Shared Decision Making

Medicine Options of Uterine Fibroids

This decision aid is for people with uterine fibroids that cause heavy bleeding and/or pain. It is not for people with cancer in the uterus. These options typically will not make fibroids go away or get much smaller. For other treatments, see the procedure options for uterine fibroids decision aid.

About Uterine Fibroids: Uterine fibroids are growths in the uterus that are not cancer. Some people may not have symptoms, but others may have heavy bleeding and/or pain. Having fibroids may make it more difficult for some people to get and stay pregnant.

Patient Questions

What does the option involve?
Watch and Wait
You will watch for changes in your symptoms and check in with your healthcare professional as needed.
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
You will take pills a few times a day for about 1 week each month.
Tranexamic Acid Pill
You will take pills a few times a day for about 1 week each month.
Combined Estrogen and Progestin or Progestin-Only Pill
You will take a pill every day.
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
You will take pills 1 or 2 times every day.
Progestin-Only Shot
A healthcare professional will give you a shot every 3 months. You may have the option to do it yourself.
Progestin-Only Intrauterine Device (IUD)
A healthcare professional will place an IUD through your cervix and into your uterus. You can keep it for about 5 years or sometimes longer.
Watch and Wait
No. If you are close to menopause, your periods may become less regular. Bleeding often gets better after menopause.
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
Some people have less bleeding, but it may not help as much as other medicines. There is limited research.
Tranexamic Acid Pill
Some people have less bleeding.
There is limited research.
Combined Estrogen and Progestin or Progestin-Only Pill
Some people have less bleeding.
There is limited research.
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
About 39 to 63 of 100 people (39% to 63%) stop their periods.
For those whose periods continue, most people will have less bleeding.
Progestin-Only Shot
Some people have less bleeding or stop their periods.
There is limited research.
Progestin-Only Intrauterine Device (IUD)
Some people have less bleeding or stop their periods.
There is limited research.
Watch and Wait
No. People often have less pain after menopause
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
Some people have less pain.
Tranexamic Acid Pill
No
Combined Estrogen and Progestin or Progestin-Only Pill
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
Some people have less pain.
Progestin-Only Shot
Some people have less pain.
Progestin-Only Intrauterine Device (IUD)
Some people have less pain.
Watch and Wait
Does not apply.
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
No, but you need to stop if you become pregnant.
Tranexamic Acid Pill
No, but you need to stop if you become pregnant.
Combined Estrogen and Progestin or Progestin-Only Pill
Yes.
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
Yes.
Progestin-Only Shot
Yes.
Progestin-Only Intrauterine Device (IUD)
Yes.
Watch and Wait
There are no side effects.
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
Side effects include stomach pain and nausea.
Rare side effects include stomach bleeding or ulcers.
Tranexamic Acid Pill
Side effects include:
  • headaches.
  • muscle cramps.
  • nausea.
Rare side effects include blood clots and stroke.
Combined Estrogen and Progestin or Progestin-Only Pill
Side effects include breast pain and nausea.
With the combined pill, rare side effects include blood clots and stroke.
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
Side effects include hot flashes.
Rare side effects include blood clots and stroke.
Progestin-Only Shot
Side effects include:
  • rash, pain, or itching where you get the shot.
  • irregular bleeding.
  • stomach pain.
Your bones may become more fragile if you take it for a long time. Research is unclear about whether your bones are more likely to break.
Progestin-Only Intrauterine Device (IUD)
Side effects include:
  • pain with placement of the IUD.
  • cramping.
  • irregular bleeding.
  • infection.
  • having the IUD fall out of place.
Watch and Wait
Does not apply.
Nonsteroidal Anti-Inflammatory Drug (NSAID) Pill
  • Advil
  • Aleve
  • Midol
  • Motrin
Tranexamic Acid Pill
Lysteda.
Combined Estrogen and Progestin or Progestin-Only Pill
There are many different brand names, such as Yasmin and Camila.
Gonadotropin-Releasing Hormone Antagonist with Estrogen and Progestin Pill
  • Myfembree
  • Oriahnn
Progestin-Only Shot
  • Depo-Provera
  • Depo-subQ
  • Provera
Progestin-Only Intrauterine Device (IUD)
  • Mirena
  • Liletta
  • Skyla
  • Kyleena
Definitions

Nonsteroidal anti-inflammatory drug (NSAID): These medicines can relieve pain and swelling.

Tranexamic acid: This medicine controls bleeding by helping your blood clot.

Gonadotropin-releasing hormone antagonists: These medicines block some hormones.

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The EBSCO Health Option Grid ™ decision aids are not intended to be medical advice, diagnosis or treatment and are intended to provide information to help people engage in shared decision making with health professionals.
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