cheryl,
age 45

My periods were really painful about 5
years ago. I went to my doctor, and he asked a lot of questions about my
periods and did an exam and some tests. When all the tests came back normal, he
said uterine fibroids might be the cause of my pain. He said the only sure
treatment for uterine fibroids was a hysterectomy. I didn't want to have
surgery, so I asked if waiting a few months would be dangerous. He said waiting
would be fine, and maybe I should try birth control pills and taking ibuprofen
during my periods. After a few months, the pain eased up. I am glad I decided
to wait and see if my pain decreased before having surgery.

Francine, age 42

I have large
uterine fibroids and have had them since I was in my early 30s. They didn't
cause any problems until I got pregnant with my first child. I went into labor
about a month early, and my daughter had to spend several days in the intensive
care unit. My husband and I would like to have one more child, but I want to
avoid another preterm labor if I can. My doctor has told me about a procedure
called a myomectomy. It doesn't guarantee that I won't deliver early, but it
may help. He will be able to remove the uterine fibroids from my uterus without
taking my uterus out. I won't have to have a large incision in my abdomen
either. I am looking forward to having this done. We will wait several months
and then try to have another child. Even if I need to deliver by cesarean after
a myomectomy, I'm happy to have the chance of a full-term pregnancy!

Terry, age
37

I was surprised when my doctor told me
that uterine fibroids could be the cause of the pain I was having with my periods. I
had never heard of uterine fibroids before. He told me all about uterine
fibroids and the treatments I could try. When he said using ibuprofen for a few
days right before my period starts and then for several days during my period
might stop the pain, I thought I might as well try it. It took a couple of
months of using this system, but now I hardly have any pain. I am glad that I
did not have surgery.

Ginny, age 37

What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery for fibroids

Reasons not to have surgery for fibroids

I'm having trouble getting pregnant because of fibroids, so I want to have them taken out.

Fibroids aren't keeping me from getting pregnant.

More important
Equally important
More important

I have so much bleeding and pain that I'm miserable part of every month.

I can control my symptoms with medicine.

More important
Equally important
More important

I want to do everything I can to treat my fibroids.

I don't want to have any surgery.

More important
Equally important
More important

I'm not close to menopause, and I can't stand my symptoms, so I want surgery.

I'm close to menopause, so I'd rather try hormones and pain medicine until menopause.

More important
Equally important
More important

My other important reasons:

My other important reasons:

More important
Equally important
More important

Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

Leaning toward
Undecided
Leaning toward

What else do you need to make your decision?

Check the facts

1, Surgery to take out just my fibroids will cure my problem.
2, Surgery to take out just my fibroids is the best choice if fibroids are keeping me from getting pregnant.
3, If I'm close to menopause, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may be all that I need to help my symptoms.

Decide what's next

1,Do you understand the options available to you?
2,Are you clear about which benefits and side effects matter most to you?
3,Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

Not sure at all
Somewhat sure
Very sure


Your Summary

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.

Your decision 

Next steps

Which way you're leaning

How sure you are

Your comments

Your knowledge of the facts 

Key concepts that you understood

Key concepts that may need review

Getting ready to act 

Patient choices

Credits and References

Credits
Author Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Martin J. Gabica, MD - Family Medicine
Primary Medical Reviewer Elizabeth T. Russo, MD - Internal Medicine
Specialist Medical Reviewer Divya Gupta, MD - Obstetrics and Gynecology, Gynecologic Oncology

References
Citations
  1. Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 438–469. Philadelphia: Lippincott Williams and Wilkins.
  2. Parker WH, et al. (2009). Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses' Health Study. Obstetrics and Gynecology, 113(5): 1027–1037.
You may want to have a say in this decision, or you may simply want to follow your doctor's recommendation. Either way, this information will help you understand what your choices are so that you can talk to your doctor about them.

Uterine Fibroids: Should I Have Surgery?

Here's a record of your answers. You can use it to talk with your doctor or loved ones about your decision.
  1. Get the facts
  2. Compare your options
  3. What matters most to you?
  4. Where are you leaning now?
  5. What else do you need to make your decision?

1. Get the Facts

Your options

  • Have surgery to take out just your fibroids or to take out your
    uterus.
  • Don't have surgery. You can choose another treatment, such as over-the-counter pain medicine, hormones, or fibroid embolization.

This decision aid is for women who
have decided to treat their uterine fibroids. Many fibroids do not need treatment.

If you've decided to treat your uterine fibroids, you may also need to make a decision about embolization or a decision about GnRH-A hormone therapy.

Key points to remember

  • You might want to choose surgery if fibroids
    are making it hard for you to get pregnant or if you have other symptoms that
    affect your quality of life, and other treatments have not worked for you.
    There are two surgical treatments for fibroids: taking fibroids out of the
    uterus (myomectomy) and removing the uterus (hysterectomy).
  • After
    menopause, fibroids usually get smaller or go away. If
    you are close to menopause, you could take
    nonsteroidal anti-inflammatory drugs (NSAIDs) (such as
    ibuprofen or naproxen) for pain or have
    fibroid embolization. You also could try birth control hormones, get a certain
    type of
    IUD, or take
    hormone therapy (GnRH-a) for a short time if you have bad
    symptoms.
  • If you want to have a baby, taking out just the fibroids
    may improve your chance of getting pregnant. But this type of surgery can lead to a problem with the
    placenta. It also can make a
    cesarean delivery more likely.
  • Taking out
    the uterus is the only cure for uterine fibroids. But it's not a good choice if
    you want to have children (or more children). You can't get pregnant after your
    uterus is taken out.
  • Both types of surgery have short-term risks, such as blood loss
    and infection. Both surgeries also can cause scar tissue, which can cause
    pelvic pain and
    infertility.
FAQs

What are uterine fibroids?

Uterine fibroids are
growths in or on the
uterus. They are not cancer. Fibroids can grow on the
inside of the uterus ,
within the muscle wall of the uterus , or on the
outer surface of the uterus . They can change the shape of the uterus as they
grow. This can make it hard for you to get pregnant.

Over time, the size, shape, location, and
symptoms of fibroids may change.

As women get older, they are more likely to have
uterine fibroids, especially from their 30s and 40s until menopause. Most have mild or no
symptoms. But fibroids can cause bad pain, bleeding, and other
problems.

The cause of fibroids is not known. But the hormones
estrogen and
progesterone can make them grow. A woman's body makes
the highest levels of these hormones during her childbearing years. After
menopause, when hormone levels decrease, fibroids often shrink or
disappear.

When do fibroids need to be treated?

Uterine
fibroids usually need treatment when they cause:

  • Anemia from
    heavy fibroid bleeding.
  • Ongoing low back pain or a feeling of
    pressure in the lower belly.
  • Trouble getting pregnant.
  • Problems during
    pregnancy, such as
    miscarriage or preterm labor.
  • Problems with the urinary tract or bowels.
  • Infection,
    if the tissue of a large fibroid dies.

Depending on the reasons you need treatment, one type of
treatment may work better for you than another.

What should you know about surgery to take out just the fibroids?

Myomectomy, which is surgery to take
out just the fibroids, can decrease pain and other symptoms. It also may make
it possible for you to get pregnant.

Surgery can be
done:

  • Through the vagina and into the uterus using
    a lighted scope.
  • Through a large cut in the
    belly.
  • Through several small cuts in the belly using a lighted
    scope. This is called a
    laparoscopy.

How well myomectomy works

Taking out fibroids decreases menstrual bleeding and pelvic pain from
fibroids. It may improve your chances of having a
baby.

Chance that fibroids can come back

Fibroids tend to grow back, unless you have your
uterus taken out. New fibroids also can grow. Fibroids return in up to half
of women who have surgery to take out just the fibroids. They are more likely
to come back if you had many fibroids.1 Talk to your doctor about whether your type of fibroid is
likely to grow back.

Risks of myomectomy

Cutting into the uterine wall during this
surgery can cause problems in a future pregnancy. There could be a problem with
the way the
placenta grows, such as
placenta abruptio or
placenta accreta. During labor, the uterus might not
work like it should.
This could
mean that you would need a
cesarean delivery.

What should you know about surgery to take out the uterus?

Hysterectomy, which is surgery to take
out the uterus, cures fibroids. But it's usually the last choice for treatment,
because it's major surgery and it makes you unable to get pregnant. Having this
surgery means that you will no longer have menstrual periods. The
ovaries and fallopian tubes also may be taken out at
the same time.

This surgery
gives most women relief from their symptoms.

Talk to your doctor
if you are not close to
menopause (about age 50) and you're thinking about
having your uterus and ovaries taken out. Experts say that women live longer
when they keep their ovaries until at least age 65. This may be because women
who have their ovaries have fewer hip fractures and are less likely to get
heart disease.2

How well hysterectomy works

This
surgery:

  • Relieves pain from fibroids.
  • Stops
    anemia from heavy and irregular vaginal
    bleeding.
  • May fix leakage of urine if it was caused by
    fibroids.

Chance that fibroids can come back

Fibroids do not grow back after your uterus is taken
out.

Risks of hysterectomy

Most women don't have problems from this surgery. But possible long-term
problems include:

  • Scar tissue that can cause pelvic pain.
  • Early menopause caused by a slow, early decline of the
    ovaries.
  • Weakness of the pelvic muscles and ligaments that support the
    vagina, bladder, and rectum. This can cause bladder or bowel problems.
  • Trouble urinating.
  • Pelvic pain. If you had pain before surgery, taking out your
    uterus may not relieve your pain.

What are the risks of having either surgery?

Most
women do not have problems after either surgery to treat fibroids. But problems
can include:

  • A fever. A slight fever is common after any
    surgery.
  • Rare problems, such as:
    • Infection.
    • Blood clots in the
      legs or lungs.
    • Scar tissue (also called adhesions).
    • Injury to other organs, such
      as the bladder or bowel.
    • A collection of blood at the surgical
      site.
    • Continued
      heavy bleeding. Some vaginal bleeding within 4 to 6
      weeks after you have the uterus removed is normal.
    • Problems from the medicine
      used to make you sleep during surgery.
    • Severe blood loss that causes you to need more blood
      (transfusion).

Why might your doctor recommend surgery to treat fibroids?

Your doctor might suggest that you have surgery to
take out just your fibroids if:

  • You want to treat your fibroids in a way that
    may make it possible for you to get pregnant later.

Your doctor might suggest that you have surgery to
remove your uterus if:

  • You have bad symptoms and:
    • Other treatments have not helped.
    • You're not
      near
      menopause.
    • You don't plan to have children
      (or more children).
    • There is a risk of cancer.

2. Compare your options

  Have surgery to take out
fibroids or your uterus
Don't have either
surgery
What is usually involved?
  • You may take the hormone
    GnRH-a before surgery to shrink your fibroids.
  • You may have outpatient surgery, which means you would go home
    the same day. Or you may spend 1 to 4 days in the hospital after
    surgery.
  • Recovery can take from a few days to 6 weeks, depending on
    the type of surgery you have.
  • If you have your uterus taken out,
    you won't be able to get pregnant.
  • You may take hormones (GnRH-a) to
    shrink the fibroids.
  • You can take
    nonsteroidal anti-inflammatory drugs (NSAIDs), take birth control hormones, or get a
    certain type of
    IUD to reduce pain and bleeding.
  • You may
    have other procedures such as fibroid embolization, endometrial ablation or magnetic resonance guided ultrasound.
  • You may choose to
    have surgery later if you change your mind.
What are the benefits?
  • Either surgery can ease your pain
    and other symptoms.
  • Surgery to take out just your fibroids (myomectomy) may make it
    possible for you to get pregnant.
  • Surgery to take out your uterus (hysterectomy) will cure your fibroids.
  • You may be able to control
    your symptoms without surgery.
  • If you have bad symptoms and are close to menopause, you may be
    able to control your symptoms long enough to go through
    menopause.
  • You won't have the risks of surgery.
What are the risks and side effects?
  • Both surgeries have
    risks, some of which are rare. Risks include bleeding, infection, and scar
    tissue.
  • Cutting into the uterus to take out just the fibroids
    could cause a problem with how the uterus works in a future pregnancy.
  • Pelvic pain that you had before either surgery may not get
    better.
  • If you have just the fibroids taken out but not the uterus,
    the fibroids can grow back.
  • Your pain or
    other symptoms could get worse.
  • If fibroids are making it hard for
    you to get pregnant, NSAIDs and hormones won't help you get
    pregnant.
  • NSAIDs can cause bleeding and other problems in some
    people. Talk to your doctor before taking them.
  • Hormones can have serious side effects, such as menopause
    symptoms and bone-thinning.
  • Fibroid embolization can have side
    effects such as infection and pain.

Personal stories

Personal stories about surgery to treat uterine fibroids

These stories are based on information gathered from health professionals and consumers. They may be helpful as you make important health decisions.

"Uterine fibroids made me miserable for a week to 10 days every month. Since my husband and I did not want any more children, I decided it was time to take action. Not only was the pain getting to me, but I was losing enough blood that I had anemia I couldn't beat. I was tired all the time! I knew a hysterectomy was the only sure cure for the pain caused by uterine fibroids. My doctor talked with me about the discomfort and risks of a hysterectomy. She also said she might have to remove my ovaries. I had a hysterectomy, and my ovaries were removed. The first 2 weeks after the surgery were pretty rough, but my family and I managed. I now take estrogen every day. It's been a year since my surgery, and I feel great."

—
Cheryl,
age 45

"My periods were really painful about 5 years ago. I went to my doctor, and he asked a lot of questions about my periods and did an exam and some tests. When all the tests came back normal, he said uterine fibroids might be the cause of my pain. He said the only sure treatment for uterine fibroids was a hysterectomy. I didn't want to have surgery, so I asked if waiting a few months would be dangerous. He said waiting would be fine, and maybe I should try birth control pills and taking ibuprofen during my periods. After a few months, the pain eased up. I am glad I decided to wait and see if my pain decreased before having surgery."

— Francine, age 42

"I have large uterine fibroids and have had them since I was in my early 30s. They didn't cause any problems until I got pregnant with my first child. I went into labor about a month early, and my daughter had to spend several days in the intensive care unit. My husband and I would like to have one more child, but I want to avoid another preterm labor if I can. My doctor has told me about a procedure called a myomectomy. It doesn't guarantee that I won't deliver early, but it may help. He will be able to remove the uterine fibroids from my uterus without taking my uterus out. I won't have to have a large incision in my abdomen either. I am looking forward to having this done. We will wait several months and then try to have another child. Even if I need to deliver by cesarean after a myomectomy, I'm happy to have the chance of a full-term pregnancy!"

—
Terry, age
37

"I was surprised when my doctor told me that uterine fibroids could be the cause of the pain I was having with my periods. I had never heard of uterine fibroids before. He told me all about uterine fibroids and the treatments I could try. When he said using ibuprofen for a few days right before my period starts and then for several days during my period might stop the pain, I thought I might as well try it. It took a couple of months of using this system, but now I hardly have any pain. I am glad that I did not have surgery."

— Ginny, age 37

3. What matters most to you?

Your personal feelings are just as important as the medical facts. Think about what matters most to you in this decision, and show how you feel about the following statements.

Reasons to have surgery for fibroids

Reasons not to have surgery for fibroids

I'm having trouble getting pregnant because of fibroids, so I want to have them taken out.

Fibroids aren't keeping me from getting pregnant.

             
More important
Equally important
More important

I have so much bleeding and pain that I'm miserable part of every month.

I can control my symptoms with medicine.

             
More important
Equally important
More important

I want to do everything I can to treat my fibroids.

I don't want to have any surgery.

             
More important
Equally important
More important

I'm not close to menopause, and I can't stand my symptoms, so I want surgery.

I'm close to menopause, so I'd rather try hormones and pain medicine until menopause.

             
More important
Equally important
More important

My other important reasons:

My other important reasons:

   
             
More important
Equally important
More important

4. Where are you leaning now?

Now that you've thought about the facts and your feelings, you may have a general idea of where you stand on this decision. Show which way you are leaning right now.

Having surgery

NOT having surgery

             
Leaning toward
Undecided
Leaning toward

5. What else do you need to make your decision?

Check the facts

1.
Surgery to take out just my fibroids will cure my problem.

  • True

  • False
  • I'm not sure

You're right. Fibroids can grow back after surgery to take them out. The only cure for fibroids is surgery to take out your uterus (hysterectomy).

2.
Surgery to take out just my fibroids is the best choice if fibroids are keeping me from getting pregnant.

  • True
  • False

  • I'm not sure

That's right. Surgery to take out fibroids is the best choice if you want to get pregnant. Surgery to take out your uterus would mean that you can't get pregnant.

3.
If I'm close to menopause, taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may be all that I need to help my symptoms.

  • True
  • False

  • I'm not sure

You're right. Fibroids usually get smaller or go away after menopause. Taking nonsteroidal anti-inflammatory drugs (NSAIDs) and maybe hormones may help your symptoms until you go through menopause.

Decide what's next

1.
Do you understand the options available to you?

2.
Are you clear about which benefits and side effects matter most to you?

3.
Do you have enough support and advice from others to make a choice?

Certainty

1.
How sure do you feel right now about your decision?

         
Not sure at all
Somewhat sure
Very sure

2.
Check what you need to do before you make this decision.

  • I'm ready to take action.
  • I want to discuss the options with others.
  • I want to learn more about my options.

 

Credits
By Healthwise Staff
Primary Medical Reviewer Sarah Marshall, MD - Family Medicine
Primary Medical Reviewer Kathleen Romito, MD - Family Medicine
Primary Medical Reviewer Martin J. Gabica, MD - Family Medicine
Primary Medical Reviewer Elizabeth T. Russo, MD - Internal Medicine
Specialist Medical Reviewer Divya Gupta, MD - Obstetrics and Gynecology, Gynecologic Oncology

References
Citations
  1. Parker WH (2012). Uterine fibroids. In JS Berek, ed., Berek and Novak's Gynecology, 15th ed., pp. 438–469. Philadelphia: Lippincott Williams and Wilkins.
  2. Parker WH, et al. (2009). Ovarian conservation at the time of hysterectomy and long-term health outcomes in the Nurses' Health Study. Obstetrics and Gynecology, 113(5): 1027–1037.

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