There are many treatment options, both medical and surgical, which can help to relieve the symptoms of fibroids.

The choice of treatment will depend on a number of factors such as:

• Age 
  
• Type of symptoms 
  
• Severity of symptoms 
  
• Size, extent and type of fibroid 
  
• Desire to have children
  

Patients need to discuss with their doctor the best treatment option(s) for them.

No Treatment – if the fibroids are small and are not causing any symptoms, they may be left untreated. However, it is important to regularly review this option depending on whether symptoms start to appear.

Analgesics – pain is not a major symptom. However for women with mild pain, the use of simple, over the counter analgesics such as paracetamol/acetaminophen or non-steroidal anti-inflammatory drugs e.g. ibuprofen may provide relief. If these are not effective there are stronger analgesics that can be prescribed by the doctor.

Iron – since fibroids can lead to the loss of a lot of blood during menstruation, iron deficiency anaemia can develop. Taking daily doses of iron e.g. ferrous sulphate tablets can treat this.

Hormonal Treatments – these provide symptom relief by reducing the levels or decreasing the effect of oestrogen, in order to prevent ovulation. Some of these treatments also prevent the fibroid from growing and allows them to shrink.

Hormonal treatments are generally only effective while they are being taken. Once treatment stops, symptoms usually return.

There are a number of hormonal treatment options:

• Oral Contraceptives (The Pill) - which prevent ovulation and reduce bleeding. 
  
• Progesterone preparations e.g. medroxyprogesterone acetate (MPA) – which acts in a similar way to the Pill 
  
• Gonadotrophin Releasing Hormone analogues (GnRHa’s) e.g. goserelin (ZOLADEX), which is given as an injection either once a month or once every 3 months. They tend to be used prior to surgery. They reduce the levels of oestrogen and reduce the size of the uterus as well as reducing bleeding. They therefore improve anaemia and make surgery easier. 
  
• Male hormones e.g. danazol – which lower oestrogen levels.
  

Surgery – this is usually the best option for women with large fibroids or severe symptoms. This can be achieved by:

• Myomectomy – where the fibroid is cut out from the healthy tissue. This has the benefit that the uterus is retained. Therefore, the ability to become pregnant is maintained. However, new fibroids may develop and further surgery may be necessary.
  
• Uterine Artery Embolisation – this does not require major surgery. However, it does involve making a small cut in a blood vessel in the groin and then passing a very thin catheter into this blood vessel. This is guided to an artery (blood vessel) that supplies the fibroid. This blood vessel is then blocked off and the fibroid shrinks. This is a relatively new method of treatment and the long-term results are awaited. 
  
• Hysterectomy – this is the complete surgical removal of uterus. This is the most effective treatment for fibroids, since there is no possibility that fibroids can grow again. However, it is a major operation and means that women can no longer become pregnant.
  

Combination Therapy – combining both hormonal therapy (e.g. goserelin) to reduce the size and amount of tissue followed by surgery to remove the tissue can be a useful treatment option.

Patients need to discuss with their doctor the best treatment option(s) for them.