Natural and "alternative" treatments
The least invasive, most natural treatment for fibroids is to wait for menopause. Without the monthly hormonal stimulation of the menstrual cycle, many fibroids will shrink on their own.
Naturopaths, homeopaths, acupuncturists, chiropractors, and other alternative health care providers may have treatments to offer as well, but these are not generally supported by scientific studies that prove effectiveness.
Various hormonal medications are available. These include birth control pills, which can regulate your natural hormone balance and reduce bleeding symptoms; progesterone, which reduces the effects of the monthly cycle on the fibroid; and Lupron, which creates a "false" menopause, shrinking fibroids like the true menopause. Unfortunately, the effect of these medications is limited–fibroid symptoms usually come back when the medications are stopped. In addition, they can cause side effects (like hot flashes or bloating) in some women. On the positive side, they do not require surgery or any other invasive procedures.
The "gold standard" surgical treatment is hysterectomy. The uterus can be removed through an abdominal incision or through the vagina. Although it may take several months for a woman to recover from hysterectomy, she is forever protected from a recurrence of fibroids and from cancers or other problems in the uterus. None of the other available treatments can make this claim.
Myomectomy is the surgical removal of a fibroid, leaving the uterus in place. In many women, Myomectomy can be done through a series of small incisions (one to two inches long) on the abdominal wall. It takes less time to recover from this type of surgery than from a regular abdominal hysterectomy. Also, the fibroid is removed from the patient's body and can't cause any further symptoms. Unfortunately, many women grow new fibroids, and 10-15% eventually need another operation.
Hysteroscopy/polypectomy is a procedure that can remove fibroids growing into the uterine cavity. A camera and tiny surgical instruments are introduced into the uterus through the vagina, and fibroids can be cut or "shaved" away from the uterine wall. This procedure is an excellent choice for women with pedunculated submucosal fibroids.
Uterine fibroid embolization
This technique, also called UFE, uses tiny plastic particles to block blood flow to the fibroid, causing it to shrink by as much as 65%. The particles are introduced through an angiographic catheter (a tiny tube about as big around as a piece of spaghetti). This catheter enters the body where the leg meets the abdomen, through an artery near the skin surface. Because the catheter is so small, the recovery period is very short–just a few days–and most patients can go home the same day. The major disadvantage of UFE is that while fibroids shrink, they do not go away completely. Most women get complete relief or signficant improvement in their symptoms, but up to 20% of patients may still have symptoms after embolization.