About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all women with fibroids have symptoms. Women who do have symptoms often find fibroids hard to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.

Uterine Fibroids & Women’s Health

More on Uterine Fibroids & Women's Health

Uterine Fibroids: Overview

What are uterine fibroids?

Uterine fibroids are growths made of smooth muscle cells and other tissue that develop within the wall of the uterus.

Fibroids may grow as a single tumor or in clusters. A single fibroid can be microscopic in size or can grow to eight inches or more across. In many cases, a single uterus can contain many fibroids. Most fibroids range from about the size of a large marble to slightly smaller than a baseball.¹

Bunches or clusters of fibroids are often of different sizes. Not all fibroids grow, and some may shrink, or remain constant over time.²

Health care providers categorize fibroids based on where in the uterine wall they grow:

• Submucosal (pronounced sub-­myoo-­KOH­-sul) fibroids grow just underneath the uterine lining and into the endometrial cavity.

• Intramural (pronounced in­tra­-MYUR­-ul) fibroids grow in between the muscles of the uterus.

• Subserosal (pronounced sub-­sur­-OH-­sul) fibroids grow on the outside of the uterus.

Some fibroids grow on stalks that grow out from the surface of the uterus or into the cavity of the uterus. These are called pedunculated (pronounced ped­-UN-­kyoo-­lay­-ted) fibroids.

What are the symptoms of uterine fibroids?

?Uterine fibroids can cause uncomfortable or sometimes painful symptoms, such as:

1. Heavy bleeding or painful periods
2. Anemia
3. Bleeding between periods
4. Feeling “full” in the lower abdomen (belly)—this is sometimes called “pelvic pressure”
5. Frequent urination (caused by a fibroid pressing on the bladder)
6. Pain during sex
7. Lower back pain
8. Reproductive problems, such as infertility, multiple miscarriages, and early onset of labor during pregnancy
9. Obstetrical problems, such as increased likelihood of cesarean section

Many women have no symptoms of fibroids.

How many people are affected by or at risk of uterine fibroids?

How many women are affected by uterine fibroids?

One study found that between 80% and 90% of African American women and 70% of white women will develop fibroids by age 50.

Some may have no symptoms. However, hundreds of thousands of women seek treatment for fibroids each year.

Research shows that over 90% of women who are newly diagnosed with fibroids will seek medical or surgical treatment for the condition within a year of the diagnosis. In 2000, more than 250,000 hospital admissions were related to uterine fibroids. Every year, fibroids lead to more than 200,000 hysterectomies. Women  who wish to have children have the option of myomectomy, a surgical procedure that removes the fibroids while leaving the uterus intact.

Which women are at risk of uterine fibroids?

Fibroids usually grow in women of childbearing age. Among U.S. women ages 25 to 44, about 30% have symptoms of fibroids. Affected African American women are more likely to have multiple fibroids. We don't know exactly how many new cases of fibroids occur in a year, as fibroids may not cause any symptoms, but clearly millions of American women have fibroids at any one time.

There have been reports of rare cases in which young girls, who have not yet started their periods (pre­pubertal), had small fibroids. For African American women, fibroids typically develop at a younger age, grow larger, and cause more severe symptoms.

Fibroids may shrink after menopause. However, research shows that they are more likely to shrink in postmenopausal white women than in premenopausal black women.

Several factors affect a woman's risk for having uterine fibroids.

Factors that increase the risk of fibroids:

1. Age older than 40 years
2. African American race
3. Obesity
4. Family history of uterine fibroids
5. High blood pressure
6. No history of pregnancy
7. Low levels of vitamin D

Factors that lower the risk of fibroids:

• Pregnancy (the risk decreases with increasing number of pregnancies)

• Long-term use of progestin-only birth control pills or oral contraceptives

• Use of the birth control shot (depot medroxyprogesterone acetate [DMPA], or Depo-Provera®)

Figure 1. Graph showing black and white women's chances of having more than one fibroid (leiomyoma), by age. Black women's risk of fibroids is about three times that of white women. The disparity increases with age. For example, in women younger than age 30, the risk of having more than one uterine fibroid is slightly higher than 20% for blacks and slightly less than 20% for whites. Black women's risk of having more than one uterine fibroid continues to increase with age, while white women's risk remains around 20%.

What causes uterine fibroids?

We don't know what causes uterine fibroids. Scientists have a number of theories, but none of these ideas explains fibroids completely.

Some factors researchers believed to be related to fibroid growth are:

1. Estrogen
2. Progesterone
3. Growth hormones
4. Genetic changes
5. Misplaced cells present in the body before birth

Other factors that may affect fibroid growth are:

• Quantity of micronutrients—nutrients such as iron that the body needs only small amounts of — in the blood. For instance, a deficiency of vitamin D may be associated with uterine fibroids.

• Major stresses

It is likely that fibroids are caused by many factors interacting with one another. Once we know the cause or causes of fibroids, our efforts to find a cure or even prevent fibroids could move ahead more quickly.

How are uterine fibroids diagnosed?

Unless you have symptoms, you probably won’t know that you have uterine fibroids.

Sometimes, health care providers find fibroids during a routine gynecological exam. During this exam, the health care provider checks the size of your uterus by putting two fingers of one hand into the vagina while using the other hand to press lightly on your abdomen. If you have fibroids, your uterus may feel larger than normal or it may feel irregularly shaped. But even small fibroids in the uterus may cause considerable symptoms and heavy periods leading to anemia. Smaller fibroids which can’t be found through a routine manual examination can be detected with ultrasound.

If your health care provider thinks you have fibroids, he or she may use one or more types of imaging technology—machines that create a picture of the inside of your body—to confirm the diagnosis.

Some common types of imaging technology are:

1. Ultrasound, which uses sound waves to form the picture
2. Saline infusion sonography, which uses an injection of salt solution into the uterus to help create the ultrasound image
3. Magnetic resonance imaging (MRI), which uses magnets and radio waves to create the picture
4. X-­rays, which use a form of electromagnetic radiation to “see” into the body
5. Computed tomography (CT) or computer-assisted tomography (also called a “CAT” scan), which scans the body with X-rays from many angles to create a more complete picture

What are the treatments for uterine fibroids?

There are medical treatments, surgical treatments, and radiological treatments for uterine fibroids. This page also includes information about emotional support for living with fibroids.

Your health care provider will consider a number of things before recommending treatment for your fibroids, including:

1. Your age
2. Your general health
3. The severity of your symptoms
4. The location of the fibroids
5. The type and size of the fibroids
6. Whether you are pregnant now or want to get pregnant in the future

If you have uterine fibroids but have no symptoms or problems, you may not need treatment. Each year, your health care provider will check the fibroids at your routine gynecological exam to see if they have grown. If you are close to menopause, your health care provider may find that your fibroids are shrinking, which is common during and after menopause.

Medical Treatments for Fibroids

Your health care provider may suggest medical treatments to reduce the symptoms of fibroids or to stop the growth of fibroids. These treatments are less invasive than surgery. However, if the medical treatments are not helpful, then surgery is often recommended. Certain medical treatments to reduce fibroid size and blood loss may be used to help the surgery succeed.

Common medical treatments for fibroids include:

1. Pain medication. Over-the-counter or prescription medication is often used for mild or occasional pain from fibroids.
2. Birth control pills or other types of hormonal birth control. These medications control heavy bleeding and painful periods. However, this therapy can sometimes cause fibroids to grow larger.
3. Progestin-releasing intrauterine device (IUD). The IUD, also called intrauterine contraception (IUC), reduces heavy and painful bleeding but does not treat the fibroids themselves. It is not recommended for women whose fibroids result in an extremely large uterine cavity.
4. Gonadotropin-releasing hormone agonists (GnRHa). These medications block the body from making the hormones that cause women to ovulate and have their periods. The medications also reduce the size of fibroids. Because this treatment can cause side effects that mimic the symptoms of menopause (such as hot flashes, night sweats, and vaginal dryness) and bone loss (which weakens the bones), it is not meant for long-term use. Most of the time, these medications are used for a short time to reduce the size of fibroids prior to surgery, or to treat anemia. If you need to take this treatment for a long time, the doctor may prescribe medication to put back the hormones that were blocked.
5. Antihormonal agents. These drugs, which include mifepristone, can slow or stop the growth of fibroids, but the U.S. Food and Drug Administration has not approved their use for treating fibroids.

Medical treatments may give only temporary relief from the symptoms of fibroids. Once you stop the treatment, fibroids often grow back and symptoms return.

Medications are generally safe, but they can have side effects, some of which may be serious. Be sure to talk to your health care provider about the possible side effects of any medical treatment you consider.

1. Evans, P., & Brunsell, S. (2007). Uterine fibroid tumors: Diagnosis and treatment. American Family Physician 75(10), 1503-1508.

Surgical Treatments for Fibroids

Emotional Support for Living with Fibroids

Emotional support may be just as important as medical treatment for dealing with the chronic symptoms and potential reproductive problems associated with fibroids. Many women find that joining a support group and talking to other women who have fibroids helps them come to terms with their condition.

Hospitals and health clinics may offer support groups for women and families affected by fibroids. Your health care provider may be able to refer you to a support group. You may also find it helpful to work with a “professional listener,” such as a social worker, a psychologist, a psychiatrist, or another mental health professional.

Uterine Fibroids: Other FAQs

Basic information for topics, such as “What is it?” and “How many people are affected?” is available in the Condition Information section. In addition, Frequently Asked Questions (FAQs) that are specific to a certain topic are answered in this section.

If I have uterine fibroids, can I still get pregnant?

If I have fibroids, will I need a hysterectomy?

Do uterine fibroids lead to cancer?

Do uterine fibroids ever go away without treatment?

If I have uterine fibroids, can I still get pregnant?

If you have fibroids, you may still be able to get pregnant. Many women who have fibroids get pregnant naturally. Advances in treatments for fibroids and for infertility have greatly improved the chances for a woman to conceive. If you have fibroids and wish to become pregnant, it is wise to consult with a knowledgeable provider about the location of the fibroids and possible related problems with pregnancy or growth of a baby in the womb.

However, some women with fibroids do have trouble getting pregnant. Current research suggests that submucosal and intramural fibroids—fibroids that change the shape and size of the uterine cavity—seem to affect a woman's ability to get pregnant, even with in vitro fertilization. These fibroids may reduce fertility by as much as 70%. However, if the fibroid is treated, fertility may be restored.

Fibroids can also cause pregnancy complications, such as miscarriage, preterm delivery, abnormal position of the fetus, and the need for cesarean (C-section or surgical) delivery. Fibroids can also increase the risk of heavy bleeding after delivery.

If I have fibroids, will I need a hysterectomy?

Hysterectomy (pronounced hiss-tur-EK-toh-mee) is the removal of the uterus. It is the only certain cure for uterine fibroids. But it is not the only treatment option, and it is not the best treatment for every woman with fibroids.

If you want to have children, talk to your doctor about other treatments before having a hysterectomy. If your fibroids are small or if you have minor or no symptoms of fibroids, medical treatments may be effective. Surgical procedures that remove the fibroids without removing the uterus are almost always possible.

Do uterine fibroids lead to cancer?

Uterine fibroids are not cancerous. Less than one in a thousand cases of fibroids develop into cancer.¹

In a very small number of patients with a condition called hereditary leiomyomatosis and renal cell cancer (HLRCC), the fibroids are linked to kidney cancer. However, this association is not seen in women who do not have HLRCC.²

1. Levy, B., Mukherjee, T., & Hirschhorn, K. (2000). Molecular cytogenetic analysis of uterine leiomyoma and leiomyosarcoma by comparative genomic hybridization. Cancer Genetics and Cytogenetics 121(1), 1­8.

2. Berger, L. (2008, October 23). A Decade of Developments in Fibroid Research. New York Times. Retrieved from http://www.nytimes.com/ref/health/healthguide/esn-fibroids-expert.html .

Do uterine fibroids ever go away without treatment?

In most cases, fibroids stop growing or they shrink without treatment. Once a woman goes through menopause, but this is not true for all women. Interestingly, each of a woman's fibroids may grow or shrink at different times.

Some studies have suggested a link between uterine fibroids and the hormone replacement therapy (HRT) used to reduce the symptoms of menopause, but the nature of this relationship is still unclear.¹ More research is needed on this topic.

1. Berger, L. (2008, October 23). A Decade of Developments in Fibroid Research. New York Times. Retrieved from http://www.nytimes.com/ref/health/healthguide/esn-fibroids-expert.html .

Uterine Fibroids: NICHD Research Information

Uterine Fibroids: For Patients and Consumers

Uterine Fibroids: For Researchers and Health Care Providers

Source: NICHD, NIH

1. What are fibroids?
2. Why should women know about fibroids?
3. Who gets fibroids?
4. Where can fibroids grow?
5. What are the symptoms of fibroids?
6. What causes fibroids?
7. Can fibroids turn into cancer?
8. What if I become pregnant and have fibroids?
9. How do I know for sure that I have fibroids?
10. What questions should I ask my doctor if I have fibroids?
11. How are fibroids treated?
12. What new treatments are available for uterine fibroids?
13. More information on uterine fibroids

What are fibroids?

Fibroids are muscular tumors that grow in the wall of the uterus (womb). Another medical term for fibroids is "leiomyoma" (leye-oh-meye-OH-muh) or just "myoma". Fibroids are almost always benign (not cancerous). Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large.

Why should women know about fibroids?

About 20 percent to 80 percent of women develop fibroids by the time they reach age 50. Fibroids are most common in women in their 40s and early 50s. Not all women with fibroids have symptoms. Women who do have symptoms often find fibroids hard to live with. Some have pain and heavy menstrual bleeding. Fibroids also can put pressure on the bladder, causing frequent urination, or the rectum, causing rectal pressure. Should the fibroids get very large, they can cause the abdomen (stomach area) to enlarge, making a woman look pregnant.

Who gets fibroids?

There are factors that can increase a woman's risk of developing fibroids.

• Age. Fibroids become more common as women age, especially during the 30s and 40s through menopause. After menopause, fibroids usually shrink.

• Family history. Having a family member with fibroids increases your risk. If a woman's mother had fibroids, her risk of having them is about three times higher than average.

• Ethnic origin. African-American women are more likely to develop fibroids than white women.

• Obesity. Women who are overweight are at higher risk for fibroids. For very heavy women, the risk is two to three times greater than average.

• Eating habits. Eating a lot of red meat (e.g., beef) and ham is linked with a higher risk of fibroids. Eating plenty of green vegetables seems to protect women from developing fibroids.

Where can fibroids grow?

Most fibroids grow in the wall of the uterus. Doctors put them into three groups based on where they grow:

• Submucosal (sub-myoo-KOH-zuhl) fibroids grow into the uterine cavity.

• Intramural (ihn-truh-MYOOR-uhl) fibroids grow within the wall of the uterus.

• Subserosal (sub-suh-ROH-zuhl) fibroids grow on the outside of the uterus.

Some fibroids grow on stalks that grow out from the surface of the uterus or into the cavity of the uterus. They might look like mushrooms. These are called pedunculated (pih-DUHN-kyoo-lay-ted) fibroids.

What are the symptoms of fibroids?

Most fibroids do not cause any symptoms, but some women with fibroids can have:

1. Heavy bleeding (which can be heavy enough to cause anemia) or painful periods
2. Feeling of fullness in the pelvic area (lower stomach area)
3. Enlargement of the lower abdomen
4. Frequent urination
5. Pain during sex
6. Lower back pain
7. Complications during pregnancy and labor, including a six-time greater risk of cesarean section
8. Reproductive problems, such as infertility, which is very rare

What causes fibroids?

No one knows for sure what causes fibroids. Researchers think that more than one factor could play a role. These factors could be:

• Hormonal (affected by estrogen and progesterone levels)

• Genetic (runs in families)

Because no one knows for sure what causes fibroids, we also don't know what causes them to grow or shrink. We do know that they are under hormonal control — both estrogen and progesterone. They grow rapidly during pregnancy, when hormone levels are high. They shrink when anti-hormone medication is used. They also stop growing or shrink once a woman reaches menopause.

Can fibroids turn into cancer?

Fibroids are almost always benign (not cancerous). Rarely (less than one in 1,000) a cancerous fibroid will occur. This is called leiomyosarcoma (leye-oh-meye-oh-sar-KOH-muh). Doctors think that these cancers do not arise from an already-existing fibroid. Having fibroids does not increase the risk of developing a cancerous fibroid. Having fibroids also does not increase a woman's chances of getting other forms of cancer in the uterus.

What if I become pregnant and have fibroids?

Women who have fibroids are more likely to have problems during pregnancy and delivery. This doesn't mean there will be problems. Most women with fibroids have normal pregnancies. The most common problems seen in women with fibroids are:

1. Cesarean section. The risk of needing a c-section is six times greater for women with fibroids.
2. Baby is breech. The baby is not positioned well for vaginal delivery.
3. Labor fails to progress.
4. Placental abruption. The placenta breaks away from the wall of the uterus before delivery. When this happens, the fetus does not get enough oxygen.
5. Preterm delivery.

Talk to your obstetrician if you have fibroids and become pregnant. All obstetricians have experience dealing with fibroids and pregnancy. Most women who have fibroids and become pregnant do not need to see an OB who deals with high-risk pregnancies.

How do I know for sure that I have fibroids?

Your doctor may find that you have fibroids when you see her or him for a regular pelvic exam to check your uterus, ovaries, and vagina. The doctor can feel the fibroid with her or his fingers during an ordinary pelvic exam, as a (usually painless) lump or mass on the uterus. Often, a doctor will describe how small or how large the fibroids are by comparing their size to the size your uterus would be if you were pregnant. For example, you may be told that your fibroids have made your uterus the size it would be if you were 16 weeks pregnant. Or the fibroid might be compared to fruits, nuts, or a ball, such as a grape or an orange, an acorn or a walnut, or a golf ball or a volleyball.

Your doctor can do imaging tests to confirm that you have fibroids. These are tests that create a "picture" of the inside of your body without surgery. These tests might include:

1. Ultrasound – Uses sound waves to produce the picture. The ultrasound probe can be placed on the abdomen or it can be placed inside the vagina to make the picture.
2. Magnetic resonance imaging (MRI) – Uses magnets and radio waves to produce the picture
3. X-rays – Uses a form of radiation to see into the body and produce the picture
4. Cat scan (CT) – Takes many X-ray pictures of the body from different angles for a more complete image
5. Hysterosalpingogram (hiss-tur-oh-sal-PIN-juh-gram) (HSG) or sonohysterogram (soh-noh-HISS-tur-oh-gram) – An HSG involves injecting x-ray dye into the uterus and taking x-ray pictures. A sonohysterogram involves injecting water into the uterus and making ultrasound pictures.

You might also need surgery to know for sure if you have fibroids. There are two types of surgery to do this:

• Laparoscopy (lap-ar-OSS-koh-pee) – The doctor inserts a long, thin scope into a tiny incision made in or near the navel. The scope has a bright light and a camera. This allows the doctor to view the uterus and other organs on a monitor during the procedure. Pictures also can be made.

• Hysteroscopy (hiss-tur-OSS-koh-pee) – The doctor passes a long, thin scope with a light through the vagina and cervix into the uterus. No incision is needed. The doctor can look inside the uterus for fibroids and other problems, such as polyps. A camera also can be used with the scope.

What questions should I ask my doctor if I have fibroids?

1. How many fibroids do I have?
2. What size is my fibroid(s)?
3. Where is my fibroid(s) located (outer surface, inner surface, or in the wall of the uterus)?
4. Can I expect the fibroid(s) to grow larger?
5. How rapidly have they grown (if they were known about already)?
6. How will I know if the fibroid(s) is growing larger?
7. What problems can the fibroid(s) cause?
8. What tests or imaging studies are best for keeping track of the growth of my fibroids?
9. What are my treatment options if my fibroid(s) becomes a problem?
10. What are your views on treating fibroids with a hysterectomy versus other types of treatments?
11. A second opinion is always a good idea if your doctor has not answered your questions completely or does not seem to be meeting your needs.

How are fibroids treated?

Most women with fibroids do not have any symptoms. For women who do have symptoms, there are treatments that can help. Talk with your doctor about the best way to treat your fibroids. She or he will consider many things before helping you choose a treatment. Some of these things include:

1. Whether or not you are having symptoms from the fibroids
2. If you might want to become pregnant in the future
3. The size of the fibroids
4. The location of the fibroids
5. Your age and how close to menopause you might be

If you have fibroids but do not have any symptoms, you may not need treatment. Your doctor will check during your regular exams to see if they have grown.

Medications
If you have fibroids and have mild symptoms, your doctor may suggest taking medication. Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain. If you have heavy bleeding during your period, taking an iron supplement can keep you from getting anemia or correct it if you already are anemic.

Several drugs commonly used for birth control can be prescribed to help control symptoms of fibroids. Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The same is true of progesterone-like injections (e.g., Depo-Provera®). An IUD (intrauterine device) called Mirena® contains a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.

Other drugs used to treat fibroids are "gonadotropin releasing hormone agonists" (GnRHa). The one most commonly used is Lupron®. These drugs, given by injection, nasal spray, or implanted, can shrink your fibroids. Sometimes they are used before surgery to make fibroids easier to remove. Side effects of GnRHas can include hot flashes, depression, not being able to sleep, decreased sex drive, and joint pain. Most women tolerate GnRHas quite well. Most women do not get a period when taking GnRHas. This can be a big relief to women who have heavy bleeding. It also allows women with anemia to recover to a normal blood count. GnRHas can cause bone thinning, so their use is generally limited to six months or less. These drugs also are very expensive, and some insurance companies will cover only some or none of the cost. GnRHas offer temporary relief from the symptoms of fibroids; once you stop taking the drugs, the fibroids often grow back quickly.

Surgery
If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them. Here are the options:

1. Myomectomy (meye-oh-MEK-tuh-mee) – Surgery to remove fibroids without taking out the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or who wish to keep their uterus for other reasons. You can become pregnant after myomectomy. But if your fibroids were imbedded deeply in the uterus, you might need a cesarean section to deliver. Myomectomy can be performed in many ways. It can be major surgery (involving cutting into the abdomen) or performed with laparoscopy or hysteroscopy. The type of surgery that can be done depends on the type, size, and location of the fibroids. After myomectomy new fibroids can grow and cause trouble later. All of the possible risks of surgery are true for myomectomy. The risks depend on how extensive the surgery is.
2. Hysterectomy (hiss-tur-EK-tuh-mee) – Surgery to remove the uterus. This surgery is the only sure way to cure uterine fibroids. Fibroids are the most common reason that hysterectomy is performed. This surgery is used when a woman's fibroids are large, if she has heavy bleeding, is either near or past menopause, or does not want children. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may be able to reach the uterus through the vagina, instead of making a cut in the abdomen. In some cases hysterectomy can be performed through the laparoscope. Removal of the ovaries and the cervix at the time of hysterectomy is usually optional. Women whose ovaries are not removed do not go into menopause at the time of hysterectomy. Hysterectomy is a major surgery. Although hysterectomy is usually quite safe, it does carry a significant risk of complications. Recovery from hysterectomy usually takes several weeks.
3. Endometrial Ablation (en-doh-MEE-tree-uhl uh-BLAY-shuhn) – The lining of the uterus is removed or destroyed to control very heavy bleeding. This can be done with laser, wire loops, boiling water, electric current, microwaves, freezing, and other methods. This procedure usually is considered minor surgery. It can be done on an outpatient basis or even in a doctor's office. Complications can occur, but are uncommon with most of the methods. Most people recover quickly. About half of women who have this procedure have no more menstrual bleeding. About three in 10 women have much lighter bleeding. But, a woman cannot have children after this surgery.
4. Myolysis (meye-OL-uh-siss) – A needle is inserted into the fibroids, usually guided by laparoscopy, and electric current or freezing is used to destroy the fibroids.
5. Uterine Fibroid Embolization (UFE), or Uterine Artery Embolization (UAE) – A thin tube is thread into the blood vessels that supply blood to the fibroid. Then, tiny plastic or gel particles are injected into the blood vessels. This blocks the blood supply to the fibroid, causing it to shrink. UFE can be an outpatient or inpatient procedure. Complications, including early menopause, are uncommon but can occur. Studies suggest fibroids are not likely to grow back after UFE, but more long-term research is needed. Not all fibroids can be treated with UFE.
   
   The best candidates for UFE are women who:

• Have fibroids that are causing heavy bleeding
• Have fibroids that are causing pain or pressing on the bladder or rectum
• Don't want to have a hysterectomy
• Don't want to have children in the future

What new treatments are available for uterine fibroids?

The following methods are not yet standard treatments, so your doctor may not offer them or health insurance may not cover them.

• Radiofrequency ablation uses heat to destroy fibroid tissue without harming surrounding normal uterine tissue. The fibroids remain inside the uterus but shrink in size. Most women go home the same day and can return to normal activities within a few days.

• Anti-hormonal drugs may provide symptom relief without bone-thinning side effects.