If you have heavy periods, pelvic pressure, or pain that keeps getting in the way, you may be wondering whether surgery is your only way forward. The honest answer is that it depends, and the first step is finding out what is causing your symptoms. Surgery may be the right choice for some people, and it is not the only conversation worth having.
Uterine fibroids (also called leiomyomas) are noncancerous growths that form in or on the uterus. They are common, and they can cause very real, very annoying symptoms. This article covers the symptoms worth bringing to a doctor and the factors that shape your treatment choices, including a minimally invasive option called uterine fibroid embolization (UFE).
Which fibroid symptoms are worth discussing with a doctor?
Fibroids are made of muscle and fibrous tissue. They can be small like a pea or large enough to change the shape of the uterus. Symptoms often depend on where the fibroid sits and how big it is.
Common fibroid symptoms include:
- Heavy menstrual bleeding, such as soaking through pads or tampons or passing clots
- Long periods, with bleeding that lasts many days
- Pelvic pressure or fullness
- Frequent urination, if the uterus presses on the bladder
- Constipation, if the uterus presses on the bowel
- Pelvic pain or cramps
- Pain during sex
- Fatigue or dizziness from blood loss
Some people also develop anemia (low iron) from heavy bleeding, which can make you feel tired, weak, or short of breath. If symptoms like these are disrupting your work, sleep, energy, or confidence, it is worth bringing them up with a clinician. You deserve options that feel realistic and respectful.
Does having these symptoms mean you have fibroids?
Not necessarily. These symptoms can also happen with other conditions, like adenomyosis or endometriosis. A proper evaluation matters, because “it’s probably fibroids” is not a diagnosis.
A visit before any procedure typically reviews your symptoms, your medical history, and imaging. Having fibroids confirmed on imaging is one of the signs that UFE may be a good fit. If cancer is suspected or your diagnosis is unclear, you may need more workup and a different approach or extra caution, and guidelines emphasize careful evaluation.
How should you think about fibroid treatment choices?
There is no single right answer for everyone. The best choice depends on your symptoms, your fibroid type and location, your overall health, and your future pregnancy goals.
It can help to ask yourself a few questions before your visit:
- How much are my symptoms affecting daily life?
- Do I hope to become pregnant in the future?
- Would I like to keep my uterus if that is an option? For some people this matters for personal or medical reasons.
- Do I prefer to avoid or delay major surgery, or am I open to it?
Your answers are not right or wrong. They simply help your care team talk through the options with you. Surgery may be part of that conversation, and UFE is another option worth understanding, so you can make a decision that fits your body and your life.
Where does UFE fit in?
UFE, also called uterine artery embolization, is a procedure designed to shrink fibroids by reducing their blood supply. A specialist uses imaging guidance to place a thin tube (catheter) into an artery. Tiny particles are then delivered to block the small blood vessels feeding the fibroids.
UFE does not remove the uterus, and it does not involve a large abdominal incision. Compared with many surgical options, it is minimally invasive, and studies have noted a shorter hospital stay and faster return to activities. Research also shows UFE can improve quality of life and reduce symptoms for many patients.
The tradeoff is that some people may need additional treatment later, such as repeat embolization or surgery for persistent symptoms. UFE is well studied and many patients do well, but it is not a one size fits all fix. That is why shared decision making matters.
UFE may not be the right fit if you are pregnant or have an active pelvic infection. If you are trying to conceive soon or have complex fertility concerns, talk with your care team carefully. Fertility after UFE is possible, but it should be discussed with a clinician before you decide.
What questions can you bring to your appointment?
A short list can make the visit easier. Consider asking:
- What is causing my symptoms, and could another condition be involved?
- Where are my fibroids, and what type are they?
- Is UFE an option for me, and what other fibroid treatments should I consider?
- How might each option affect my plans for pregnancy?
- What risks and side effects should I expect, and what follow up will I have?
Possible effects of UFE include cramping, pelvic pain, nausea, and fatigue, especially in the first days after. Infection is uncommon but serious when it happens. Changes in ovarian function or earlier menopause are also possible, especially in older patients, and your care team can explain how the risks apply to you.
When should you see a vascular specialist?
If fibroid symptoms are affecting your daily life, an evaluation can help clarify what is causing them and which choices make the most sense for you. At VidaVascular, a vascular and interventional care practice, uterine fibroid embolization is offered as a minimally invasive option for fibroid symptom relief. Your care team can talk through UFE alongside other fibroid treatment options.
VidaVascular is led by Medical Director Dr. Meghal Antani, a board certified vascular and interventional radiologist. You can also browse the other conditions we evaluate if you have additional symptoms you want to ask about.
Ready to talk it through? Call VidaVascular at (866) 800-2346 or request an appointment online. We see patients at our offices in Oxon Hill and White Plains, MD and Springfield, VA. You can find addresses on our locations page. Most major insurance providers are accepted, so call to confirm your plan.
References
- Manyonda, I., Belli, A. M., Lumsden, M. A., Moss, J. G., McKinnon, W., Middleton, L. J., Cheed, V., Wu, O., Sirkeci, F., Daniels, J. P., McPherson, K., & FEMME Collaborative Group. (2020). Uterine artery embolization or myomectomy for uterine fibroids. The New England Journal of Medicine, 383(5), 440-451. doi:10.1056/NEJMoa1914735
- de Bruijn, A. M., Ankum, W. M., Reekers, J. A., Birnie, E., van der Kooij, S. M., Volkers, N. A., & Hehenkamp, W. J. K. (2016). Uterine artery embolization vs hysterectomy in the treatment of symptomatic uterine fibroids: 10 year outcomes from the randomized EMMY trial. American Journal of Obstetrics and Gynecology, 215(6), 745.e1-745.e12. doi:10.1016/j.ajog.2016.06.051
- Moss, J. G., Cooper, K. G., Khaund, A., Murray, L. S., Murray, G. D., Wu, O., Craig, L. E., & Lumsden, M. A. (2011). Randomised comparison of uterine artery embolisation with surgical treatment in patients with symptomatic uterine fibroids (REST trial): 5 year results. BJOG: An International Journal of Obstetrics & Gynaecology, 118(8), 936-944. doi:10.1111/j.1471-0528.2011.02952.x
- Goodwin, S. C., Spies, J. B., Worthington Kirsch, R., Peterson, E., Pron, G., Li, S., Myers, E. R., & FIBROID Registry Steering Committee and Core Site Investigators. (2008). Uterine artery embolization for treatment of leiomyomata: Long term outcomes from the FIBROID Registry. Obstetrics & Gynecology, 111(1), 22-33. doi:10.1097/01.AOG.0000296526.71749.c9
- Edwards, R. D., Moss, J. G., Lumsden, M. A., Wu, O., Murray, L. S., Twaddle, S., & Committee of the Randomized Trial of Embolization versus Surgical Treatment for Fibroids. (2007). Uterine artery embolization versus surgery for symptomatic uterine fibroids. The New England Journal of Medicine, 356(4), 360-370. doi:10.1056/NEJMoa062003
- Mohan, P. P., Hamblin, M. H., & Vogelzang, R. L. (2013). Uterine artery embolization and its effect on fertility. Journal of Vascular and Interventional Radiology, 24(7), 925-930. doi:10.1016/j.jvir.2013.03.014
- Dariushnia, S. R., Nikolic, B., Stokes, L. S., & Spies, J. B. (2014). Quality improvement guidelines for uterine artery embolization for symptomatic leiomyomata. Journal of Vascular and Interventional Radiology, 25(11), 1737-1747. doi:10.1016/j.jvir.2014.08.029
