Uterine fibroids affect many women, with clinical data indicating that Black women are disproportionately impacted, often experiencing more severe symptoms at earlier ages. According to the National Institutes of Health (NIH), Black women are three times more likely to develop uterine fibroids compared to other women. As July—recognized as Fibroid Awareness Month—highlights the ongoing need for better care, patients are increasingly encouraged to adopt a goal-oriented approach to treatment, focusing on whether their primary objective is fertility preservation or immediate symptom management.
Dr. Pierre Johnson, a board-certified OB-GYN, emphasizes that clinical decisions should be driven by the patient’s specific life goals. This perspective is central to modern gynecological care, which has evolved significantly from historical practices that often presented hysterectomy as the only viable solution for chronic pelvic pain or heavy menstrual bleeding. By identifying whether a patient’s priority is maintaining the ability to carry a pregnancy or alleviating debilitating symptoms, physicians can better tailor surgical and non-surgical interventions.
Image: Dr. Pierre Johnson
Understanding Treatment Goals: Pregnancy vs. Symptom Relief
For many patients, the path forward begins with a clear assessment of their reproductive and health priorities. Dr. Johnson, who has gained national attention for complex surgical procedures—including the removal of a 27-pound fibroid while preserving a 17-week pregnancy—advocates for a patient-first philosophy. He notes that treatment discussions should center on the patient’s individual goals rather than defaulting to a standard procedure.
In cases where a patient is not actively seeking pregnancy and symptoms are manageable, many clinicians recommend a “watch and wait” approach. Fibroids often shrink naturally during menopause, as hormone levels shift. However, for many Black women, the tendency to normalize heavy periods and chronic pelvic pain can lead to delayed diagnosis. For women experiencing symptoms such as severe anemia, exhaustion, and significant pelvic pressure, continuing to wait may come at the expense of their health, quality of life or fertility.
Medical and Lifestyle Management Strategies
When fibroids begin to disrupt daily life, various medical interventions are available to manage symptoms. The Mayo Clinic reports that while medications such as hormonal birth control, progestin-releasing IUDs, and tranexamic acid can effectively reduce heavy bleeding, they do not shrink the size of the fibroids themselves. Furthermore, while NSAIDs can assist with pain management, they do not address the underlying bleeding issues.
Lifestyle adjustments, including dietary changes, have been explored as supplementary support. The Cleveland Clinic suggests that incorporating high-fiber foods like broccoli and apples, along with vitamin D-rich options like salmon and consistent physical activity, may help some patients manage symptoms. However, Dr. Johnson cautions that while certain lifestyle changes can improve daily comfort, many widely marketed herbal remedies and supplements may help with pain but don’t actually shrink fibroids.
Surgical Options: Myomectomy and Hysterectomy
For patients prioritizing fertility, the myomectomy remains the primary surgical intervention. This procedure removes the fibroids while leaving the uterus intact. The location of the fibroid is a critical factor in determining the severity of symptoms; the Cleveland Clinic notes that submucosal fibroids, which push into the uterine cavity, are frequently associated with both increased symptoms and infertility, even when they are relatively small.
Surgical approaches vary, and some surgeons prefer open procedures for complex cases. Dr. Johnson argues that for deep-seated, pebble-sized fibroids, an open approach can allow for more precise tactile identification and removal compared to robotic-assisted surgery. While a 2025 study published in the American Journal of Obstetrics and Gynecology indicated a 20 percent reintervention rate over an 11-year period, individual outcomes and surgical techniques continue to be a subject of ongoing clinical evaluation.
For women who have completed their families or are seeking a definitive solution to chronic symptoms, a hysterectomy remains an effective option. While historically associated with invasive recovery, modern practices often utilize robotic-assisted techniques that involve smaller incisions. According to Dr. Johnson, these advancements have significantly reduced recovery times, with many patients returning to work in about a week.
Taking Charge of Clinical Consultations
Advocating for one’s health during medical appointments is essential for achieving the best outcomes. Patients are encouraged to ask specific questions about the location and type of their fibroids, as this information directly influences the range of available treatments. If surgery is recommended, patients should inquire about the surgeon’s rationale, the expected recovery timeline, and the potential for recurrence.
If a patient does not feel that their concerns are being addressed or if they desire further clarity on their options, seeking a second opinion is a standard and recommended practice. The ultimate goal of any intervention, as Dr. Johnson emphasizes, is to ensure that a patient can live a healthy life without their quality of life being significantly compromised by their condition. For further information on managing uterine health, patients are encouraged to consult with their primary care providers or a board-certified gynecologist to discuss their specific health history and treatment goals.