Dr Kola Tytler MBBS CertHE MBA MRCGPClinical Lead • iatroX
Lifestyle modifications and conservative management strategies for patients with fibroids experiencing mild symptoms include:
- Providing information and advice on the condition, including sources of support such as the British Fibroid Trust website, to help women understand their symptoms and management options.
- For mild heavy menstrual bleeding associated with fibroids, consider pharmacological treatments such as nonsteroidal anti-inflammatory drugs (NSAIDs) and tranexamic acid, which can be initiated in primary care to reduce bleeding and pain.
- Hormonal options like combined hormonal contraception, cyclical oral progestogens, or the levonorgestrel-releasing intrauterine system (LNG-IUS) may be offered to manage symptoms conservatively, especially if fibroids are less than 3 cm and not distorting the uterine cavity.
- Advise women that asymptomatic or mildly symptomatic fibroids often require no active treatment or routine follow-up but should be reviewed if symptoms worsen or new symptoms develop.
- Discuss contraception options as appropriate, noting that without uterine distortion, there are no restrictions on contraceptive choice.
- Encourage women to report any new or worsening symptoms promptly for reassessment.
These strategies focus on symptom control and patient education, reserving more invasive treatments for moderate to severe symptoms or complications.
References: NICE CKS, NICE NG88, NICE CKS