Do Fibroids Mean I’ll Need a Hysterectomy? The Truth About Natural Alternatives

September 10, 2025

Uterine fibroids are common, benign tumors that can cause heavy bleeding, pelvic pressure, pain, and fertility challenges. If you’ve been told you have fibroids, you might wonder whether a hysterectomy—the surgical removal of the uterus—is inevitable. The short answer: for many people, no. A range of evidence-based options, including medications and uterus-sparing procedures, can control symptoms and sometimes shrink fibroids. Here’s what the research and trusted health authorities say—and what to know about “natural” alternatives.

Do fibroids always require a hysterectomy?

Not usually. Hysterectomy is a definitive cure for fibroid symptoms because fibroids cannot return without a uterus. But it is rarely the only reasonable option. The National Institutes of Health (NIH) notes that treatment should be individualized based on your symptoms, fibroid size and location, age, and reproductive goals (NIH/NICHD).

Evidence-based alternatives to hysterectomy

Watchful waiting

If fibroids are small and symptoms are mild, monitoring can be appropriate. Many fibroids grow slowly, and some shrink after menopause as estrogen levels fall (NIH/NICHD).

Medications that manage symptoms

NSAIDs (e.g., ibuprofen) may reduce pain and modestly reduce bleeding.
Hormonal contraceptives (pills, patch, ring) can regulate periods and lessen bleeding.
Levonorgestrel-releasing IUD can significantly reduce heavy menstrual bleeding, even with fibroids, depending on uterine anatomy (see ACOG patient guidance).
Tranexamic acid is a non-hormonal pill taken during menses to reduce bleeding; it’s FDA-approved for heavy menstrual bleeding.
GnRH agonists (short-term) can shrink fibroids and correct anemia before surgery, but side effects (hot flashes, bone loss) limit long-term use.
Oral GnRH antagonists with add-back therapy are FDA-approved for heavy bleeding due to fibroids, offering an effective, non-surgical option:
- Elagolix combination (Oriahnn)
- Relugolix combination (Myfembree)

Uterus-sparing procedures

Myomectomy: Surgical removal of fibroids while preserving the uterus. It can be performed hysteroscopically (through the cervix), laparoscopically, or via open surgery depending on fibroid size/location. It is the standard option for those seeking to maintain fertility (ACOG).
Uterine fibroid embolization (UFE): A minimally invasive procedure that blocks blood flow to fibroids, causing them to shrink. Many patients see improvements in bleeding and pressure. See MedlinePlus for an overview.
MRI-guided focused ultrasound (MRgFUS): Uses high-intensity ultrasound to heat and destroy fibroid tissue. It’s noninvasive and FDA-cleared for select patients; availability may be limited, and not all fibroid types are suitable.

What about “natural” alternatives? What the evidence shows

Many people prefer to start with lifestyle changes and supplements. While some approaches can support overall health and possibly reduce symptoms, the evidence that “natural” remedies shrink fibroids reliably is limited. Here’s the state of the science:

Lifestyle strategies with supportive evidence

Healthy weight and physical activity: Observational studies suggest higher body mass index is associated with increased fibroid risk. Regular exercise and weight management may reduce risk and improve wellbeing, though they are not proven to shrink established fibroids (NIH/NICHD overview).
Dietary pattern: Diets rich in fruits, vegetables, and whole grains and lower in red and processed meats are associated with better gynecologic health. These choices support anemia correction and inflammation control, even if they don’t directly shrink fibroids.
Vitamin D: Low vitamin D levels are common in people with fibroids, and early studies suggest a potential role in fibroid biology. However, clinical trials are small and not definitive. Test and treat deficiency per established guidance (NIH ODS), but do not expect guaranteed fibroid shrinkage.

Supplements and herbs: promising signals, limited proof

Green tea extract (EGCG): Small randomized trials suggest EGCG may reduce bleeding and fibroid volume compared with placebo, but larger, longer studies are needed (PubMed/NIH). Quality and dose vary across products.
Other botanicals (e.g., turmeric/curcumin, vitex, milk thistle): Evidence for fibroid-specific benefits is insufficient. They should not replace proven therapies, especially for severe bleeding or anemia.

Important safety note: In the U.S., dietary supplements are not FDA-approved to diagnose, treat, cure, or prevent disease. Quality and purity can vary, and some supplements interact with medications or affect surgery/anesthesia. Discuss with your clinician before starting any supplement.

Mind–body and complementary approaches

Acupuncture, yoga, and stress-reduction techniques may help with pelvic pain or overall quality of life. Evidence is limited for direct effects on fibroid size. Consider these as adjuncts, not replacements, for medical care when symptoms are significant.

When is hysterectomy the best option?

Hysterectomy can be appropriate when:

Symptoms are severe (e.g., heavy bleeding causing significant anemia, uncontrolled pain) and other treatments have failed or are not suitable.
Fibroids are very large or numerous, causing bulk symptoms or compressing nearby organs.
You do not desire future pregnancy and prefer a definitive solution.
There is concern for other uterine disease.

Minimally invasive hysterectomy approaches may shorten recovery time. If hysterectomy or myomectomy is done laparoscopically, be aware of FDA guidance about the rare risk of spreading unsuspected cancer with power morcellators; containment systems and careful patient selection are recommended (FDA safety communication).

How to choose the right path

Your goals should drive your plan. Bring these questions to your visit:

What is causing my symptoms—size, number, or location of fibroids?
What options preserve my fertility and uterus?
What are the expected benefits, risks, recovery time, and impact on future pregnancy for each option?
Are medications like relugolix or elagolix combinations appropriate for me?
Am I a candidate for myomectomy, UFE, or MRgFUS here or via referral?
How will we manage anemia and monitor response?

Second opinions—especially from a gynecologist who offers multiple treatment types or from an interventional radiologist (for UFE)—can clarify choices.

When to seek urgent care

Soaking through a pad or tampon every 1–2 hours for several hours
Symptoms of severe anemia (chest pain, shortness of breath, fainting)
Sudden severe pelvic pain or fever

Bottom line

Fibroids don’t automatically mean you need a hysterectomy. Many people manage symptoms effectively with medications and uterus-sparing procedures. Lifestyle changes can support overall health, and a few supplements show early promise, but none are proven cures. Work with a clinician who listens to your goals, weighs the evidence, and helps you choose the least invasive option that reliably controls your symptoms.