Getting rid of uterine fibroids depends on their size, location, how severe your symptoms are, and whether you want to preserve your fertility. Options range from medications that shrink fibroids and control bleeding to minimally invasive procedures and surgery that remove them entirely. No single approach works best for everyone, but most people with symptomatic fibroids have several effective choices.
Medications That Shrink Fibroids
A class of oral medications works by lowering estrogen and progesterone, the hormones that fuel fibroid growth. One well-studied option, relugolix combination therapy, achieved a 50% reduction in fibroid volume from baseline in clinical trials, with 73% of participants reaching complete absence of menstrual periods. These medications are typically paired with low-dose hormones (called “add-back therapy”) to prevent menopause-like side effects such as hot flashes and bone density loss.
Newer medications in this class, including linzagolix, have shown strong results in large trials. In the PRIMROSE studies involving over 1,000 women with heavy menstrual bleeding from fibroids, roughly 86% to 90% of women on the higher-dose regimens with add-back therapy saw meaningful reductions in blood loss by one year. Bone density was well preserved across all groups. However, these medications don’t eliminate fibroids permanently. In the PRIMROSE trials, nearly 89% of women who had stopped bleeding on treatment saw bleeding return within 12 weeks of stopping the drug.
Hormonal IUDs for Symptom Control
A hormonal IUD (the levonorgestrel-releasing type) can significantly reduce heavy menstrual bleeding caused by fibroids, but it does not shrink the fibroids themselves. A systematic review of 11 studies confirmed that these IUDs decrease menstrual blood loss and improve anemia markers like hemoglobin and ferritin, while fibroid volume stays essentially unchanged. If your main problem is heavy periods rather than pressure or bulk symptoms, a hormonal IUD can be a low-maintenance solution that avoids surgery entirely.
Uterine Artery Embolization
Uterine artery embolization (UAE) is a nonsurgical procedure performed by an interventional radiologist. A thin catheter is threaded through a blood vessel in your wrist or groin, and tiny particles are injected to block the arteries feeding the fibroids. Cut off from their blood supply, the fibroids shrink over the following months.
UAE works for most people, but it has an overall failure rate of about 9.4%, meaning roughly 1 in 10 women eventually need a follow-up surgery. Among those who did need surgery in one study, about 7% had a hysterectomy and about 3% had a myomectomy. Women who had a previous myomectomy were more likely to experience UAE failure. Recovery is generally faster than open surgery, with most people returning to normal activity within one to two weeks, though cramping and fatigue in the first few days can be intense.
Radiofrequency Ablation
Radiofrequency ablation (RFA) uses heat delivered through a needle-like probe to destroy fibroid tissue from the inside. The dead tissue is gradually reabsorbed by the body over months. This can be done laparoscopically (through small abdominal incisions) or transcervically (through the vagina and cervix with no incisions at all).
A large meta-analysis of 11 studies found that fibroid volume shrank by an average of 46% at three months and 65% at one year. One longer-term study reported an 84% reduction at three years. Because the uterus stays intact and incisions are minimal or absent, recovery tends to be quick. Most people return to normal activities within a few days to a week.
Myomectomy: Removing Fibroids Surgically
Myomectomy removes the fibroids while leaving the uterus in place, making it the standard choice if you want to preserve your ability to have children. There are three main approaches, and which one your surgeon recommends depends on the number, size, and location of your fibroids.
Hysteroscopic myomectomy is used for fibroids that bulge into the uterine cavity. A thin scope is passed through the vagina and cervix, so there are no incisions. You can typically drive and return to work the next day, though taking a couple of days off is reasonable.
Laparoscopic myomectomy uses a few small abdominal incisions and a camera. Recovery is moderate: most people can drive within a week and return to work in one to three weeks.
Abdominal (open) myomectomy involves a larger incision and is reserved for very large or numerous fibroids. You can expect to return to a desk job in about two weeks, but more physically demanding work typically requires a six-week recovery.
One important caveat: fibroids can grow back after myomectomy. Even so, research from Mayo Clinic found that myomectomy provided the same symptom relief as hysterectomy at a lower cost.
Hysterectomy: The Permanent Option
Hysterectomy, the surgical removal of the uterus, is the only treatment that guarantees fibroids will never return. It’s generally considered when fibroids are very large, symptoms are severe, other treatments have failed, or you’re certain you don’t want future pregnancies. The procedure can be done vaginally, laparoscopically, or through an open abdominal incision depending on uterus size and other factors. Recovery from a laparoscopic or vaginal hysterectomy is typically two to four weeks before returning to normal activities, while an open approach may require six weeks or more.
Diet, Supplements, and Lifestyle Factors
Lifestyle changes alone won’t eliminate existing fibroids, but certain dietary patterns may influence growth or risk. A meta-analysis found that high intake of soy-based foods in adulthood was associated with a 2.5 times higher risk of developing fibroids compared to low intake, likely because soy isoflavones mimic estrogen in the body. This doesn’t mean you need to eliminate soy entirely, but consistently high consumption may be worth reconsidering if you’re prone to fibroids.
Green tea extract, specifically a compound called EGCG, has shown promise in laboratory studies. Research at Johns Hopkins found that EGCG reduced key proteins involved in fibroid tissue growth by 46% to 86% in cell cultures. Clinical trials in humans are still needed to determine effective doses and safety, so supplements aren’t a proven standalone treatment yet. Maintaining a healthy weight also matters, since excess body fat increases circulating estrogen, which promotes fibroid growth.
Choosing the Right Approach
The decision comes down to a few practical questions: How much are your symptoms affecting your daily life? Do you want to become pregnant in the future? How quickly do you need relief? And how do you feel about the possibility of fibroids returning?
For mild to moderate bleeding without significant bulk symptoms, a hormonal IUD or medication may be enough. For larger fibroids causing pressure, pain, or fertility problems, myomectomy or radiofrequency ablation preserves the uterus while providing meaningful shrinkage. UAE is a strong middle ground for those who want to avoid surgery but need more than medication can offer. And hysterectomy remains the definitive solution when other options have been exhausted or aren’t appropriate. Many people try less invasive approaches first and escalate only if symptoms persist.