• Endometrial ablation.To end heavy bleeding, several outpatient methods exist for removing the uterine lining through the vagina. Ask your gynecologist to detail these different techniques, including microwave, balloon, and hot- or cold-water ablation.

• Hysteroscopic myomectomy (also called resection).Some fibroids can be removed directly through the vaginal opening and cervix, using a scope that allows the doctor to see exactly what he or she is doing. Laparoscopic myomectomy (using tiny abdominal incisions) is also available for smaller fibroids.

• MRI-guided focused ultrasound surgery (FUS).This technique uses high-intensity ultrasound waves to destroy fibroids. Results look promising, but no long-term studies on this method or possible fibroid recurrence yet exist.

• Uterine artery embolization (UAE).A recent and specialized technique, this entails a radiologist inserting miniature granules that block blood flow to the fibroid. UAE may not be appropriate for submucosal fibroids (bulging into the inner cavity of the uterus) because dead tissue can detach into the uterus, causing infection and possibly requiring later removal.