Nearly 60% of women undergo hysterectomy (removal of the uterus) for fibroids rather than having a less invasive treatment first, according to a study published last year.This was the focus of a recent review published in theNew England Journal of Medicine, which notes that hysterectomy exposes patients to a higher risk of complications than less-invasive treatments.

Uterine fibroidsare benign growths in the uterus that can cause pain andheavy menstrual bleeding, and in some cases, miscarriages and fertility issues.

“Less invasive treatments can help women recover faster and resume their normal activities more quickly. Additionally, many studies have now shown that there are health benefits to keeping the uterus and the ovaries,” saidShannon Laughlin-Tommaso, MD, MPH, an obstetrician/gynecologist at the Mayo Clinic and coauthor of the paper.

Removing the uterus also increases the risks of cardiovascular disease—because the body stops producing estrogen, which can be heart-protective—as well asdepression,anxiety, and higher mortality, Laughlin-Tommaso said.

And, she said, doctors should talk openly about these risks. “Women contemplating ahysterectomydeserve counseling about these risks since there are other less invasive options for many women with fibroids.”

Hysterectomy: What to Expect on the Day of Surgery

What Exactly Are Uterine Fibroids?

Uterine fibroids are tumors that grow in the wall of the uterus. They are almost always benign and can range in size from apple seeds to grapefruits. Up to 80% of women develop fibroids in their lifetime, with Black women at higher risk.

Fibroids can cause severe pain, heavy bleeding, and evenanemia, though some women may have no symptoms at all, according toNavid Mootabar, MD, an obstetrician/gynecologist at Northern Westchester Hospital in New York State.

While more research is needed, a study published earlier this month in theBritish Medical Journalfound that women who have had uterine fibroids may also have a slightly increased risk of death before age 70 from ovarian and cervical cancers.

Uterine Fibroids

What Other Treatment Options Exist for Fibroids?

In the last few years, the Food and Drug Administration (FDA) has approved two medications—Myfembreeand Oriahnn—to treat uterine fibroids. The drugs stop the symptoms rather than removing the fibroids, and come with warnings about the risk ofblood clots. Other options include procedures that use heat to destroy fibroids,which are far less invasive than a hysterectomy.

When fibroids are found early, they tend to be smaller and easier to treat, which is why women should talk to their doctor about menstrual cramps and heavy periods, saidElizabeth Stewart, MD, a professor of obstetrics and gynecology at the Mayo Clinic and a co-author of the new review.

The likelihood of having fibroids increases as you get older and largely stops duringmenopause, Steward added.

How to Identify and Treat Fibroid Pain

Why Are Doctors More Likely To Opt for Hysterectomy?

Doctors might opt for a hysterectomy first for a number of reasons. For one, this type of surgery removes the risk of future fibroids, and may help you avoid a rare cancer. In other cases, pushing for hysterectomy may be a way of getting through complex treatment decision-making, or providers simply may not know about newer treatment options, said Stewart.

“For example, the two medications to treat fibroids were approved at the height of the pandemic when doctors were incredibly busy,” Stewart said.

But, whether or not to move forward with a hysterectomy should be a discussion with your doctor, not a choice that’s made for you,Veronica Gillispie-Bell, MD, a gynecologist at Ochsner Health in Louisiana, told Verywell.

“We hope that can make doctors more comfortable discussing the range of options with their patients because we know that not all doctors are letting their patients know every treatment that might work for them,” said Gillispie-Bell, who is also a member of an NIH panel looking at how to assess fibroid treatment options for women.

Overview of Fibroids Surgery

How Can You Advocate For Yourself Around Treatment?

Knowing options before the doctor visit helps empower women, said Gillispie-Bell. If you find that you are interested in a treatment option that your doctor is not, get a second opinion. Insurance will typically pay for it, she added.

Hysterectomy: Recovery

What This Means For YouThere are many options for uterine fibroid treatment, though not all options are appropriate for all women. If you have been experiencing heavy periods and pain, talk to your doctor about whether you might have uterine fibroids and all the treatments available to you—not just hysterectomy.

What This Means For You

There are many options for uterine fibroid treatment, though not all options are appropriate for all women. If you have been experiencing heavy periods and pain, talk to your doctor about whether you might have uterine fibroids and all the treatments available to you—not just hysterectomy.

5 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Liao L, Chen L, Melamed A, Hershman DL, Wright JD.Use of conservative therapies before hysterectomy for uterine leiomyomas.Obstet Gynecol. 2023;141(2):371-374. doi:10.1097/AOG.0000000000005053Stewart EA, Laughlin-Tommaso SK.Uterine fibroids.N Engl J Med. 2024;391(18):1721-1733. doi:10.1056/NEJMcp2309623UpToDate.Patient education: uterine fibroids (Beyond the Basics).Department of Health and Human Services Office on Women’s Health.Uterine fibroids.Wang YX, Farland LV, Gaskins AJ, et al.Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study.BMJ. 2024;387:e078797. doi:10.1136/bmj-2023-078797

5 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Liao L, Chen L, Melamed A, Hershman DL, Wright JD.Use of conservative therapies before hysterectomy for uterine leiomyomas.Obstet Gynecol. 2023;141(2):371-374. doi:10.1097/AOG.0000000000005053Stewart EA, Laughlin-Tommaso SK.Uterine fibroids.N Engl J Med. 2024;391(18):1721-1733. doi:10.1056/NEJMcp2309623UpToDate.Patient education: uterine fibroids (Beyond the Basics).Department of Health and Human Services Office on Women’s Health.Uterine fibroids.Wang YX, Farland LV, Gaskins AJ, et al.Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study.BMJ. 2024;387:e078797. doi:10.1136/bmj-2023-078797

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

Liao L, Chen L, Melamed A, Hershman DL, Wright JD.Use of conservative therapies before hysterectomy for uterine leiomyomas.Obstet Gynecol. 2023;141(2):371-374. doi:10.1097/AOG.0000000000005053Stewart EA, Laughlin-Tommaso SK.Uterine fibroids.N Engl J Med. 2024;391(18):1721-1733. doi:10.1056/NEJMcp2309623UpToDate.Patient education: uterine fibroids (Beyond the Basics).Department of Health and Human Services Office on Women’s Health.Uterine fibroids.Wang YX, Farland LV, Gaskins AJ, et al.Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study.BMJ. 2024;387:e078797. doi:10.1136/bmj-2023-078797

Liao L, Chen L, Melamed A, Hershman DL, Wright JD.Use of conservative therapies before hysterectomy for uterine leiomyomas.Obstet Gynecol. 2023;141(2):371-374. doi:10.1097/AOG.0000000000005053

Stewart EA, Laughlin-Tommaso SK.Uterine fibroids.N Engl J Med. 2024;391(18):1721-1733. doi:10.1056/NEJMcp2309623

UpToDate.Patient education: uterine fibroids (Beyond the Basics).

Department of Health and Human Services Office on Women’s Health.Uterine fibroids.

Wang YX, Farland LV, Gaskins AJ, et al.Endometriosis and uterine fibroids and risk of premature mortality: prospective cohort study.BMJ. 2024;387:e078797. doi:10.1136/bmj-2023-078797

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