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Patients with heavy menstrual bleeding related to fibroids are offered uterine artery embolization, myomectomy, and hysterectomy as treatment options.
Fibroids are one of the primary causes of heavy menstrual bleeding. Uterine artery embolization, myomectomy, and hysterectomy are effective options for patients with symptomatic fibroids. Myomectomy and uterine artery embolization should be considered conservative treatment options in selected patients who have been counselled on the potential risks and benefits of each option. For patients who do not wish to preserve fertility and have been counselled about the risks and benefits of hysterectomy, this treatment can be offered (see Statements 10 and 11 for details).
Prior to any procedural intervention for fibroids, anemia management with oral or intravenous iron is recommended to optimize the patient’s hemoglobin level to greater than 120 g/L. Gonadotropin-releasing hormone analogues or selective progesterone-receptor modulators can be used to supress menstruation and facilitate minimally invasive approaches.
If fibroids (non-cancerous growths) are causing your heavy menstrual bleeding, you should be offered a uterine artery embolization, myomectomy, or hysterectomy. Uterine artery embolization shrinks the fibroids by blocking their blood supply. Myomectomy is surgery to remove the fibroids. Hysterectomy is surgery to remove your uterus.
Offer uterine artery embolization, myomectomy, and hysterectomy as treatment options to all patients with heavy menstrual bleeding related to fibroids. Ensure patients have all the information they need to make an informed choice. If your patient has a hemoglobin level of less than 120 g/L, use oral or intravenous iron to raise their hemoglobin above 120 g/L before the procedure.
Ensure systems, processes, and resources are in place such that patients have access to uterine artery embolization, myomectomy, and hysterectomy as treatment options for fibroids causing heavy menstrual bleeding. Ensure clinicians are aware of specialists who accept referrals for these procedures.
Percentage of patients with heavy menstrual bleeding who had a diagnosis of fibroids and who were offered the following procedures: uterine artery embolization, myomectomy, and hysterectomy
Denominator: number of patients with heavy menstrual bleeding who had a diagnosis of fibroids
Numerator: number of patients in the denominator who were offered a choice of the following procedures:
Uterine artery embolization
Myomectomy
Hysterectomy
Data source: local data collection
Note: This indicator can be calculated as an overall percentage and by each listed procedure.
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