Do uterine fibroids need treatment?

Whether uterine fibroids require treatment depends on the size of the fibroids, severity of symptoms, and the patient's reproductive needs. Small fibroids without obvious symptoms can be observed regularly, while fibroids that cause abnormal bleeding, abdominal pain or compression symptoms require medical intervention.

Uterine fibroids that are asymptomatic and less than 5 cm in diameter usually do not require immediate treatment, especially in near-menopausal women who may naturally shrink due to declining estrogen levels. It is recommended to review the ultrasound every 6-12 months to monitor changes, and adjust lifestyle, such as reducing red meat intake, controlling weight and other physiological interventions. If the diameter of the fibroid exceeds 5 cm or causes symptoms of heavy menstruation, anemia, or compression, drug treatment or surgical removal needs to be considered.

Asymptomatic small fibroids usually do not require active intervention, but gynecological ultrasound needs to be reviewed every 6-12 months. This type of fibroid is more common in women of childbearing age and may naturally shrink due to the influence of estrogen levels. Common clinical physiological changes include temporary increase during pregnancy and gradual shrinkage after menopause. The progression can be effectively controlled by avoiding long-term use of estrogen health products on a daily basis. If suspicious malignant signs such as rapid growth of fibroids and abnormal blood flow signals appear during ultrasound follow-up, active treatment is required.

Symptomatic fibroids require treatment options based on individual circumstances. Medical treatment is suitable for patients who wish to preserve their fertility. Lupron injection is commonly used to reduce the size of fibroids, or tranexamic acid tablets are commonly used to control excessive menstrual flow. Hysteroscopic myomectomy is the preferred method when submucosal fibroids cause severe anemia or recurrent miscarriage. For patients with multiple giant fibroids accompanied by bladder compression symptoms, laparoscopic or open hysterectomy may be considered. Elderly patients with underlying diseases such as hypertension and diabetes need to develop a personalized plan after comprehensively assessing the risks of surgery.

Patients with uterine fibroids must maintain a low-fat and high-fiber diet, supplement with appropriate amounts of vitamin D and deep-sea fish oil, and limit the intake of phytoestrogens such as soy products. Regular exercise such as yoga and brisk walking can help regulate endocrine, but avoid sit-ups and other actions that increase abdominal pressure. If abnormal vaginal bleeding, lower abdominal distension, or worsening frequency of urination occur, you should seek follow-up consultation in time. All treatment decisions must be made under the guidance of a gynecologist and based on comprehensive judgment based on age, fertility needs and risk of complications.