Small Uterine Fibroids: Treatment Options & Management

Management of small uterine fibroids depends on symptoms, fertility desires, and patient preference.

1. Watchful Waiting

Asymptomatic fibroids: regular monitoring via pelvic exams and ultrasound to track growth.

2. Medications

• NSAIDs (ibuprofen, naproxen): Pain relief.
• Oral contraceptives: Regulate cycles, reduce bleeding, alleviate pain.
• GnRH agonists: Temporarily suppress estrogen/progesterone → shrink fibroids (short-term use due to side effects).
• SPRMs (e.g., ulipristal): Block progesterone receptors; control growth and bleeding.

3. Minimally Invasive Procedures

• Uterine Artery Embolization (UAE): Blocks blood supply → fibroids shrink.
• Focused Ultrasound Surgery (FUS): Non-invasive; ultrasound waves destroy fibroids.
• Myomectomy: Surgical removal preserving uterus; preferred for fertility.

4. Hysterectomy

Definitive treatment; removes uterus. Considered for severe, refractory symptoms when childbearing is complete.

Decision-Making

Discuss with your gynecologist: symptom severity, fertility goals, risks/benefits of each option, and personal values.