Uterine fibroids are among the most common benign gynecologic conditions affecting women of reproductive age. Yet their impact extends well beyond the uterus. Heavy menstrual bleeding, pelvic pain and pressure, anemia, reproductive concerns, and effects on daily functioning and quality of life can have substantial personal and economic consequences. Importantly, the burden of fibroids and access to treatment are not experienced equally. Evidence has consistently documented racial, socioeconomic, and geographic disparities in fibroid prevalence, severity, treatment, and outcomes. [1-3]
Uterine fibroid embolization (UFE), also referred to as uterine artery embolization, has expanded the range of minimally invasive treatment options available to women with symptomatic fibroids. By reducing blood flow to fibroids, UFE can provide symptom relief while avoiding major surgery and preserving the uterus. However, the future of fibroid care should not be defined by procedural innovation alone. The larger challenge is ensuring that women have equitable access to information, treatment choices, and care that reflects their individual health and reproductive goals.
Moving Beyond a Procedure-Centered Model
Historically, discussions of fibroid treatment have often focused on the technical characteristics of individual interventions. Today, a more patient-centered approach is needed.
Women may consider multiple treatment options depending on the severity and location of their fibroids, symptoms, age, reproductive plans, medical history, access to care, and personal preferences. These options can include medications, hysteroscopic or surgical myomectomy, hysterectomy, UFE, and other minimally invasive approaches.
The important question is therefore not simply whether a particular procedure is effective. It is whether women are receiving understandable information about the available options and are able to participate meaningfully in decisions about their care.
This is especially important for women who wish to preserve fertility or avoid hysterectomy. A systematic review and meta-analysis examining UFE versus hysterectomy found that patient characteristics were associated with treatment utilization, while also highlighting the limited evidence available regarding demographic differences in UFE use. [4]
Health Equity Must Be Part of Fibroid Innovation
Innovation in fibroid care will have limited population-level impact if access remains unequal.
Recent research continues to demonstrate associations between race, socioeconomic circumstances, rurality, education, insurance, and the invasiveness of fibroid treatment. A 2026 study of more than 133,000 patients found that race, income, education, and rurality were independently associated with the level of treatment invasiveness after adjustment for age, year of surgery, and insurance type. [5]
These disparities should not be interpreted simply as differences in patient preference. Access to specialists, referral patterns, health literacy, transportation, financial resources, geographic availability of minimally invasive procedures, and the quality of communication between patients and clinicians can all influence treatment pathways.
A recent consensus panel on fibroids and health equity identified several priorities, including improving patient education for individuals with lower health literacy, using digital technologies to improve awareness, and understanding barriers that influence access to fibroid care and treatment choices. [6]
For healthcare systems, this suggests that improving fibroid outcomes requires more than adding new procedures. It requires building systems that help patients reach appropriate care and understand their choices.
Patient-Centered Care Begins With Listening
Patient-centered fibroid care should begin with a simple question: What matters most to the patient?
For one woman, controlling heavy bleeding may be the highest priority. For another, preserving fertility may be central. Someone else may prioritize minimizing recovery time, avoiding major surgery, reducing pain, or maintaining the ability to work and care for family.
These priorities should be incorporated into shared decision-making rather than treated as secondary considerations.
Health literacy is particularly important. Research suggests that limited health literacy may contribute to differences in awareness, diagnosis, and treatment of fibroids. Patient education should therefore use clear, accessible language and allow women to understand the benefits, limitations, risks, and uncertainties associated with available treatment options. [7]
Culturally responsive communication is equally important. Women’s beliefs about menstruation, fertility, surgery, the uterus, and reproductive health can influence how they perceive treatment. Healthcare professionals should recognize these perspectives without making assumptions about individual patients.
From Access to Equity
The next generation of fibroid care should measure success not only by procedural outcomes but also by whether patients receive timely, appropriate, and equitable care.
Healthcare systems can take several practical steps:
- strengthen referral pathways between primary care, gynecology, and interventional radiology;
- provide accessible educational materials about fibroids and treatment options;
- incorporate patient-reported outcomes and quality of life into treatment decisions;
- address transportation, cost, scheduling, and geographic barriers;
- use patient navigation for women facing complex treatment decisions;
- strengthen shared decision-making and culturally responsive communication; and
- evaluate treatment patterns by race, socioeconomic status, geography, insurance, and other relevant social determinants of health.
These strategies shift the conversation from simply expanding treatment availability to ensuring that innovations actually reach the women who need them.
Looking Ahead
UFE represents an important development in minimally invasive fibroid treatment, but its greatest potential will be realized when procedural innovation is combined with health equity and patient-centered care.
The future of fibroid care should therefore ask more than “Can we treat the fibroid?” It should ask: “Can we ensure that every woman has the information, access, choices, and support needed to make a treatment decision consistent with her health, circumstances, and goals?”
That broader perspective can help transform fibroid care from a procedure-centered model into a more equitable model of women’s health – one in which innovation, access, and patient voice are equally important.
References
- Al-Hendy A, Myers ER, Stewart E. Uterine Fibroids: burden and unmet medical need. Seminars in Reproductive Medicine. 2017.
- Katon JG, Plowden TC, Marsh EE. Racial disparities in uterine fibroids and endometriosis: a systematic review and application of social, structural, and political context. Fertility and Sterility. 2023
- Evans J. The impact of health literacy on uterine fibroid awareness, diagnosis, and treatment in the United States: a mini literature review. Frontier Reproductive Health. 2024
- Srinivas T, Lulseged B, Attari MM, et al. Patient characteristics associated with embolization versus hysterectomy for uterine fibroids: a systematic review and meta-analysis. Journal of the American College of Radiology. 2024
- Louie M, Stevens MA, Salunke J, et al. Racial and socioeconomic disparities in approach to treatment of uterine fibroids. Journal of Minimally Invasive Gynecology. 2026.
- Taylor AC, Marsh EE, Stewart EA, et al. Fibroids and health equity: proceedings from the Society of Interventional Radiology Foundation Research Consensus Panel. Journal of Vascular and Interventional Radiology. 2025.
- Laily A, Nair I, Shank SE, et al. Enhancing uterine fibroid care: clinician perspectives on diagnosis, disparities, and strategies for improving health care. Women’s Health Reports. 2024.