ENUterine fibroid treatment in Germany depends on symptoms, the size and position of the fibroids and pregnancy plans, ranging from ultrasound checks to medicines and womb-sparing surgery. A fibroid (myoma) is a benign growth of the womb muscle and very common; many cause no symptoms and need no treatment.
This page is for women advised at home to have a hysterectomy or fibroid removal, or with heavy periods, pain, pressure symptoms or pregnancy plans. In Germany, options that keep the womb are weighed before a hysterectomy. Below: treatment timing, tests, options and hospitals. Other conditions are covered under gynaecology in Germany.
When fibroids are treated and when they are watched
Fibroids are treated when they cause symptoms or hinder pregnancy; small fibroids without symptoms are usually just watched. Reasons to treat include heavy periods with anaemia, pelvic pain, pressure on the bladder or bowel, a growing fibroid, and difficulty conceiving or carrying a pregnancy.
Watching means repeat ultrasound scans. After the menopause, when hormone levels fall, fibroids generally shrink, so rapid growth, especially at this age, calls for a careful work-up to rule out a rare malignant tumour, a sarcoma. Malignant tumours are covered under uterine cancer treatment.
Tests before treatment
Before treatment, fibroids are assessed with ultrasound, if needed MRI, and a blood count. Transvaginal ultrasound (via the vagina) shows the number, size and position of the fibroids; pelvic MRI is added for large or multiple fibroids to plan surgery, and the blood count checks for anaemia.
The position decides the method: fibroids may bulge into the womb cavity, grow within its wall or sit on its outer surface, sometimes on a stalk. A fibroid in the cavity is examined by hysteroscopy, with a thin camera passed through the cervix, and can be removed the same way.
Fibroid treatment options in Germany
Fibroid treatment options in Germany are medicines, womb-sparing removal of fibroids, embolisation and, as a last resort, hysterectomy. Hormonal medicines reduce bleeding, and some shrink fibroids, so they are often used before surgery. Tablets lowering female sex hormones are authorised in the EU for moderate to severe fibroid symptoms. Some cannot be taken long because of side effects such as bone loss, so the doctor chooses the drug and duration.
A fibroid in the cavity is removed hysteroscopically, through the vagina and cervix with no abdominal cuts: the surgeon shaves it away under camera guidance, sometimes in two sessions if it is large.
Fibroids in the wall or on the surface are removed laparoscopically through small cuts; this myomectomy keeps the womb. Difficult cases may be operated robotically, and very large or numerous fibroids may need open surgery. Hysterectomy is discussed when other options do not suit or have failed and no pregnancy is planned. A large fibroid is cut into pieces for removal (morcellation); as this can spread an undetected sarcoma, German surgeons assess the risk beforehand and discuss it with the patient.
In uterine artery embolisation, an interventional radiologist injects tiny particles through a catheter in an artery to block the vessels feeding the fibroids, which then shrink. MRI-guided focused ultrasound destroys fibroid tissue with heat, without cuts, but is not available everywhere. Gaps in the evidence on these methods are set out in a review of fibroid treatments in The Lancet. Women who want children are usually offered myomectomy, as there is less data on pregnancy after embolisation; see also fertility treatment. Fibroids can coexist with endometriosis, and the plan then covers both; see endometriosis treatment.
Where fibroids are treated: hospitals and doctors
Fibroids are treated in the women’s departments of university and large hospitals across Germany. Look for experience in minimally invasive surgery and interventional radiology on site, so that embolisation can be weighed against surgery.
At Marienkrankenhaus Hamburg, the women’s clinic is headed by Assoc. Prof. Ahmed Farouk Abdelkawi, a specialist in minimally invasive and robotic surgery with MIC III, the highest certification level, who speaks German, English and Arabic; the hospital’s robotic system is also used for fibroids. In Frankfurt, Prof. Marc Thill heads the Clinic for Gynaecology at AGAPLESION MARKUS KRANKENHAUS and trained as a DaVinci robotic surgeon in 2018. In Munich, Prof. Martin Pölcher heads gynaecology at the Red Cross Clinic Munich, focusing on gynaecological oncology and minimally invasive surgery, and Prof. Christoph Scholz, whose focus also includes minimally invasive surgery, leads the women’s clinic at München Klinik Harlaching, where fibroid treatment is part of the range. The hospital decides which doctor sees the patient.
Frequently asked questions
Do uterine fibroids always need treatment?
No. Fibroids that cause no symptoms and do not affect pregnancy plans are usually just monitored with ultrasound. Treatment is needed for heavy periods, anaemia, pain, pressure on nearby organs, or when a fibroid hinders conception. A fibroid that grows quickly should be checked promptly.
Can fibroids be removed without removing the womb?
Yes, that is what a myomectomy does. A fibroid in the cavity is removed hysteroscopically without abdominal cuts, fibroids in the wall or on the surface laparoscopically, sometimes robotically, and very large ones by open surgery. Whether this suits you depends on the number, size and position of the fibroids.
Can I get pregnant after fibroid removal?
Yes, keeping the womb is why myomectomy is chosen when a woman wants children. A scar left in the wall of the womb can, rarely, tear during pregnancy or birth, so the surgeon advises how long to wait before conceiving and how to plan the delivery.
How does embolisation differ from surgery?
Embolisation does not remove fibroids but cuts off their blood supply, so they shrink over time; it works through a catheter in an artery, without abdominal cuts. Surgery removes fibroids at once and provides tissue for microscopic examination. Women planning a pregnancy are more often offered surgery.
How AlenMed arranges fibroid treatment in Germany
AlenMed prepares your documents, finds suitable hospitals and organises the trip. Send ultrasound and MRI reports with the size and position of the fibroids, the scans, recent blood tests and earlier operation reports, and mention pregnancy plans in the cover letter; we translate them into German and send the request.
If a hysterectomy has been proposed at home, a German specialist can review your documents for a second opinion before you travel, including whether the womb can be kept. The hospital replies with a cost estimate (Kostenvoranschlag); after the deposit we arrange the visa invitation and an interpreter. AlenMed’s office is in Munich, with partner hospitals across Germany.
This material is for reference only and is not an offer: the treatment plan is decided by a doctor in person.