Following your evaluation, we will openly discuss all treatment options available to you. Treatments may involve medical management, non-surgical solutions, or minimally invasive or standard surgery.
Non-surgical therapy
Current medications typically treat only the symptoms of fibroids. However, medications won't help when fibroids are too large or numerous. Medications being developed to permanently shrink fibroids are not yet approved.
An emerging medical treatment for menstrual disorders is Mirena(R). This estrogen-free IUD-like device, implanted in the lining of the uterus, sends out small amounts of hormone that can stop periods for up to five years.
If periods are irregular due to obesity, a bariatric specialist on our team can help you manage your weight and improve your nutrition.
Finally, we offer alternative treatments for problems such as severe cramping, to promote healing and relaxation, and reduce stress. Alternative techniques include acupuncture, massage, Reiki, and yoga for stress reduction and healing. We offer group sessions for women in conjunction with our Wellness Institute .
Surgical options
If surgical intervention is warranted, our specialists are experts in many minimally invasive procedures. We routinely treat complex cases, and are experienced in performing surgery on women who are obese, for whom surgery is risky.
For women who hope to have children
To treat menstrual problems in women who want babies, we can preserve the uterus using hysteroscopic, laparoscopic or abdominal techniques. Learn more:
Hysteroscopic surgery
Once we have examined the uterus with the hysteroscope, we can insert slender instruments through a separate channel to remove fibroids or other abnormal growths. These include endometrial polyps, finger-like growths arising from the uterine lining that can become infected and bleed. Tissue that remains after miscarriage can also trigger bleeding and may be removed hysteroscopically.
Minimally invasive myomectomy
Fibroid removal is known as myomectomy. Our gynecologists are highly skilled at removing difficult-to-access or large numbers of fibroids using minimally invasive methods. Fibroids may be removed hysteroscopically, through a scope inserted into the uterus; laparoscopically, through a scope inserted into the abdomen; or using a robotic laparoscope inserted into the abdomen (the robot streamlines suturing).
In addition, fibroids can be removed through a small incision in the belly, a less invasive form of open surgery called minilaparotomy.
Abdominal myomectomy
When fibroids are too numerous or large, sometimes they must be removed in an open surgical procedure, through a bikini-line incision. The advantage is that the uterus can be repaired in layers, making it as strong as possible for subsequent pregnancies.
For women not interested in having children
Other options can end excessive bleeding without removing the uterus in older women or in younger women who do not want children but are not ready to enter menopause.
Endometrial ablation
In this procedure, which can be done in the office or O.R., a thin layer of the uterine lining is destroyed using one of five equally effective devices. Heat, electrical current, laser energy or cold are applied to the inner walls of the uterus, halting periods.
Uterine fibroid embolization (UFE)
Cleveland Clinic gynecologists collaborate with Cleveland Clinic interventional radiologists on uterine fibroid embolization. This procedure is not for women who wish to conceive because its effects on the strength of the uterus are unknown. The radiologist guides a catheter to arteries that supply the fibroids, then inserts tiny plastic particles to block blood flow. This robs the fibroids of oxygen and nutrients, and the fibroids shrink over a period of months.