Women's Health Services

NewYork-Presbyterian Women's Health Services

Fibroids

Ranked #4 Nationally for Gynecology by U.S. News & World Report

Fibroids — noncancerous growths on the uterus — are among the most common health problems women face during childbearing years. While not life-threatening, fibroids can seriously impact health, fertility, and quality of life.  NewYork-Presbyterian offers comprehensive and multidisciplinary programs for the diagnosis, treatment, and management of fibroids. Blending the expertise of our physician specialists with the most advanced therapies and all of the resources available at our two renowned medical centers — Columbia University Irving Medical Center and Weill Cornell Medicine, our comprehensive fibroid programs provide women with the best treatment options tailored to their specific condition, symptoms, and reproductive goals.

Uterine fibroids

What are Fibroids?

Uterine fibroids, also called uterine myomas or leiomyomas, are benign (noncancerous) tumors that develop from the muscle tissue of the uterus. The cause of uterine fibroids is not well understood, and a variety of factors have been examined, including ethnicity and age of the first period. Also, the sex hormones estrogen and progesterone play an important role in the growth of fibroids.

Fibroids may be as small as a pea and as large as a grapefruit. The size, amount, and location of fibroids can have different effects on women. Common symptoms include:

  • Heavy or prolonged menstrual periods
  • Abnormal bleeding between menstrual periods
  • Pelvic pressure or pain
  • Urinary frequency
  • Abnormal bowel function
  • Low back pain
  • Pain during intercourse
  • Abdominal bloating
  • Anemia
  • Reproductive problems
Early fibroids diagnosis

Early diagnosis and treatment by expert gynecologists can significantly help improve symptoms and reduce future health and fertility problems for all patients with fibroids.

Various risk factors can increase a woman's risk of developing fibroids, including:

  • age (fibroids become more common during the 30s and 40s through menopause)
  • having a family member with fibroids
  • ethnicity (African-American women are more likely to develop fibroids than white women)
  • obesity
  • diets high in red meat

Our Approach to Care

Multidisciplinary and comprehensive programs to treat fibroids

Doctor talking with a patient

NewYork-Presbyterian provides compassionate, multidisciplinary, and comprehensive care to women with fibroids. At NewYork-Presbyterian/Columbia University Irving Medical Center and NewYork-Presbyterian/Weill Cornell Medical Center, teams of board-certified gynecologists, gynecologic surgeons, reproductive endocrinologists, radiologists, interventional radiologists, and hematologists combine their extensive experience in the management of fibroids and fibroid-related complications to create a comprehensive plan of care tailored to a woman’s specific condition, symptoms, and reproductive goals.  Treatments may include lifestyle modifications such as diet and exercise, medications, hormonal therapies, or the latest cutting-edge, minimally invasive surgical approaches that result in smaller scars, fewer complications, faster recovery times, and fertility preservation.

Advancing the field through research

Columbia and Weill Cornell Medicine clinician-investigators remain at the forefront of research related to fibroids. Our clinician-investigators continue to pursue studies of newer therapies.  Our patients benefit from treatments and therapies based on the most up-to-date research and findings.

Our approach to care

How We Diagnose and Treat Fibroids

Many fibroids complications can be minimized by addressing them earlier as it is much more challenging to manage large fibroids in patients who wish to become pregnant. There are many factors involved in deciding when to pursue diagnosis and treatment, such as the individual’s symptoms, the extent and location of the fibroids, and her childbearing goals.

Diagnosis

If you have signs or symptoms of fibroids, you'll have an extensive evaluation by our team of medical and surgical experts. You may undergo series of imaging tests to confirm that you have fibroids. These tests may include ultrasound, magnetic resonance imaging (MRI), and hysterosalpingogram (HSG), which involves injecting x-ray dye into the uterus and taking x-ray images, or a sonohysterogram, which involves injecting water into the uterus and taking ultrasound images.

You might also need surgery to confirm that you have fibroids. Types of surgery include laparoscopy, in which the doctor inserts a long, thin scope into a tiny incision made in or near the navel to view the uterus; and hysteroscopy, in which the doctor passes a long, thin scope with a light through the vagina and cervix into to view the uterus.

Treatments

If you have symptoms, our physicians will discuss the best way to treat your fibroids based on your health and lifestyle factors. These treatment options may include watchful waiting, medical therapies, surgical treatments, interventional treatments, and lifestyle recommendations for diet and exercise.

Medical therapies

If you have fibroids and have mild symptoms, your doctor may suggest taking medications:

  • Over-the-counter drugs such as ibuprofen or acetaminophen can be used for mild pain or cramps.
  • Hormonal-based therapies can be prescribed to help control fibroids’ symptoms, including low-dose birth control pills, progesterone-like injections, and IUD devices that contain a small amount of progesterone-like medication, which can be used to control heavy bleeding as well as for birth control.
  • Gonadotropin-releasing hormone agonists (such as Depo-Lupron) are given by injection or Gonadotropic-releasing hormone antagonists (such as Orlissa) are taken orally.
Surgical treatments

At NewYork-Presbyterian, our experienced gynecologic surgeons collaborate with our highly skilled staff to provide the highest level of care before, during, and after surgery.

Depending on the type of fibroid and its location, the following surgical treatments may help you:

  • Myomectomy: Surgery to remove fibroids without removing the healthy tissue of the uterus. It is best for women who wish to have children after treatment for their fibroids or keep their uterus for other reasons. Depending on the type, size, and location of the fibroids, myomectomy can be performed using minimally invasive surgical approaches, including robotic myomectomy (through several tiny incisions in the abdomen) or hysteroscopic myomectomy (through the vagina and cervix).
  • Hysterectomy: Surgery to remove the uterus is the only sure way to cure fibroids. If the fibroids are large, a woman may need a hysterectomy that involves cutting into the abdomen to remove the uterus. If the fibroids are smaller, the doctor may reach the uterus through the vagina instead of cutting in the abdomen. In some cases, we use the laparoscope to perform the hysterectomy.
  • Laparoscopic Radiofrequency Ablation: often referred to as the Acessa Procedure®): A minimally invasive procedure that uses heat to target fibroids one by one, reducing their size significantly. By shrinking the fibroids, patients enjoy less severe symptoms and a better quality of life.
  • Transcervical Radiofrequency Ablation:  Uses a miniaturized ultrasound probe to reduce the fibroids’ size from inside the uterus with high-energy waves. This minimally invasive, incision-free method allows doctors to treat fibroids and preserve a woman’s uterus and fertility. It also may give them the option of having a vaginal childbirth in the future.
Interventional vascular treatment

If fertility is not an issue, some patients can opt for uterine fibroid embolization, in which particles are delivered through a catheter inserted in the groin or wrist and guided into the blood vessels that feed fibroids to cut off their blood supply and cause them to shrink.

Long-term management

Our team is committed to giving patients with fibroids comprehensive, ongoing care to enable them to live the best quality of life.  Depending on your individual needs, your long-term care may include periodic evaluations to review your symptoms and monitor the fibroid with abdominal and pelvic examinations. Fibroids are likely to grow until a woman reaches menopause, and treatments can be offered throughout a woman’s lifetime.

Why Choose Us

Experts in minimally invasive gynecologic surgery

Our expert gynecologic surgeons are renowned for their skill in laparoscopy and robotic-assisted surgery to treat the most complex and challenging gynecologic conditions. As leaders and innovators in the field, they work collaboratively to develop and refine minimally invasive techniques that ease patients' recovery with fewer complications. These include the ever-growing application of the use of robotics in fertility-sparing and fertility-enhancing surgery to treat fibroids. 

Leading-edge treatments for fertility preservation

Fibroids can impact fertility and childbirth by disrupting the endometrial (inner lining) cavity of the uterus, where menstruation originates and a fertilized egg implants. Even if an individual can conceive, fibroids can continue to grow because of pregnancy hormones' influence. This growth can result in pain, cause a miscarriage, or lead to early or obstructed labor requiring a cesarean section.  Our gynecologists work closely with gynecologic surgeons and reproductive endocrinologists to formulate a plan to optimize fertility and enable women to carry a pregnancy.

locations

Our Providers are Conveniently Located in Manhattan, Queens, Brooklyn, & Westchester:

Weill Cornell OB/Gyn Faculty Practice

Columbia University Irving Medical Center

855-969-7564 Phone number for new patients

212-305-5904 Phone number for existing patients

NewYork-Presbyterian Brooklyn Methodist Hospital

NewYork-Presbyterian Hudson Valley

NewYork-Presbyterian Lawrence

NewYork-Presbyterian Queens

ColumbiaDoctors - Westchester

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