Uterine fibroids are benign (not cancerous) growths in the uterine wall. They can appear as a single fibroid or as a cluster, and can range in size from smaller than the head of a pin to bigger than a watermelon.
Fibroids—also referred to as leiomyomas—are fairly common. They affect up to 80% of people with uteruses by 50 years of age.
In 20% to 50% of cases, fibroids cause symptoms and may require treatment.
When fibroids require treatment, there are factors to consider, including:
- General health
- What symptoms exist and how severe are they?
- Type, number, and location of fibroids
- Current or future pregnancies
The degree to which the symptoms are affecting the quality of life also plays a large role in whether or not fibroid removal is explored and which treatment is chosen.
This article discusses fibroid removal options you can explore with your healthcare provider.
When Fibroids Removal Is Necessary
The biggest consideration for whether or not fibroids should be removed is if they are causing disruptive symptoms.
Some other things to explore in conversation between the person with fibroids and their healthcare provider include:
- What symptoms, if any, are present?
- How many fibroids are there?
- How big are the fibroids?
- Where are the fibroids located?
- Are the fibroids likely to grow larger?
- How fast have they grown since the last exam (if applicable)?
- What are some ways to know the fibroids are growing larger?
- In what ways are the fibroids affecting regular life and activities?
- What problems can the fibroids cause?
- What tests or imaging studies are best for keeping track of fibroid growth?
- What are the options for treatment if needed?
- What are the risks and benefits of removing the fibroids or leaving them intact?
- What are the risks and benefits of each treatment?
The healthcare provider may run imaging tests to get a better view of the fibroids, the pelvis, and the abdomen.
These might include:
- Ultrasound: An ultrasound probe placed on the abdomen or inside the vagina uses sound waves to produce a picture
- Magnetic resonance imaging (MRI): Creates a picture using magnets and radio waves
- X-rays: Uses a form of radiation to produce a picture of inside the body
- Cat scan (CT): A more complete image is created by taking many X-ray pictures of the body from different angles
- Hysterosalpingogram (HSG): Involves injecting dye into the uterus and doing X-rays
- Sonohysterogram: Involves injecting water into the uterus and doing an ultrasound
Occasionally, surgery may be performed to make a conclusive diagnosis of fibroids. Most commonly, one of the following will be done:
- Laparoscopy: A long, thin scope (a bright light and camera) that is inserted into a tiny incision made in or near the navel (belly button) projects images of the uterus and other organs onto a monitor during the procedure. Pictures may be taken.
- Hysteroscopy: A long, thin scope with a light (and sometimes camera) is inserted through the vagina and cervix into the uterus, allowing the healthcare provider to explore inside the uterus without making an incision.
Types of Procedures
Fibroids are "removed" in several ways:
- Surgically taken out of the body
- Caused to shrink
Which one is chosen depends on a number of factors including personal preference, but they all get rid of or greatly reduce the size of fibroids.
Two main surgeries are used to remove fibroids.
A myomectomy removes the fibroids but leaves the uterus intact.
The uterus usually returns to functioning normally after a myomectomy, including menstruation, which may be lighter than it was presurgery.
While pregnancy is possible after a myomectomy, the pregnancy may need to be monitored for possible risks if the fibroids were deeply embedded and/or if any spanned a large part of the uterine wall.
There are three main types of myomectomy:
- Open myomectomy: Invasive, uses a vertical or horizontal incision, done under general anesthesia, takes up to six weeks to recover.
- Minimally invasive laparoscopic myomectomy: Uses several small incisions or one slightly bigger incision; inserts a small, lighted telescope and special tools to remove the fibroids; performed under general anesthesia; recovery time is about a week.
- Hysteroscopic myomectomy: Requires no incisions, a camera with a specialized attachment is placed through the vagina into the uterus to remove fibroids; performed under general or regional anesthesia; recovery time is about a week.
During a hysterectomy, the uterus is removed. Sometimes the cervix, one or both ovaries, and/or the fallopian tubes are also removed.
A hysterectomy can be done via open abdominal surgery, or the less invasive options of vaginal, laparoscopic, or robotic approaches.
This procedure might be recommended if very heavy bleeding is present or if the fibroids are very large.
If the ovaries are left in place, menopause will not be triggered by a hysterectomy. If the ovaries are removed, menopause will begin immediately.
A hysterectomy is the only way to ensure fibroids are removed permanently. The fibroids and their symptoms end and do not regenerate.
A hysterectomy is a major surgery under a general anesthetic. It takes up to eight weeks to recover from, depending on the method used and carries the risks that come with major surgery.
The National Institute for Health and Care Excellence (NICE) recommends that hysterectomy should be considered only when:
- Other treatments have been unsuccessful or are unable to be conducted
- The person with fibroids wants to stop menstruating
- The person with fibroids requests the procedure after being fully informed about the surgery and the risks involved
A Warning About Laparoscopic Power Morcellation
Laparoscopic power morcellation is a procedure that breaks uterine fibroids into small pieces using a medical device, allowing them to be removed through a small incision in the abdomen.
The Food and Drug Administration (FDA) has issued a warning about this procedure. If the person also has uterine cancer, this procedure may cause the cancer to spread within the abdomen and pelvis, making the cancer harder to treat.
MRI-Guided Focused Ultrasound Surgery (MRgFUS)
This noninvasive procedure uses high-intensity ultrasound waves to generate heat and destroy fibroids.
MRgFUS uses a device called the Exablate, which combines magnetic resonance imaging (MRI) with ultrasound.
The procedure takes about three hours, during which the person lies inside an MRI machine. They are conscious, but are given a mild sedative.
The radiologist uses the MRI to target the fibroid tissue, direct the ultrasound beam, and to help monitor the temperature generated by the ultrasound.
Uterine Artery Embolization (UAE)
This procedure, also called uterine fibroid embolization (UFE), shrinks fibroids by cutting off their blood supply.
A catheter is placed through a small incision in the groin and threaded into the uterine artery. Small plastic particles (about the size of grains of sand) are then injected into the artery to block the blood supply to the tiny arteries that feed fibroid cells.
During the 60- to 90-minute procedure, the person remains conscious, but is sedated.
Most people return home the same day and return to normal activities within one week.
This is a minimally invasive laparoscopic procedure.
Using heat generated by high energy waves, this procedure destroys fibroids.
An ultrasound is to verify the correct placement of the radiofrequency device within each fibroid before the fibroids are destroyed.
It is usually performed as an outpatient procedure and is considered a safe and relatively low risk alternative to hysterectomy.
It can be also be delivered by transvaginal (across or through the vagina) or transcervical (through the cervix) approaches.
This procedure destroys the endometrium (the lining of the uterus) using some form of heat (radiofrequency, heated fluid, microwaves).
It is typically used to stop heavy menstrual bleeding, but it can also be used to treat small fibroids.
It is not used for large fibroids or for fibroids that have grown outside of the interior uterine lining.
Endometrial ablation usually stops monthly menstruation, or for some significantly reduces it.
It is usually done as an outpatient procedure and can take as little as 10 minutes to complete.
Recovery typically takes a few days, but it is normal for watery or bloody discharge to last for several weeks.
It significantly decreases the likelihood of pregnancy, but it increases the risks of complications (such as miscarriage or ectopic pregnancy) if pregnancy does occur. People who choose this procedure must take steps to prevent pregnancy.
This procedure may delay or make it more difficult to diagnose uterine cancer in the future.
People who have this procedure should continue to have recommended pap smears and pelvic exams.
Benefits and Risks
|Myomectomy||Hysterectomy||MRgFUS||UAE||Radiofrequency Ablation||Endometrial Ablation|
|Preserves fertility||Gets rid of fibroids permanently||Noninvasive||Does not require general anesthesia||Quick recovery time||Out-patient procedure|
|Allows the uterus to return to normal functioning||Gets rid of fibroid symptoms permanently||Moderately effective||No abdominal incision||Minimally invasive||Can take as little as 10 minutes|
|Fibroids never regrow or return||Does not require general anesthesia||No blood loss||Out-patient procedure||Quick recovery time|
|All fibroids can be treated at the same time||Stops heavy bleeding|
|Quick recovery time|
|About 90% of people report complete or significant symptom reduction|
|Risks and Disadvantages|
|Myomectomy||Hysterectomy||MRgFUS||UAE||Radiofrequency Ablation||Endometrial Ablasion|
|Recurrence rate of 15% to 30% at five years||Major surgery with risks such as bleeding, infection, and injury to nearby organs||There is a lack of long-term studies||As expensive as a hysterectomy||Treats one fibroid at a time||Reduces the chances of pregnancy|
|Future pregnancies may need to be monitored for possible risks||Requires general anesthesia||Few studies on the effects the procedure has on fertility and pregnancy||Not recommended for people who hope to become pregnant||Fibroids may return||Increases the risks of complications if pregnancy does occur|
|May have surgery-related complications including bleeding and infection||Increased risk of urinary incontinence||Cannot treat all types of fibroids||A possibility of delayed infection sometime in the first year||May delay or make it more difficult to diagnose uterine cancer in the future|
|All but one technique requires general anesthesia||May reach menopause an average of two years earlier||Cannot treat fibroids that are located near the bowel and bladder, or are outside of the imaging area||Some insurance plans may not cover it|
|Long recovery time||Ends menstruation and childbearing||Requires an extensive period of time involving MRI equipment||Has a recurrence rate of more than 17% at 30 months|
|Can have negative psychological impacts||Not covered by all insurance companies|
Frequently Asked Questions
When can you have sex after fibroids removal?
Because the procedures vary and so do their recovery times, when you can have sex varies too. For instance, UAE may only need one or two weeks while a hysterectomy can take six weeks or more.
It's best to speak to your healthcare provider before resuming sex.
How long does it take to heal after fibroids removal?
Recovery time depends on the procedure used. For some, like endometrial ablation, recovery time is as little as a few days. For others, like some forms of myomectomy, it can take eight weeks or more to fully recover.
How long after fibroids removal can you have IVF?
Best practice is to delay pregnancy by any means of conception for at least three months after fibroid removal.
IVF can be done at this three-month mark.
A Word From Verywell
Fibroids are rarely dangerous, but they can cause symptoms that interfere with your quality of life.
When symptoms become bothersome enough to prompt the removal of fibroids, several options are available with varying degrees of invasiveness and efficacy. Which option to choose depends on you and your fibroids.
If you have fibroids or symptoms of fibroids, talk with your healthcare provider about your options.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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Marsh EE, Al-Hendy A, Kappus D, Galitsky A, Stewart EA, Kerolous M. Burden, prevalence, and treatment of uterine fibroids: a survey of u. S. Women. J Womens Health (Larchmt). 2018;27(11):1359-1367. doi:10.1089/jwh.2018.7076
Office On Women's Health. Uterine fibroids.
Cleveland Clinic. Myomectomy.
Khan A, Shehmar M, Gupta J. Uterine fibroids: current perspectives.IJWH. Published online January 2014:95. doi:10.2147/IJWH.S51083
Cleveland Clinic. Uterine fibroids.
American Cancer Society. FDA warns of cancer risk in a type of uterine fibroid surgery.
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By Heather Jones
Heather M. Jones is a freelance writer with a strong focus on health, parenting, disability,and feminism.
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You can expect some pain for the first few days. Your provider will give you medication for pain. They'll also encourage you to move your legs or take small walks after surgery to prevent blood clots. With an open myomectomy, full recovery before getting back to your normal activities can take up to six weeks.How do I prepare my body for fibroid surgery? ›
- If you smoke, plan to quit six weeks before surgery.
- Avoid aspirin and other blood thinners before surgery.
- Follow your doctor's instructions about when you should stop eating and drinking before your procedure.
- Arrange for any necessary help at home as you recover.
Risks include bleeding, infection, and scar tissue. Cutting into the uterus to take out just the fibroids could cause a problem with how the uterus works in a future pregnancy. Pelvic pain that you had before either surgery may not get better.At what stage should fibroids be removed? ›
The answer is fairly straightforward. If the fibroids are asymptomatic, or cause you no issues, treatment is probably not needed. Whereas, if your fibroids cause you pain and other problems, treatments are available for you to choose from depending on the severity of the symptoms.How many hours does fibroid surgery last? ›
Laparoscopic myomectomy can take two to four hours, based on the number of fibroids and their size. You can go home the same day or spend a night in the hospital, depending on how you feel after the procedure.How many days rest is required after fibroid surgery? ›
Recovery after abdominal myomectomy takes four to six weeks. During this time, avoid heavy lifting or any type of strenuous activity. Depending on your job, you may need to take four to eight weeks off work. But Vargas stresses that it's important to stay mobile during recovery by walking each day.What is the fastest way to recover from fibroid surgery? ›
- Rest when you feel tired. ...
- Try to walk each day. ...
- For 4 to 6 weeks, avoid lifting anything that would make you strain. ...
- Avoid strenuous activities, such as biking, jogging, weightlifting, and aerobic exercise, for 4 to 6 weeks.
- You may shower. ...
- Ask your doctor when you can drive again.
Patients often ask about having a flat stomach after their UFE. After UFE, fibroid-related weight gain starts to come off. For women with large fibroids and/or multiple fibroids, this can mean a significant body change. As you move out from under a fibroid issue, you'll recover your drive and energy.Are you awake during fibroid surgery? ›
If you require surgery to remove fibroids, you'll likely be given general anesthesia and will be asleep during the procedure. Anesthesiologists work alongside the surgeons who remove uterine fibroids, monitoring you closely.What is the hardest fibroid to remove? ›
In general fibroids that are larger than 10cm and are inside the uterine muscle (intramural) can be difficult to remove. Also, if there are many fibroids (>5) it can be difficult to complete the surgery laparoscopically.
Hysterectomy is a permanent solution for fibroids, and is an option if other treatments have not worked or are not appropriate. A woman cannot become pregnant after having a hysterectomy. If the ovaries are removed along with the uterus, hysterectomy causes immediate menopause.What happens if you don't remove large fibroids? ›
A rapidly growing or large fibroid can cause swollen abdomen, pain, and pressure on the nearby structures, such as pressure on the bladder causing problems with passing urine or pressure on the bowel leading to constipation. Fibroids can cause bleeding that may cause anemia when left untreated.How long are you in the hospital for fibroid surgery? ›
Whether you stay in the hospital for just part of the day or overnight depends on the type of procedure you have. Abdominal myomectomy (laparotomy) usually requires a hospital stay of one to two days. In most cases, laparoscopic or robotic myomectomy is done outpatient or with only one overnight stay.At what size are fibroids removed? ›
This procedure is called a myomectomy. A myomectomy can be performed through an open incision, or in some cases, laparoscopically. Most experts believe that about 9-10 centimeters (about 4 inches) diameter is the largest size fibroid that should be removed laparoscopically.At what size do fibroids cause problems? ›
Larger fibroids—about four centimeters or more—that are in the muscle of the uterus can also impact implantation. Fibroids that are inside the muscle of the uterus might block the fallopian tubes, which can cause infertility. Sometimes fibroids can affect the mode of delivery of a baby.How painful is fibroid surgery? ›
Most patients with hysteroscopic myomectomy do not have a lot of pain and do not need prescription pain medication. You can take over-the-counter pain medication (such as acetaminophen) to manage pain after surgery. Your surgeon will talk with you about stronger pain medications if necessary.Is removing fibroids a big operation? ›
Also known as an "open" myomectomy, an abdominal myomectomy is a major surgical procedure. It involves making an incision through the skin on the lower abdomen, known as a "bikini cut," and removing the fibroids from the wall of the uterus. The uterine muscle is then sewn back together using several layers of stitches.Do you lose weight when fibroids are removed? ›
If you have fibroids, you are most likely carrying extra weight. Eliminating the fibroids or shrinking them with UFE can often lead to weight loss.