15448 Myomectomy

Overview

A myomectomy is an operation to remove fibroids from the uterus (womb) while leaving the uterus in place. Fibroids are non-cancer growths in the muscle of the uterus. They can cause heavy periods, pain, pressure, or fertility problems. A myomectomy can help with these symptoms and may keep the option of pregnancy open.

Myomectomy is a common treatment for fibroids that cause problems. It is one of several options, and your doctor can help you decide if it is right for you.

It is for people who have a uterus and have fibroids that need treatment. Fibroids are most common in people in their 30s and 40s. They are also more common in Black women.

Symptoms

Common symptoms

• Heavy or long periods, sometimes with blood clots
• Pelvic pain or a heavy, full feeling in the lower belly
• Pressure on the bladder that causes frequent urination
• Pressure on the bowel that causes constipation or bloating
• Backache or pain during sex
• A belly that looks larger than usual
• Trouble getting pregnant or staying pregnant
• Tiredness or weakness from heavy periods and low iron

Symptoms in children

• Fibroids are very rare in children, and a myomectomy is not usually done before puberty. If a child has pelvic pain, unusual bleeding, or a swelling in the belly, a doctor should check it.

Symptoms in older adults

• Fibroids often shrink after menopause, so surgery is less common then. Some people still need treatment for bleeding, pain, or pressure, and a doctor can discuss the safest options.

Causes

Main causes

• Fibroids are non-cancer growths of the uterus. The exact cause is not known. Hormones such as estrogen and progesterone and genes play a part.

Risk factors

• Being in your 30s or 40s
• Having a family member with fibroids
• Being Black, as fibroids are more common in Black women
• Having obesity
• Starting periods early
• Never having been pregnant
• High blood pressure

When to see a doctor

See a doctor urgently if:

• Heavy bleeding that makes you dizzy, weak, or short of breath
• Severe pelvic pain or pain that is getting worse
• Fever after surgery, or a wound that is red, hot, swollen, or leaking pus
• Trouble passing urine
• Chest pain or trouble breathing

Book a routine appointment if:

• Periods that are heavier or longer than usual
• Pelvic pain or pressure that affects daily life
• Frequent urination or constipation caused by pressure
• Trouble getting pregnant
• You are thinking about treatment for fibroids and want to discuss options

Diagnosis

Your doctor will ask about your periods, pain, and plans for pregnancy. They will do a pelvic exam and arrange tests to see the fibroids. You may be referred to a specialist in women's health.

Tests that may be done

• Pelvic exam
• Ultrasound scan
• MRI scan if more detail is needed
• Blood tests to check for low iron or anemia
• Hysteroscopy, where a thin camera looks inside the uterus
• Other imaging tests depending on your symptoms

What to expect at your appointment

The tests help your doctor learn the size, number, and position of the fibroids. This information helps you and your doctor choose the best treatment for your symptoms and fertility plans.

Treatment

Treatment depends on your symptoms, the size and position of the fibroids, your age, and whether you want to get pregnant. Options include watching and waiting, medicines, procedures, and surgery. A myomectomy is one surgical option that keeps the uterus.

Self-care at home

• Track your periods and symptoms so you can discuss them clearly with your doctor
• Eat iron-rich foods if your periods are heavy
• Get rest and gentle movement after surgery
• Follow your surgical team's advice about wound care and follow-up visits
• Avoid heavy lifting and strenuous exercise until your doctor says it is safe

Medical treatments

Medicines can help control bleeding, pain, or shrink fibroids for a time. They do not cure fibroids, and symptoms may return when you stop. Your doctor can explain the benefits and side effects of different approaches without recommending a specific product.

When is surgery considered?

Surgery may be advised if symptoms are severe, medicines do not help, fibroids are large or growing quickly, or fibroids affect fertility. A myomectomy may be chosen when you want to keep your uterus.

Living with this condition

Recovery after a myomectomy usually takes a few weeks. You may feel tired and sore at first. Follow your surgical team's advice about rest, walking, lifting, and returning to work or school.

Lifestyle tips

• Build gentle activity back into your day
• Keep a healthy weight if possible
• Eat balanced meals with enough iron
• Ask for help with chores and family duties while you recover
• Attend follow-up appointments

Diet and exercise

No special diet has been proven to remove fibroids. A balanced diet and regular movement support your overall health and recovery. If your periods are heavy, iron-rich foods can help your body make red blood cells.

Mental health and emotional wellbeing

It is normal to feel worried, sad, or anxious about symptoms, fertility, surgery, or recovery. Talk to your doctor if these feelings are affecting your daily life. If you feel in crisis or have thoughts of harming yourself, contact your local crisis service or emergency number right away.

Prevention

Fibroids cannot be reliably prevented. Keeping a healthy weight and lifestyle may lower your risk, but it does not guarantee you will avoid fibroids.

Vaccines

There is no vaccine to prevent fibroids or to avoid needing a myomectomy.

Screening programmes

There is no routine screening for fibroids. See a doctor if you have heavy periods, pelvic pain, pressure symptoms, or trouble getting pregnant.

Complications

If left untreated

• Heavy bleeding that leads to low iron or anemia
• Ongoing pelvic pain or pressure
• Pressure on the bladder or bowel
• Fertility problems or pregnancy complications
• Fibroids that grow larger over time

Long-term outlook

Most people recover well after a myomectomy. Symptoms often improve, and the uterus is kept, so pregnancy may still be possible. Fibroids can come back, and your doctor will check you over time. Your care team will help you plan the next steps.

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