You’re the protagonist of your own life story, but are you treating yourself that way? When fictional characters face challenges—a dragon to slay, an obstacle to overcome, a quest to complete—they take decisive action. They don’t ignore problems, hoping they’ll resolve themselves. They don’t minimise their struggles because others have it worse. They confront what’s holding them back and do something about it.
So here’s a question: if your body is dealing with fibroids causing heavy bleeding, severe pain, or interfering with your fertility, why are you accepting that as your narrative? Why aren’t you pursuing the solution that could genuinely change your story?
Myomectomy—surgical removal of uterine fibroids whilst preserving your uterus—might be exactly the plot twist your life needs. Not because surgery is glamorous or exciting, but because sometimes the protagonist’s most courageous act is prioritising their own wellbeing. Here’s what you need to know about rewriting your story.
The Fibroid Subplot Nobody Asked For
Fibroids are non-cancerous growths in the uterus affecting up to 70% of women by age 50. For many, they cause no problems whatsoever. But for others, fibroids create a relentless subplot of heavy periods requiring multiple pad changes hourly, debilitating pain that disrupts work and life, a protruding abdomen despite healthy weight, pressure on the bladder causing constant bathroom trips, pain during sex, and fertility challenges or recurrent miscarriage.
You’ve probably tried managing symptoms conservatively. Hormonal medications that maybe help slightly but come with side effects. Painkillers that barely touch the pain. Lifestyle modifications that make a minimal difference. Your GP might have suggested “monitoring” or told you fibroids often shrink after menopause—helpful if you’re 48, less so if you’re 32 and planning a family.
Meanwhile, you’re arranging your life around your symptoms. Declining social invitations during your period. Worrying about bleeding through clothes at work. Cancelling plans because the pain is too severe. Postponing pregnancy plans because fibroids are interfering. This isn’t living—it’s survival mode.
What Myomectomy Actually Involves
Myomectomy is the surgical removal of fibroids whilst preserving your uterus. The key distinction from hysterectomy is that your uterus remains intact, maintaining fertility if desired and avoiding the physical and emotional impacts of uterus removal.
Three main myomectomy approaches exist, chosen based on fibroid size, number, location, and your circumstances:
Abdominal myomectomy involves an incision in your lower abdomen, allowing the surgeon to remove even large or numerous fibroids. Recovery takes 4-6 weeks. This approach handles complex fibroid situations that other methods cannot.
Laparoscopic myomectomy uses several small incisions and a camera, removing fibroids with specialised instruments. Recovery is faster (2-4 weeks) with less scarring. It works well for smaller fibroids in accessible locations.
Hysteroscopic myomectomy accesses fibroids growing into the uterine cavity through the cervix—no external incisions required. Recovery is quickest (days rather than weeks), though it’s only suitable for specific fibroid types.
Your surgeon assesses which approach suits your situation. Sometimes, combination approaches are used. The goal is to remove all problematic fibroids whilst preserving uterine structure and function.
Why Myomectomy Instead of Other Options
Several fibroid treatments exist, so why consider myomectomy specifically? Because it’s the only option that removes fibroids completely whilst preserving fertility and avoiding permanent changes.
Medications manage symptoms temporarily but don’t eliminate fibroids. Once you stop medication, symptoms typically return. They’re useful for temporary relief or pre-surgery symptom control, but aren’t long-term solutions.
Uterine artery embolisation (UAE) blocks the blood supply to fibroids, causing them to shrink. It’s less invasive than myomectomy, but not recommended for women wanting future pregnancies. It also doesn’t remove fibroids—they remain in your uterus, just smaller.
Hysterectomy removes your uterus entirely, eliminating fibroids permanently but also ending fertility and triggering surgical menopause if your ovaries are removed. For women finished childbearing and are certain they don’t want to preserve their uterus, a hysterectomy might be appropriate. For women wanting to maintain fertility or simply preferring to keep their uterus, myomectomy is the clear choice.
MRI-guided focused ultrasound is a newer, non-invasive option, but it has limitations regarding fibroid size and location. Long-term effectiveness data are still emerging, and it’s not widely available.
Myomectomy offers definitive fibroid removal, fertility preservation, and addresses symptoms comprehensively. It’s more invasive than some alternatives but delivers results that others cannot.
The Fertility Question
If you’re planning a pregnancy or keeping that option open, myomectomy’s fertility-preserving nature becomes crucial. Fibroids can interfere with conception, increase miscarriage risk, and complicate pregnancy. Removing them through myomectomy often significantly improves fertility outcomes.
However, timing matters. Recovery requires several months before attempting pregnancy. Your surgeon will advise specific timeframes based on your procedure—typically 3-6 months for full healing. Future pregnancies might require caesarean section depending on the myomectomy approach and fibroid location, as uterine incisions need protection during labour.
Many women successfully conceive and carry healthy pregnancies after myomectomy. The procedure doesn’t guarantee fertility—other factors obviously matter—but it removes a significant obstacle for women whose fibroids were contributing to fertility challenges.
Recovery: The Chapter You Muscle Through
Recovery from myomectomy requires real time off—this isn’t a “back to normal in 48 hours” situation. Abdominal myomectomy typically needs 4-6 weeks before returning to normal activities and 6-8 weeks before strenuous exercise. Laparoscopic myomectomy recovers faster at 2-4 weeks. Hysteroscopic myomectomy might only require a few days.
Initial recovery involves managing pain (prescription medications initially, transitioning to over-the-counter options), avoiding heavy lifting and strenuous activity, attending follow-up appointments, and gradually increasing activity as healing progresses. Fatigue is common initially—surgery is physically demanding, and your body needs energy for healing.
Most women find that whilst recovery requires patience, the relief from fibroid symptoms makes it absolutely worthwhile. The pain, bleeding, and disruption they’d been living with disappear, making a few weeks of recovery feel like a small price for long-term improvement.
Making the Decision
Choosing myomectomy is significant, and rushing the decision serves nobody. Consider whether your symptoms genuinely impact quality of life. If fibroids are merely incidental findings causing no problems, myomectomy probably isn’t necessary. But if you’re arranging your life around symptoms, experiencing significant pain or bleeding, or facing fertility challenges, intervention makes sense.
Evaluate whether you’ve exhausted appropriate conservative options. Sometimes symptoms improve with different medications or approaches. Other times, you’ve tried everything and surgery is the logical next step.
Consider your fertility goals. If preserving your uterus matters—whether for future pregnancy possibilities or simply because you want to keep it—myomectomy preserves that option whilst addressing symptoms.
Discuss thoroughly with a gynaecologist experienced in myomectomy. Not all surgeons perform the procedure regularly, and experience matters significantly for outcomes. Ask about their approach, complication rates, and post-operative care.
Choosing Your Surgeon
Myomectomy is technically demanding, and a surgeon’s experience directly impacts outcomes. Look for gynaecologists who regularly perform myomectomy (not just once occasionally), have a specific interest in fibroid management, can offer multiple surgical approaches, and discuss options thoroughly rather than pushing particular treatments.
Ask specific questions: How many myomectomies do you perform annually? What’s your approach for my specific fibroid situation? What are your complication rates? How do you handle unexpected findings during surgery? What’s your post-operative care protocol?
Trust your instincts during consultations. You should feel heard, not rushed. Your concerns should be addressed properly, not dismissed. If something feels off, seek a second opinion.
Your body deserves to be treated like the main character it is. Sometimes that means pursuing treatment that genuinely resolves problems rather than just managing symptoms indefinitely. Myomectomy might be exactly the plot development your story needs.
