Up to 80% of people with a uterus develop fibroids, and about half have symptoms such as heavy bleeding, anemia, or pelvic pressure. Medication is the recommended first step. Newer oral pills (GnRH antagonist combinations) cut heavy bleeding by 50–75%. Uterus-sparing procedures, including hysteroscopic and mini-laparotomy myomectomy, can treat fibroids without a hysterectomy. Peyman Banooni, MD, a board-certified OB-GYN in Beverly Hills, offers medical and surgical fibroid treatment for patients across Los Angeles.
If you soak through a pad or tampon every hour or two, or your period lasts more than a week, that isn’t something you have to live with. Uterine fibroids are one of the most common causes. Up to 80% of people with a uterus develop them at some point.
Many people wait years for a diagnosis. In one national survey, a third of patients waited 5 years or more. Part of the reason is that talking about periods still feels taboo, so many people never learn that their bleeding is heavier than normal.
Today there are more ways than ever to treat fibroids without removing the uterus. Below, Beverly Hills gynecologic surgeon Peyman Banooni, MD, walks through what the latest research says, based on a 2024 review in the New England Journal of Medicine.
What are uterine fibroids?
Fibroids (also called leiomyomas or myomas) are noncancerous growths in the muscle wall of the uterus. They usually grow slowly, though they can shrink or have growth spurts. About half of people with fibroids have symptoms, such as:
- Heavy or long periods, sometimes with clots or leaks
- Fatigue from iron-deficiency anemia
- Pelvic pressure, bloating, or a fuller-looking belly
- Pain during or between periods
- Frequent urination or trouble emptying the bladder
- Constipation
- Pain during sex
Because these symptoms overlap with digestive, blood, and other gynecologic conditions, fibroids are often missed. They take an emotional toll, too: in one study, nearly all patients with symptomatic fibroids reported worry, depression, anger, or body-image distress.
Who is most affected by fibroids?
Fibroids become more common with age until menopause. Black women are affected earlier, more often, and more severely. They are also more likely to have a hysterectomy or myomectomy, even though many prefer to avoid surgery.
Studies also show Black patients are less often offered uterus-sparing options early on. If you have heavy periods or a family history of fibroids, ask your clinician about a pelvic ultrasound.
How are fibroids diagnosed?
A pelvic ultrasound is usually the first and most cost-effective test. It shows the size, number, and location of fibroids.
- MRI gives a more detailed map. It helps when the uterus is large, there are many fibroids, or surgery is being planned.
- Saline-infusion sonography or hysteroscopy checks for fibroids inside the uterine cavity.
- CT scans are not useful for diagnosing fibroids.
Doctors describe fibroid location on the FIGO scale, from type 0 (inside the cavity) to type 8. Location decides which treatment fits best. For example, fibroids inside the cavity can often be removed through the cervix with hysteroscopic myomectomy.
Medication: the first line of treatment
Guidelines from the American College of Obstetricians and Gynecologists (ACOG) recommend starting with medication for most people with symptomatic fibroids.
| Option | What it does | Good to know |
|---|---|---|
| Hormonal birth control (pill, patch, hormonal IUD) | Lightens bleeding; the levonorgestrel IUD works best | Usually the first step |
| Tranexamic acid or NSAIDs | Taken during your period to reduce flow | Best studied in heavy periods without large fibroids |
| Oral GnRH antagonist combinations (Oriahnn, Myfembree) | Cut bleeding by 50–75% and pain by 40–50% | Few side effects; FDA-approved for up to 24 months; not birth control |
| GnRH agonist injections (Lupron) | Stop periods and shrink the uterus 30–60% | Short-term, often before surgery; menopause-like side effects |
The newer oral GnRH antagonist pills work regardless of how many fibroids you have, how big they are, or where they sit. They’re a strong option for patients who want to delay or avoid surgery.
Uterus-sparing procedures
When medication isn’t enough, several procedures can relieve symptoms while keeping your uterus. Smaller fibroids near the cavity (FIGO types 0–2) can often be removed through the cervix. Larger fibroids, or those deeper in the wall or on the outer surface, are treated through the abdomen.
| Procedure | How it works | Recovery |
|---|---|---|
| Hysteroscopic myomectomy | Removes fibroids inside the cavity through the cervix, with no incisions | Usually home the same day; back to routine in a few days |
| Mini-laparotomy myomectomy | Removes larger or multiple fibroids through a single 4–5 cm bikini-line incision | Often home the same day or next day; about 2 weeks |
| Laparoscopic myomectomy | Removes fibroids through several small incisions with a camera | Often same day; about 2 weeks |
| Uterine fibroid embolization (UFE) | A radiologist blocks blood flow to the fibroids through a catheter | 1–2 days; best-studied nonsurgical procedure |
| Radiofrequency or focused ultrasound ablation | Heat or sound energy shrinks individual fibroids | Same day |
Myomectomy, which removes the fibroids and repairs the uterus, is the usual choice for people who want to become pregnant. One caveat applies to every procedure: new fibroids can grow. About half of people develop new fibroids within 5 years of myomectomy, though not all cause symptoms.
What about hysterectomy?
Hysterectomy permanently ends periods and fibroids, and it remains the most common fibroid treatment. Yet nearly 60% of patients who have one never tried a less invasive option first.
Newer research suggests hysterectomy may carry long-term risks even when the ovaries are kept, including higher rates of heart disease, anxiety, and depression. The risks appear greatest when it’s done at age 35 or younger. These studies are observational, so they can’t prove cause and effect, but they’re worth discussing before you decide.
Fibroid treatment with Dr. Banooni in Beverly Hills
Peyman Banooni, MD, treats uterine fibroids for patients from Beverly Hills, West Hollywood, Santa Monica, Burbank, and across Los Angeles. His approach follows current ACOG guidance: start with the least invasive option that controls your symptoms, and protect your uterus and fertility whenever possible.
- Medical management, including hormonal options and newer oral GnRH antagonist pills
- Hysteroscopic myomectomy for fibroids inside the uterine cavity
- Mini-laparotomy myomectomy for large or multiple fibroids, through a small bikini-line incision
- Personalized plans based on your symptoms, imaging, and pregnancy goals
When to see a fibroid specialist
- Periods lasting more than 7 days, or changing protection every 1–2 hours
- Leaks or accidents despite double protection
- Fatigue, shortness of breath, or a diagnosis of anemia
- Pelvic pressure, bloating, or frequent urination
- A hysterectomy recommendation and you want to know your alternatives
Schedule a fibroid consultation with Dr. Peyman Banooni in Beverly Hills. Call (310) 652-9347 or request a consultation online.
Frequently asked questions
Are uterine fibroids cancerous?
No. Fibroids are benign. A cancer called uterine sarcoma can look similar, but it’s rare, and an MRI can help tell them apart when there’s concern.
What is the best treatment for fibroids without surgery?
Oral GnRH antagonist combination pills reduce heavy bleeding by 50–75% and work regardless of fibroid size or location. Hormonal birth control and tranexamic acid are other common first steps.
Can I get pregnant after fibroid treatment?
Often, yes. Myomectomy is usually preferred if you want to conceive. If you plan to get pregnant later, medication can control symptoms in the meantime.
Do fibroids come back after treatment?
New fibroids can develop. Up to a third of patients need another treatment within 5 years, with lower rates after age 45.
Who treats uterine fibroids in Beverly Hills?
Peyman Banooni, MD, a board-certified OB-GYN and gynecologic surgeon in Beverly Hills, treats fibroids with medication, hysteroscopic myomectomy, and mini-laparotomy myomectomy for patients throughout Los Angeles.
Related articles
Sources
- Stewart EA, Laughlin-Tommaso SK. Uterine Fibroids. New England Journal of Medicine 2024;391:1721–33.
- American College of Obstetricians and Gynecologists. Management of Symptomatic Uterine Leiomyomas. Practice Bulletin No. 228, 2021.
This article is for general education and is not medical advice. Talk with your healthcare provider about your symptoms and treatment options.
Peyman Banooni, MD, FACOG, is a board-certified obstetrician-gynecologist and gynecologic surgeon in Beverly Hills, California, serving patients across Los Angeles. He treats uterine fibroids with medication and uterus-sparing surgery, including hysteroscopic myomectomy and mini-laparotomy myomectomy. Dr. Banooni earned his bachelor’s degree in biology from UCLA with summa cum laude honors and is a surgeon at Cedars-Sinai Medical Center. FACOG means he is a Fellow of the American College of Obstetricians and Gynecologists.
Office: 150 N Robertson Blvd, Suite 200, Beverly Hills, CA 90211 · Phone: (310) 652-9347 · Website: fibroid-treatment.com