Fibroid Treatment Without Surgery: What Are Your Options?

A fibroid diagnosis doesn’t automatically mean surgery. Many fibroids cause no symptoms at all and simply need monitoring, and where symptoms do need managing, there are non-surgical options, including medication to control heavy bleeding and procedures such as uterine fibroid embolisation.

Which approach suits you depends on the size and location of the fibroids, the symptoms they’re causing, your age, and whether you’re planning for a pregnancy. Here’s what each option involves and when it’s typically considered.

What are uterine fibroids?

Uterine fibroids are non-cancerous growths that develop around or within your uterus (womb). They are made of muscle and fibrous tissue and may range from very small (about the size of a pea) to several centimetres across. 

They are most commonly diagnosed during a woman's reproductive years, typically between the ages of 30 and 50. This is because, although the exact cause of fibroids is not fully understood, oestrogen and progesterone – the hormones that regulate your menstrual cycle – play a role in stimulating their growth. 

During your reproductive years, fibroids may cause symptoms such as:

• Prolonged and heavy menstrual bleeding

• Frequent urination

• Lower back pain

• Pelvic pain or pressure

• Bloating

• Abdominal pain or swelling

• Constipation

While not all women with fibroids will experience the aforementioned symptoms, the need for treatment usually depends on how severe these symptoms are, rather than on the fibroids themselves.

Available treatment for fibroids without surgery

If your symptoms are mild or if you would prefer to avoid surgery, your doctor may suggest several non-surgical treatments. The most suitable treatment for you will depend on the size, number, and location of your fibroids, as well as which symptoms are affecting you the most.

Pain relief medication

Common pain relievers such as paracetamol or nonsteroidal anti-inflammatory drugs (NSAIDs) may help ease pelvic pain and cramping. NSAIDs may also help reduce the amount of bleeding during the period in some women.

Hormonal therapy

Hormonal therapy works by regulating the hormones that influence fibroid growth and menstrual bleeding. It does not eliminate or shrink fibroids, but it may help to ease symptoms, making it a practical option for many women who wish to avoid surgery or preserve fertility.

Common hormonal therapy options include:

• Oral contraceptive pills, which could reduce bleeding and ease cramping

• Hormonal injections, which may help control bleeding and hormonal fluctuations

• A hormonal IUD, a small device placed inside the uterus that could help reduce heavy bleeding during periods

Hormonal treatments are generally most effective for managing bleeding and discomfort rather than reducing fibroid size. It is often used as a medium-term solution, on its own or while other options are being considered.

GnRH agonists

GnRH agonists are medicines that lower oestrogen levels in your body, which lead fibroids to shrink. They are often used for a few months, for example, to reduce fibroid size before a procedure or to manage symptoms while you await treatment. 

However, because this treatment may reduce bone density over time, they are used under close medical supervision and are not suitable for extended use.

Uterine fibroid embolisation

Uterine fibroid embolisation (UFE) is a minimally invasive procedure. A thin tube is guided through a small incision in the wrist or groin to the blood vessels feeding the fibroids. 

Tiny particles are then injected to block the blood supply to the fibroids, causing the growths to shrink over time. Most women go home the same day and return to normal activities within one to two weeks.

UFE may not be suitable if you are planning a future pregnancy, and it tends to work better for some fibroid types than others.

Radiofrequency ablation

Radiofrequency ablation uses ultrasound imaging to locate fibroids, then delivers heat energy to shrink the tissue. Depending on the technique, it may be performed through the cervix or through small abdominal incisions.

The suitability of this procedure depends on factors such as fibroid size, number, and location. Recovery is generally quick, and the uterus remains intact, which may suit women who wish to retain their fertility.

Although this radiofrequency energy treatment preserves the uterus, the lasting effects on fertility are still being studied. If you are planning a future pregnancy, this is something to discuss with your doctor.

Endometrial ablation

Endometrial ablation treats the lining of the uterus (the endometrium) using heat energy, which could significantly reduce or stop heavy menstrual bleeding. This is usually a short and straightforward procedure.

It does not remove the fibroid tissue but targets the bleeding they cause. This option is suitable only if you are not planning future pregnancies.

Discussing your fertility plans early helps your doctor recommend treatments that ease your symptoms while preserving your options for the future.

If you are unsure which non-surgical uterine fibroid treatment is suitable for you, it may be worth consulting a fertility specialist, who could help to discuss the available options with you. Request an appointment with Thomson Medical.

What should you consider when deciding on a treatment?

The most appropriate fibroid treatment varies from woman to woman. What works well for one woman may not be appropriate for another. Several factors may influence the most suitable treatment for you, and your doctor will consider them all together.

Severity of your symptoms

Mild fibroid symptoms that do not disrupt your daily life may not need active treatment. But more significant symptoms usually do need treatment. These may include anaemia from heavy blood loss or pain that affects your sleep and your ability to work.

Your fertility plans

If you are planning to become pregnant, some treatments are more suitable than others. Procedures that preserve the uterus are generally preferred, while those that affect the lining of the uterus may not be appropriate for you.

Size and location of the fibroids

The size and position of your fibroids could affect which treatments are likely to work best. Some procedures work better for smaller fibroids, while others are better suited to larger fibroids or multiple ones.

Your overall health

Certain medical conditions, such as heart and blood vessel disease or blood clotting disorders, may affect which treatments are considered safe for you.

Your doctor will look at the full picture before recommending a plan. This includes your symptoms, scan findings, health history, reproductive goals, and your own priorities. Your preferences matter in this process. Do not hesitate to ask questions and take the time you need to decide.

Lifestyle changes that may support symptom management

Although there is no quick fix for fibroids, adopting certain lifestyle habits may help. While these changes will not make the fibroids shrink on their own, they could help balance your hormones, reduce inflammation, and ease symptoms when coupled with medical treatment.

These lifestyle changes include:

Diet

Oestrogen plays an important role in fibroid growth, and certain dietary choices may help keep levels in check.

You might find it helpful to:

• Eat more foods rich in fibre, such as fruits, vegetables, and whole grains, which help the body clear excess oestrogen through the digestive system

• Include foods that contain omega-3 fats, such as oily fish, flaxseeds, and walnuts, which may help reduce inflammation

• Limit red meat, processed foods, and dairy that is high in fat, which are associated with higher oestrogen levels

• Reduce alcohol intake, as it may interfere with oestrogen breakdown in the liver, and limit caffeine, which may worsen pelvic pain

Weight management

As body fat tissue produces oestrogen, a higher body weight may contribute to fibroid growth in some women. Maintaining a healthy weight through a balanced diet and regular activity may help moderate oestrogen levels.

Exercise

Regular, moderate exercise helps regulate hormones and reduces inflammation. Gentler activities such as walking, swimming, cycling, and jogging are well suited for most women with fibroids. Very intense exercise or movements that strain the abdomen are best avoided when symptoms flare.

Stress management and sleep

Persistent stress raises cortisol levels, which could disrupt oestrogen and progesterone balance and worsen symptoms. Calming practices such as mindfulness, yoga, or breathing exercises done regularly may help.

Poor sleep also weakens your immune system and raises inflammation in the body. Aiming for 7 to 9 hours per night may support your body's ability to manage symptoms.

While these changes will not make fibroids disappear, they give you practical steps you could take alongside medical treatment. Even small adjustments may make symptoms easier to manage.

When might surgery be needed?

Non-surgical treatments could provide effective relief for many women, but there are situations where they may not be sufficient. Surgery becomes a consideration when fibroids are causing significant harm to your health or quality of life, or when other treatments have not provided adequate relief.

Your doctor may recommend surgery if:

• Fibroids are causing significant symptoms such as severe anaemia, significant pain, or bladder and bowel problems that have not responded to other treatments.

• Fibroids are large, growing, or affecting fertility or pregnancy plans.

• You have not had adequate relief from medical treatments or minimally invasive procedures.

• You have completed your family planning and are looking for a more permanent solution.

Surgery may also be the right choice when your quality of life is significantly affected and other options have not helped.

If you have been told surgery may be the next step, a second opinion may help clarify whether all other options have been considered and which surgical approach fits best. Request an appointment with Thomson Medical for a consultation with our fertility specialist.

FAQ

How can I shrink my fibroids naturally?

Lifestyle measures such as eating a balanced diet, staying physically active, maintaining a healthy weight, limiting alcohol and caffeine intake, and managing stress may support overall health and help manage fibroid growth. However, natural approaches alone are unlikely to significantly shrink fibroids.

What are the signs of fibroids shrinking?

How long does it take for fibroids to shrink with medication?

They may begin to shrink within two to three months of starting treatment. A noticeable reduction is usually seen after three to six months of treatment, particularly with medications such as GnRH agonists. However, your doctor can provide a more accurate estimate based on your specific condition.

Are there any risks with non-surgical fibroid treatments?

How are fibroids managed during pregnancy?

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique conditions, request an appointment with Thomson Medical.