After successful treatment for breast cancer, Zamala Cortes was eager to embark on the next chapter of her life: starting a family. During a routine gynecologic checkup in 2022, however, the Staten Island newlywed received a diagnosis of fibroids, noncancerous tumors of the uterus. Based on the location of the uterine fibroids, 鈥淚 knew I couldn鈥檛 get pregnant no matter how hard we tried,鈥 says Cortes, who was 37 at the time.
For decades, hysterectomy鈥攕urgically removing the uterus containing the fibroids and the fallopian tubes鈥攈as been the leading fibroid treatment. Nearly 500,000 women in the United States have a hysterectomy each year, with fibroids being the leading reason. Hysterectomy cures fibroids and bleeding permanently, but because pregnancy is no longer possible, it wasn鈥檛 right for Cortes.
After meeting with Taraneh Shirazian, MD, a minimally invasive gynecologic surgeon and director of 嘿嘿视频鈥檚 Center for Fibroid Care, Cortes learned she had other minimally invasive fibroid treatment options that didn鈥檛 involve a hysterectomy, including the one she eventually chose: transcervical fibroid ablation, which uses radiofrequency energy to destroy fibroid tissue, while preserving the uterus.
Doctors at the Center for Fibroid Care develop individual, personalized care. The treatment recommended for you can depend on your needs and goals as well as fibroid size, number, and locations. 鈥淥ur fibroid treatment toolkit has gotten bigger in terms of what we can offer patients,鈥 Dr. Shirazian says. 鈥淥ur goal is to use one or more of the tools to help you achieve the best outcome.鈥
Here鈥檚 a look at the latest uterine-sparing fibroid treatment advancements.
Decrease Bleeding with Hormone Therapy
Two U.S. Food and Drug Administration (FDA)鈥揳pproved fibroid medications: Oriahnn and Myfembree, have been shown to significantly reduce heavy menstrual bleeding associated with uterine fibroids. The medications drive down hormone levels but add back a little estrogen, to help women avoid menopausal symptoms such as hot flashes, headaches, and mood changes, says Kelsey Kossl, MD, a minimally invasive gynecologic surgeon at the Center for Fibroid Care, part of obstetrics and gynecology services at 嘿嘿视频.
Starved of estrogen, bleeding may improve. 鈥淭he medications are well-tolerated, and I鈥檝e had women who have had great responses in terms of stopping bleeding,鈥 Dr. Kossl says. 鈥淩educing bleeding may help improve anemia so subsequent fibroid procedures can be planned safely.鈥
Starve Fibroids with Uterine Fibroid Embolization
Uterine fibroid embolization is a minimally invasive outpatient procedure performed by an interventional radiologist. It involves inserting tiny medical-grade particles under X-ray guidance through the uterine artery. The particles temporarily decrease blood flow to the uterus and any fibroids. Deprived of oxygen-rich blood, fibroids degenerate and shrink over the next few months to a year.
To make an appointment with one of our fibroid specialists, visit the Center for Fibroid Care.
With uterine fibroid embolization, there鈥檚 a risk of premature menopause, especially if you鈥檙e age 45 or older. This is a factor to consider if you鈥檙e seeking pregnancy.
Remove Fibroids with Myomectomy
One of the most common fibroid procedures, myomectomy is a minimally invasive surgery that removes fibroids through the abdomen with tiny, thumb-size incisions. 鈥淕ood candidates for myomectomy are women seeking pregnancy who have only 5 to 10 fibroids, and the largest is about 6 centimeters,鈥 Dr. Shirazian says.
After a myomectomy, it鈥檚 best to wait a minimum of three to six months before trying to conceive. 鈥淲e want to make sure any cuts or scars in the uterine wall are well-healed before there鈥檚 a pregnancy,鈥 Dr. Kossl says.
Zap Fibroids with Transcervical Ablation
Transcervical fibroid ablation, often performed using the Sonata System, is one of the newest tools in fibroid treatment. Transcervical fibroid ablation uses radiofrequency energy to destroy fibroid tissue, while preserving the uterus. 鈥淲e use an ultrasound handpiece and enter through the vagina and cervix to deliver targeted energy to the fibroids,鈥 says Catherine W. Chan, MD, a minimally invasive gynecologic surgeon at the Center for Fibroid Care.
Afterward, fibroids degenerate, slowly decreasing in size over months. Results can be long-lasting. In a study in the Journal of Gynecologic Surgery involving 147 women who had Sonata treatment, 94 percent were satisfied with the treatment and 88 percent reported reduced fibroid symptoms after three years.
Ablation is the treatment Cortes ultimately chose for her fibroids, which ranged in size from 2 to 10 centimeters. 鈥淎fter the procedure, I felt a little cramping, but that was it. I walked 8 miles the next day,鈥 she says. And best of all, she gave birth to a baby boy in March 2024.
What鈥檚 on the Horizon?
The Center for Fibroid Care is actively involved in research to improve fibroid management. One study aims to identify current practices and test clinicians鈥 understanding of all available treatment options. With that insight, researchers intend to develop scripts for physicians and nurse practitioners to use in educating and counseling patients nationwide.
Separately, the center is involved in an ongoing study, , to evaluate the role of lifestyle, nutrition, and exercise among asymptomatic patients who had surgery or a procedure for fibroid elimination. 鈥淯ltimately, we hope to better understand if LIFE can modify fibroid recurrence,鈥 says Dr. Shirazian.