What Is the Best Treatment for Uterine Fibroids?

She came into the clinic with a smile that couldn’t hide her exhaustion.
Her words tumbled out: “I bled for ten days. I’m tired all the time. My stomach looks swollen, but I’m not pregnant.”

When she was examined, the cause was clear: uterine fibroids.
She isn’t alone. Nearly one in four Indian women between 30 and 50 lives with fibroids, many without even knowing it until the symptoms start controlling their lives.

The good news?
Fibroids are treatable, completely and safely. The challenge lies in choosing the right uterine fibroids treatment for your body, age, and goals.

What People Don’t Know About Uterine Fibroids

Uterine fibroids (also called leiomyomas) are non-cancerous growths made of muscle and connective tissue, growing within or around the uterus. They can be microscopic or massive — sometimes a few millimetres, sometimes large enough to press on the bladder or bowel.

They are classified by where they appear:

• Intramural fibroids: in the muscular wall of the uterus
• Submucosal fibroids: just beneath the inner lining, often causing heavy bleeding
• Subserosal fibroids: on the outer surface, causing pressure symptoms

While hormones like estrogen and progesterone encourage fibroid growth, genetics and lifestyle play a role, too. Women who are overweight, have a family history, or delay pregnancy are slightly more prone.

Common symptoms

• Heavy or prolonged periods
• Clots during menstruation
• Pelvic or back pain
• Abdominal bloating or pressure
• Frequent urination
• Difficulty conceiving

I have experience where patients never present any symptoms, but the uterine fibroids are seen during a scan.

How Uterine Fibroid Treatment Is Decided

That’s why there isn’t a universal “best treatment for fibroids.”

When I create a treatment plan, I consider:

1. Size, number, and position of fibroids
2. Severity of symptoms
3. Age and hormonal stage (reproductive vs perimenopausal)
4. Fertility goals
5. General health and preferences

The right approach could mean medical management, minimally invasive procedures, or surgery. 

Medical Treatment of Fibroid: For Early or Mild Cases

When fibroids are small and symptoms are tolerable, medication can help control pain and bleeding and sometimes shrink fibroids temporarily.

a) Hormone-regulating therapy

These medications reduce the hormones that feed fibroids.

• GnRH agonists (e.g., Leuprolide): Temporarily lower estrogen, shrinking fibroids before surgery or menopause.
• Progestin-releasing IUDs: Control heavy bleeding and cramps.
• Combined oral pills: Regulate cycles, lessen flow.

b) Non-hormonal options

• Tranexamic acid: Reduces heavy menstrual bleeding.
• NSAIDs (Ibuprofen, Mefenamic acid): Ease cramps and pain.

Best for: Small fibroids, mild symptoms, or women nearing menopause.
Limitation: Temporary relief; fibroids can grow again.

Minimally Invasive Procedures: When You Want Results Without Major Surgery

For women who need stronger results but want to preserve their uterus, minimally invasive procedures bridge the gap beautifully.

a) Laparoscopic Myomectomy

A keyhole surgery that removes fibroids through tiny incisions using a camera and advanced instruments.

It’s often the best treatment for large fibroids in women who wish to conceive.

Benefits:

• Uterus preserved
• Smaller scars, faster healing (2–3 days hospital stay)
• Lower risk of infection
• Quicker return to work

Most women resume normal life within a week, something that was unimaginable with older open surgeries.

b) Hysteroscopic Myomectomy

For fibroids growing inside the uterine cavity, we use a thin telescope (hysteroscope) inserted through the vagina.

No external cut, no stitches.
Ideal for submucosal fibroids that cause heavy periods or fertility issues.

Why women love it:

• Same-day procedure
• Minimal discomfort
• Improves fertility outcomes

c) Uterine Artery Embolization (UAE)

Performed by an interventional radiologist, UAE blocks the blood flow feeding fibroids, causing them to shrink gradually.

It’s effective for multiple or large fibroids when you want to avoid surgery.
Some women experience cramping post-procedure, but recovery is usually within a week.

Caution: Slight impact on future pregnancy chances, so it’s recommended mainly for women who’ve completed their family.

d) MRI-Guided Focused Ultrasound (MRgFUS)

The newest, completely non-surgical method.
Focused ultrasound waves heat and destroy fibroid tissue under MRI guidance.

Surgical Options: For Severe Symptoms or Very Large Fibroids

When fibroids dominate the uterus, cause severe bleeding, or resist conservative care, surgery offers lasting relief.

a) Myomectomy (Conventional or Laparoscopic)

Removes fibroids while preserving the uterus.
Depending on size and number, it may be laparoscopic, hysteroscopic, or open (for massive fibroids).

It’s safe and effective for women planning a future pregnancy.
However, fibroids can regrow later, so follow-ups are essential.

b) Hysterectomy — Permanent Relief

When symptoms are extreme, fibroids keep returning, or the uterus is severely enlarged, a laparoscopic or vaginal hysterectomy may be the best solution.

It completely removes the uterus — and with it, fibroids and menstrual bleeding.
Recovery is smooth with minimally invasive methods (usually 2–3 weeks).

For women done with childbirth, this is often life-changing.
They describe it as “finally feeling light again.”

Lifestyle & Natural Support: Strengthening Your Body After Treatment

While no diet or yoga pose can dissolve fibroids, lifestyle plays a crucial role in prevention and recovery.

Eat Smart

• Prioritize fiber-rich foods — fruits, veggies, whole grains.
  
• Limit red meat and processed foods.
  
• Include iron-rich foods (spinach, lentils, dates) to combat anemia.
  
• Maintain vitamin D levels — deficiency increases fibroid risk.
  

Stay Active

Regular movement balances hormones and improves blood flow. Even 30 minutes of brisk walking helps.

Manage Stress

High stress raises cortisol and indirectly disturbs hormonal balance. Breathing exercises, meditation, or yoga can calm your system and support healing.

How to choose the right uterine fibroid treatment?

Here’s how I usually guide my patients:

When must you consult a doctor about uterine fibroids?

Please don’t normalise any of these:

• Periods lasting longer than 7 days
• Passing large clots
• Painful cramps that affect work
• Constant pelvic pressure or bloating
• Difficulty getting pregnant

Early diagnosis means more choices and simpler procedures. 

Waiting only makes fibroids grow larger and treatment more complex.

FAQs on Fibroid Treatment

1. Can fibroids disappear on their own?

Some shrink after menopause when hormones drop, but most persist without treatment.

2. What’s the best treatment for large fibroids?

Laparoscopic myomectomy or Uterine Artery Embolization usually deliver the best balance between relief and recovery.

3. Will fibroids return after treatment?

They can, especially after myomectomy. Regular follow-up scans and hormone management help prevent recurrence.

4. Is hysterectomy safe?

Yes. When done laparoscopically, it’s one of the safest gynaecologic surgeries with quick recovery and minimal scarring.

5. Can I get pregnant after fibroid removal?

Absolutely. In fact, removing fibroids that distort the uterus often improves fertility and reduces miscarriage risk.

A Word from Dr. Pankhuri

I often tell my patients:
“Fibroids may be common, but suffering isn’t normal.”

You don’t have to keep adjusting your life around your periods.
Whether you need medication, a minimally invasive procedure, or surgery, today’s treatments are precise, uterus-preserving, and tailored to you.

If you’ve been living with heavy bleeding, fatigue, or pelvic pain, don’t wait for it to get unbearable. The earlier we intervene, the simpler the fibroid treatment and the faster the recovery.