What is the first treatment for uterine fibroids?

Fibroids are non-cancerous growths in the muscle of the uterus. They may cause heavy or painful periods, pressure, urinary symptoms, constipation or difficulty becoming pregnant, although some cause no symptoms. Treatment is guided by the size and position of the fibroids, bleeding pattern, anaemia, age and plans for pregnancy.

Tranexamic Acid for Heavy Bleeding may be discussed for heavy periods. A Hormonal Coil can reduce menstrual bleeding for some people, but suitability depends on the shape of the uterine cavity and individual goals.

Book a gynaecology assessment if bleeding or pressure affects daily life. Keep a record of bleeding, pain, pelvic pressure and medicines, and ask whether blood tests or imaging are needed. Do not start treatment for anaemia without discussing the cause of the bleeding.

If medicines do not control symptoms, options can include Operative Hysteroscopy, Myomectomy or Uterine Artery Embolisation. Hysterectomy removes the uterus and is considered in selected circumstances, including when future pregnancy is not desired.

Seek urgent care for bleeding that soaks through protection repeatedly, fainting, severe weakness, sudden severe pelvic pain, fever or possible pregnancy with pain or bleeding. Prompt review is also needed for breathlessness or dizziness that may reflect anaemia.

Ask which fibroid is causing the symptom, whether you have anaemia, which medicine fits your health history, and how each procedure could affect fertility and future pregnancy.