Personalized care
Your doctor will talk with you about options for treating fibroids.
When you visit the Fibroid Clinic at Mayo Clinic, you'll find a team of compassionate doctors who are experts in the full range of care options. These doctors are committed to finding the best solution for you and working with you to develop a personalized care plan.
Uterine fibroids are noncancerous (benign) growths in or around the uterus. Fibroids are common and usually occur between the ages of 30 and 40. Black women are more likely to have fibroids — and more severe symptoms — than are white women. Signs and symptoms of uterine fibroids can include heavy or painful menstrual bleeding, a sensation of pelvic pressure or fullness, compression of the bladder or bowels, and difficulty with fertility.
In many situations, fibroids don't require treatment. For those who have troublesome symptoms, effective treatment options are available. Medications may be helpful to improve heavy bleeding, and nonsurgical approaches can decrease bleeding and shrink fibroids. Surgical therapy to remove the fibroids or uterus is sometimes the best option. Fibroids can be located in different parts of the uterus, and the approach to treatment may vary depending on their size and location and your treatment goals.
Virtual visits
Virtual consultations are a useful option, especially if you're considering traveling to Mayo Clinic from a long distance. These discussions between you and a gynecology specialist can be done over the phone or by videoconference before an in-person visit. You can talk with a doctor about treatment options and plan next steps based on your condition and treatment goals.
If possible, the Fibroid Clinic staff will help arrange any necessary imaging tests or exams that can be completed locally. These results and images can then be sent for review before you make the trip to Mayo Clinic. And the Fibroid Clinic team can help you arrange any necessary follow-up tests — such as blood tests, pelvic ultrasound or MRI — here at Mayo Clinic in coordination with an in-person visit to the Fibroid Clinic.
If you are already sure about which procedure or surgery is right for you after completing your virtual visit, it may be possible for the Fibroid Clinic team to help you reserve a date for this while planning the remainder of your evaluation.
In-person visits
Questions answered
A doctor uses a 3D model of the uterus to answer questions about fibroids.
After your initial virtual discussion, you might decide to travel to Mayo Clinic to meet with one or more members of the Fibroid Clinic team. Team members include minimally invasive gynecologic surgeons, reproductive endocrinology and infertility specialists, interventional radiologists, and others as needed.
At your in-patient visit, you'll talk with your doctor, who will review your initial test results and might suggest additional assessments, such as a pelvic exam, endometrial sampling or hysteroscopy.
Individualized treatment
The Fibroid Clinic at Mayo's campus in Rochester, Minnesota, offers a full range of noninvasive and minimally invasive treatment options for fibroids. In addition, its staff members are equipped to address serious or complex medical needs.
You may benefit from nonsurgical approaches to manage fibroid symptoms, such as drugs to reduce the amount of blood flow during periods, injections to shrink fibroids or medications to control pain. You might also benefit from radiologic procedures to treat fibroids, such as uterine artery embolization or focused ultrasound surgery. Talk with your doctor about the benefits of each of these approaches and possible side effects.
Together, you and your doctor will look at the range of treatment options, including innovative minimally invasive surgical approaches. Then once all your questions are answered, you and your Fibroid Clinic care team develop a treatment plan that fits your needs and goals.
Considering surgery
If surgery is the best option for you, you'll consult with a surgeon with advanced training in the surgical care of the female reproductive system (gynecologic surgeon). The clinic's surgeons are experts in the most advanced treatment options, including:
- Radiofrequency ablation
- Myomectomy — surgery to remove large fibroids that protects the ability to get pregnant
- Hysterectomy — surgery to remove the womb (uterus)
- Advanced hysteroscopic and laparoscopic surgery
Offerings at Mayo Clinic sites
Each Mayo Clinic site — Scottsdale, Arizona, Jacksonville, Florida, Rochester, Minnesota — has an excellent team of highly skilled gynecologists who specialize in the treatment of uterine fibroids. The specific procedures offered at each site may vary. So if you have a particular treatment in mind, it may be a good idea to contact the Mayo Clinic site nearest you for more information.
Available at each of Mayo Clinic's three campuses in Arizona, Florida and Minnesota:
- Advanced hysteroscopic fibroid surgery
- Advanced laparoscopic/robotic and open fibroid surgery to remove fibroids or the uterus
- Uterine artery embolization in collaboration with interventional radiology colleagues
Additionally available at Mayo Clinic in Jacksonville, Florida:
- Vaginal radiofrequency ablation procedure
Additionally available at Mayo Clinic in Rochester, Minnesota:
- Laparoscopic and vaginal radiofrequency ablation procedures
- Focused ultrasound surgery in collaboration with radiology colleagues
- Reproductive medicine treatments in collaboration with the Division of Reproductive Endocrinology and Infertility
Research to improve outcomes
Mayo Clinic doctors and scientists are widely acknowledged leaders in fibroid research. They develop new solutions that improve treatment. You may be offered the opportunity to be part of a research study related to fibroids when you are seen in the Fibroid Clinic. See a list of publications about fibroids by Mayo Clinic doctors on PubMed, a service of the National Library of Medicine.
See physician staff
Hi everyone. My name is Samir Babayev, M.D., and I am fertility specialist and reproductive surgeon and IVF clinic director here at Mayo Clinic, Rochester, Minnesota.
How can fibroids impact fertility? Many women who have fibroids can get pregnant naturally. Treatment may not be even necessary for conception. That said, fibroids are present in 10 percent of infertile women and maybe a sole cause of infertility. For example, submucosal fibroids, a type of a fibroid that grows and bulges into the uterine cavity, increases the risk of infertility and pregnancy loss. The main reason for this is that sudden because of fibroids distort the uterine cavity and make it more difficult for pregnancy to attach itself. Bottom line, while fibroids may cause infertility for some women, other explanations for infertility are more common. If you are having trouble conceiving or maintaining a pregnancy, I recommend you see a fertility specialist to explore other possible causes before attributing the issue to fibroids.
Should I have my fibroid treated/removed prior to attempting pregnancy? I tell my patients that fibroids are like real estate. It is all about location and size. It is well-known that larger fibroids, and especially those closer to the inside lining of the uterus, may cause trouble with pregnancy and delivery. Medium and large sized fibroids can impact surrounding organs by causing pressure on the bladder, bowel, causing symptoms like frequent urination, difficulty emptying the bladder, and constipation. Because uterus sits close in close proximity to rectum and bladder, medium and large sized fibroids may pressure these organs. It isn't inherently dangerous, however, these fibroids can lead to uncomfortable symptoms and even pain.
What will happen to my fibroids if I become pregnant? Any complications that can happen during pregnancy? While there is a large amount of research on fibroids in non-pregnant patients, data is limited on how fibroids can affect pregnancy. During pregnancy, fibroids tend to grow in size, but most will shrink by the postpartum period. Thankfully, we do know that most patients with fibroids will have an uneventful pregnancy and delivery. Having a few small fibroids is rarely cause for concern. However, depending on your fibroids location, size, how many you have, certain problems may occur during pregnancy. Among other issues, fibroids may cause the placental attachment abnormalities, restrict the growth of the baby, increase the risk of preterm delivery, and bottom-down instead of head-down presentation at the time of delivery.
What sort of procedures are recommended when you want to get pregnant in the future? For women experiencing difficulty with uterine fibroids and infertility, there are treatment options that may help. Here at Mayo Clinic, we offer all available options ranging from medications to non-invasive treatments and surgery. Based on your goals and symptoms, this might change. Most women who are concerned about future fertility do choose to do fibroid removal surgery, or it's also known as myomectomy. That said, I recommend seeing a fibroid specialists to help you to choose the best available treatment. For more information about our fibroid clinic, please go to MayoClinic.org.
How long do I have to wait after a fibroid treatment to try to get pregnant? The time needed for healing of the uterus after fibroid treatment depends on the treatment type and extent. For example, for a myomectomy, the suggested waiting time could be as short as two weeks or up to three to six month before attempting to conceive.
Common Questions about Visiting the Fibroid Clinic at Mayo Clinic
Hello, my name is Janet Nelson and I'm one of the nurses who works very closely with the Fibroid Clinic. Today I'm going to answer some common questions you may have about visiting the Fibroid Clinic.
What should I expect when coming to the Fibroid Clinic? Your initial fibroid consult is completed with one of our Mayo Clinic gynecologists using telemedicine, also called a virtual consultation. During that discussion, we will help you decide which follow-up visits and testing are best for you. Often it will be recommended to visit us in person to continue your fibroid work up and make final decisions regarding treatment. The physician you meet on your virtual consultation will refer you to the fibroid specialist who best suits your needs based on your individual situation and goals.
What types of things may happen during my Fibroid Clinic visit? When you come in for a follow-up visit in-person at the Fibroid Clinic, it will be similar to a traditional gynecology office visit, except it will be seen by a specialist and the type of fibroid treatment you are most interested in and the visit will be focused primarily on fibroid care. Your doctor will often want to perform an abdominal or pelvic examination to assess your fibroids. We will determine if you are do for any other testing such as a pap smear or endometrial biopsy, both of which can be performed that day in the office. By the end of the visit, the Fibroid Clinic team will help you plan next steps for your care.
Can I schedule other visits, tests the same day? We will work with you and make your visit to Mayo Clinic as productive and efficient as possible. If updated imaging such as an ultrasound or MRI is necessary, we will schedule this prior to or the same day as your Fibroid Clinic in-person visit. Also, if you have other health care needs unrelated to fibroids that you would like to address while you are visiting Mayo Clinic, please let your physician know during your virtual consultation and we can help arrange visits with other Mayo Clinic specialists for you as well.
What happens if I want to schedule a surgery for my fibroids? If you decide surgery is the best option for you, the surgical booking process can be completed during your in-person Fibroid Clinic visit. After discussing the surgery with your physician, one of the Fibroid Clinic nurses will walk you through the scheduling process and describe how to prepare yourself for a surgical procedure. We will discuss what to eat before surgery, what to do with your regular medications, and how to prepare for recovery at home after your procedure. In some cases, especially for those patients who are coming from a distance, we can potentially hold a date for surgery based on your virtual consultation as well.
What sort of follow-up visits will I need? If you schedule a surgical procedure for fibroids, you will have a postoperative visit around three to four weeks after surgery. Although we always like to see patients back in person, in some cases it may be possible to complete your post-op visit via a virtual visit. If you are undecided about the best treatment plan for your fibroids after completing your initial consultation in the Fibroid Clinic, we will offer you a follow-up visit with one of our fibroid clinic nursing specialist approximately one month later to answer any questions you may have and help arrange any treatment that you would like to pursue.
Where can I go for more information? Please visit our website for more details on the Fibroid Clinic and contact information can be found on MayoClinic.org. Thank you.
Surgical treatments for uterine fibroids
Aakriti R. Carrubba, M.D. (Senior Associate Consultant, Obstetrics and Gynecology, Mayo Clinic in Florida): Hello, my name is Dr. Carrubba, and I'm one of the minimally invasive gynecologic surgeons at Mayo Clinic Florida. I see many patients with uterine fibroids, and I would like to spend a few minutes reviewing some of the new surgical treatment options, specifically fibroid radiofrequency ablation.
There are currently two FDA-approved products: Acessa and Sonata. Acessa is a laparoscopic-assisted device that uses an ultrasound probe to identify fibroids. Then a metallic device is inserted into individual fibroids which are directly heated with radiofrequency waves to induce coagulative necrosis. The fibroids shrink over time and reduce bleeding as well as bulk symptoms. Some surgeons perform this technique concurrently with a minimally invasive myomectomy to reach deeper fibroids that may be more difficult to remove. Recovery time is similar to myomectomy.
The Sonata procedure is a transcervical radiofrequency ablation that uses an ultrasound probe inside the uterus to identify fibroids. It can be performed in the office or in the operating room. Once the fibroids are identified, they are heated with radiofrequency waves using a similar metallic device.
There are safety measures used with both the Acessa and Sonata technologies to minimize thermal risk to surrounding tissue structures, like the bowel and bladder. The Sonata procedure has excellent recovery, as there are no abdominal incisions. And the fibroids tend to shrink by up to 50 percent over the following three months. It is important to note that neither Acessa nor Sonata are indicated for use in patients desiring pregnancy, due to lack of data. However, several women have had successful pregnancies after treatment.
At Mayo Clinic the Acessa procedure is currently offered at the Rochester, Minnesota, campus. And the Sonata procedure is offered in both Rochester and at the Jacksonville, Florida, campus. It is important to discuss the best surgical intervention with your doctor, as this may vary based on your age, fertility goals, size and location of fibroids, and medical comorbidities. If you are interested in discussing treatment options, please contact Mayo Clinic to schedule a consultation with our gynecology providers.
Jan. 17, 2024