Many women in their thirties (and sometimes younger) begin to have symptoms of fibroid tumors (medically known as leiomyomas). Fibroid tumors are extremely common, usually circular or oval-shaped solid tumors that arise from the smooth muscle tissue in the uterine wall or its support ligaments. Less than 1% of these tumors are cancerous, and most of the time the symptoms are mild. Although not dangerous, they can cause abnormal bleeding, pain, or size-related problems and are a leading reason for hysterectomy. Recent data indicate that near age fifty, 70 percent of Caucasian women and more than 80 percent of African American women have evidence of fibroids on ultrasound. While it is surprising how common these tumors are, the bright side is they usually shrink dramatically after menopause.
Most medical treatments of fibroids will preserve fertility, but if a surgical option is determined to be needed, the plan will be pivotal around the issue of future fertility. The most common reason to treat fibroids is abnormal vaginal bleeding. Fibroid tumors in the wall or lining of the uterus may cause more blood to circulate into the uterus, causing heavy periods. Age-related hormonal changes that may cause irregular periods (often the case in the late 40s or perimenopause) can also result in an uneven build-up in the uterine lining, aggravating the problem. A thickened uterine lining may need to be tested or biopsied before treatment can start.
If the uterus is not markedly enlarged, the most common treatments involve the use of progesterone or progestins (synthetic progesterone-like medications) to thin the uterine lining, which tends to help bleeding related to the fibroids. The birth control pill and other forms of hormonal contraception (such as the vaginal ring or the IUD containing progestin) may reduce abnormal bleeding associated with fibroids. These methods can be extremely effective in lessening PMS, perimenopausal symptoms and cramps, as well. There are several medications that can be used to lower estrogens and/or progesterone in the body, which generally causes the fibroids to shrink. Because these medications (such as DepoLupron) are relatively expensive and may cause menopause-like side effects, they are usually used only temporarily.
Some women have small fibroids that may be accessible from the inside of the uterine cavity. A minor surgery known as hysteroscopy may be used with an instrument to cut out the tumor(s). This simple approach is usually an outpatient procedure, does not require an incision, and fertility may be maintained.
In some cases, as long as there is no future plan to try to become pregnant, noninvasive surgical procedures may also be used to permanently thin the lining of the uterus, or reduce its blood supply (i.e, a procedure known as endometrial ablation). While this procedure does not eliminate the fibroids, the most bothersome symptom (bleeding) is often markedly improved. This procedure requires no incision or stitches, and in some instances may be performed in the office setting under local anesthesia.
Another conservative treatment method is called uterine artery embolization (UAE). This minimally invasive procedure is usually performed by a radiologist and involves injecting tiny beads in the uterine blood vessels by way of an artery in the upper thigh (similar to a heart catherization) in order to block the blood supply to the fibroid. The dramatic reduction in the uterine blood flow will cause the fibroids to shrink, often reducing period bleeding as well. The procedure usually does require an overnight hospital stay, but only requires a very small incision.
There is a growing interest in using MRI and ultrasound imaging to locate and treat fibroids with almost any imaginable energy source, such as ultrasound energy or microwaves. Most of these relatively non-invasive procedures are very early in their development and are not yet commonly performed.
Surgical removal techniques are still the most commonly used approaches and involve removing the tumors or the uterus, depending on the desire to maintain fertility. A myomectomy is a surgical procedure to remove the fibroids from the uterus. This operation may be performed using laparoscopic techniques (outpatient, with tiny incisions) or in the case of multiple, very large tumors, a traditional incision may be required. Pregnancy is usually possible after myomectomy, but if the uterus has been deeply incised, a cesarean section may be recommended for delivery.
Hysterectomy is the most common approach to symptomatic fibroids, but again, this depends on the woman’s desire for a future pregnancy. Newer laparoscopic hysterectomy techniques have lessened the need for large, painful incisions and often only require an overnight stay (or less) in the hospital. Some women opt to maintain the integrity of their cervix (having only the body of the uterus removed), and this may allow a quicker recovery. Having a hysterectomy does not usually mean that the ovaries need to be removed. Recent data indicating health benefits associated with ovarian function has encouraged surgeons not to remove normal ovaries in the woman at low risk for ovarian cancer at the time of hysterectomy until after age 65.
Fibroid tumors are so common it is unusual not to have them, but most affected women will not need aggressive treatments.
Medical
- Hormonal contraceptives (Pills, ring, IUD, etc)
- Progestins (synthetic or natural progesterone agents)
- Hormone-suppressing agents
Minimally invasive options
Fertility preserving:
- Hysteroscopic removal
- Laparoscopic removal
- Targeted fibroid destruction
Non-fertility preserving:
- Endometrial ablation
- Uterine artery embolization
- Minimally invasive hysterectomy
Traditional surgical options
Fertility preserving:
- Abdominal myomectomy
Non-fertility preserving:
- Abdominal hysterectomy
What People Are Saying
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Lauren Hayes25 September 2026Trustindex verifies that the original source of the review is Google.
Ultrasound tech, Emma, was phenomenal! She was so compassionate and took her time to make our experience great. We really appreciate the care she took during our ultrasound.Posted on Google
Sidney12 August 2026Highly recommend! From the moment I walked in to the moment I walked out, my care was thoughtful, caring, and the furthest thing from feeling dismissed at a doctor’s office. Ellie did a wonderful job making me feel heard, comfortable and validate what I had been experiencing. For a first visit, I left feeling reassured and grateful that I chose this office.Posted on Google
Charisa McMahon21 July 2026I highly recommend Audrey Fenwick. She truly takes the time to listen and never makes me feel rushed during my appointments. I always feel like my concerns are heard and taken seriously. What I appreciate most is that she’s willing to explore different treatment options rather than taking a one-size-fits-all approach. She works with me until we find a plan that we’re both comfortable with, and I always leave feeling confident that I’ve received thoughtful, personalized care. It’s refreshing to have a healthcare provider who is knowledgeable, compassionate, and genuinely invested in helping her patients feel their best.Posted on Google
Amy Curry26 June 2026Dr. Shannon was a great provider during my last pregnancy with twins! She answered every question I had, kept me in the loop on all the clinical decisions and options I had available, and made me feel safe and heard during all of my interactions with her and her staff. All of the staff at Women’s first always took great care of me and my babies no matter what concern I had at the time.Posted on Google
Rhonda Eichenberger20 June 2026They are always all so nice and welcoming. I just love Brook McAfee, APRN, she is awesome!Posted on Google
Robin12 June 2026Dr Grider is the best Doctor. Very thorough, kind and personable!Posted on Google
Cathy Carter4 June 2026I cannot tell you how pleased I am with the services provided by Dr. Anne L. Oliphant and the staff at Women First of Louisville. Dr. Oliphant and staff exhibit outstanding professionalism, punctuality and courtesy. I highly recommend Dr. Oliphant based on the fact that she is an exceptionally skilled and compassionate physician who truly takes the time to listen to her patients. Throughout my appointments, she and the staff made me feel completely at ease. She thoroughly explained my diagnosis and patiently answered all my questions without ever making me feel rushed. I had to do bloodwork during my last appointment. The clinicians and staff were especially friendly and professional as well. Dr. Oliphant’s, and the staff’s, empathetic bedside manner and clear communication elicit standout medical providers in the specialized field of menopause medicine. I believe that Dr. Oliphant has really listened to my concerns and has taken the time to support my health journey. I highly recommend her and the staff to anyone seeking personalized and highly effective care.Posted on Google
Nancy Nance3 June 2026I have been a patient here for over 25 years. The best of care for any need I have had ! Simply the best !Posted on Google
Kim Goff12 May 2026The care I've received at Women First of Louisville has been outstanding for over 15 years. It is amazing that such a large practice can be so efficient, organized, and caring all at the same time. For my annual checkups, I am able to schedule my mammogram and provider visit together. Pre-check in means I simply sign in and within a minute or two I'm called for my mammogram. Another 2-5 minute wait and I'm with a friendly, knowledgeable technician who completes the mammogram with a smile and a caring attitude. In 10 minutes, I am back in the waiting area and immediately called back for vitals by another friendly professional assistant. Within 5-10 minutes I am in the exam room and my provider, Heather McLennan, arrives. Here is where the appointment is less about efficiency and more about the care she provides to me. Heather always takes the time to speak with me...asking questions about my life, my health and my concerns. These are not just a check list. She listens. She smiles. She looks me in the eyes and participates in a conversation with me that makes me feel like she cares and understands. Her exam is gentle but thorough. I often have a question about recent research or options and she gives me her honest opinion based on facts. I completely trust her and the other women in all aspects of this practice. **A few years ago I did have a less than stellar experience with an assistant who took my vitals. She was dismissive and sloppy and made me feel uncomfortable when I didn't understand her questions. After I shared this experience with the check out staff, the office manager called me the same day for details, an apology and guarantee that the practice would address this as a training issue that would hopefully correct it. I've not seen or heard anything like it since. I am 100% satisfied with the care I receive at Women First of Louisville. I highly recommend you consider them for your healthcare needs.Posted on Google
Carly Garcia11 May 2026Dr. Lauren Lewis is fabulous! She is extremely kind and patient, and she genuinely cares about those in her care. I felt very comfortable during my first appointment with her and have already recommended her to a friend!
