- Tranexamic acid and Mirena help many women.
- Submucosal fibroids often need hysteroscopic removal.
- Persistent heavy bleeding always deserves investigation.
Medical options first
Tranexamic acid during the period reduces bleeding by around 50%. NSAIDs help both pain and bleeding. Mirena IUS works well when the cavity is not too distorted and can be tried before surgery. Ulipristal acetate is used selectively due to liver-safety monitoring.
When to escalate
If medical treatment fails, or a submucosal fibroid is the cause, hysteroscopic myomectomy — through the cervix, no cuts — is often the definitive answer. Recovery is 24–48 hours and periods usually normalise from the next cycle.
Frequently asked questions
Can I keep taking iron indefinitely?
Iron restores levels but does not fix the cause. Investigate the bleeding.
Will Mirena stay in with fibroids?
Usually yes, unless the cavity is very distorted. An ultrasound confirms suitability.
Is hysteroscopic myomectomy a day case?
Yes — 20–30 minutes under general anaesthetic and home the same day.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your imaging and giving you a clear personalised plan for uterus-sparing fibroid surgery.
Request a video consultation