They told me to remove my uterus. I refused.

Remove your uterus; it’s the simplest solution.

My gynaecologist pronounced the verdict just months after I had my first miscarriage, hardly a year into my marriage. I remember sitting across from her with my arms wrapped around my abdomen, where the pain was the worst—it felt like someone had kicked me hard in the stomach.

I was diagnosed with submucosal fibroids at the age of 26. It is a non-cancerous tumour that grows in the muscle just beneath the inner lining of the uterus and is common in about 25 per cent of women between the ages of 18 and 45 across the world. Think of it this way: the uterus is like an onion, made up of several layers. Submucosal fibroids grow on the layer nearest to the centre of the uterus, where a baby would develop.

Irrespective of their position, fibroids cause heavy periods. During the first few days, particularly, the pain is so severe that it is impossible to move. At night, I lay paralysed in bed for hours, praying for an end to the misery. In the morning, painkillers—as many as four—helped me function, barely.

My periods have always been this painful. But why they have always been this way is something I found out on the first scan of my very first pregnancy, which was terminated a month before my second trimester ended.

Four months later, I was in the boxy clinic of my gynaecologist, where she told me the ‘only solution’ that exists for my condition. Removing the uterus will cure it, she said, almost as a matter of fact, as if the organ my body was built around was disposable.

I refused.

Thus began a 10-year journey that took me from one doctor to another and ultimately to an alternative most women never knew about: a procedure that could treat what was wrong with me without taking my uterus. But reaching there meant going through two rough pregnancies.

During my second pregnancy, a majority of the doctors I met were very direct: get your uterus removed without trying to conceive ever again. I held my ground, and thankfully found a doctor who was eager to support me in those nine anaemic months. I had to undergo four follow-up scans every month to track the baby’s growth and position, not to mention the several times I stayed the night at the hospital for pre-term labour pain, triggered by the growth of the baby, and the fibroids.

The cycle repeated six years later. At the time of my third delivery, I had around five to six fibroids covering nearly the entire outline of my uterus—it was truly a miracle that my baby survived. That was the point where my husband and I made the reluctant decision not to have more children.

By this time, my doctors too had warned that I would need a myomectomy sooner or later. It is a generally recommended procedure to remove fibroids, which often converts into a hysterectomy—in which both the uterus and fibroids are removed—due to medical complications such as excessive blood loss.

I wasn’t a stranger to the procedure. I had watched my mother go through multiple surgeries for fibroid removal, all of which ultimately led to a hysterectomy. After that, I saw a real decline in her health, and that of several other women her age who went through the same. It was for this reason that I had decided against it and that I had realised the uterus was not just a reproductive organ.

So my quest for better treatment continued. I had grown more desperate than ever. After my last pregnancy, things took a serious turn: my period got so heavy I couldn’t step out of the house. I used that time for obsessive research, and that’s when I came across Uterine Artery Embolisation—a procedure that shrinks fibroids by blocking the blood vessels that feed them.

The procedure itself follows a set sequence: a sedative and IV line to keep the patient comfortable, local anaesthesia at the groin, a small incision to reach the femoral artery, and a catheter guided by X-ray up to the uterine arteries. Dye is injected so the doctor can see the vessels feeding the fibroids, then tiny particles are released through the catheter to block that blood supply. Once the fibroids are cut off from circulation, the catheter is withdrawn and pressure is applied to the incision to stop the bleeding.

In comparison with a hysterectomy or a myomectomy, the recovery tends to be faster. There’s no major incision, hospital stays are shorter, and the uterus stays where it is. A 2025 study by Dr Ziauddin Hospital in Karachi—which followed 67 women treated for symptomatic fibroids—found that patients were typically discharged within hours, if not days, and that those who responded to treatment saw symptoms improve within one to two days. In my case, the stay was two and a half days, followed by counselling for post-op pelvic pain, which took a week to subside.

Just like every other procedure, this treatment too comes with risks: abnormal bleeding, uterine infection, internal injuries, blood clots, and a small chance of premature menopause in women over 45. Some also go through post-embolisation syndrome in the days following the surgery, which involves pelvic cramps, low-grade fever, nausea and fatigue that typically lasts between two and seven days and can easily be managed with medication. Since I had done my research, I knew what to expect and managed it with medication.

And yes, since the procedure does not involve removing the uterus, pregnancy remains possible. However, there isn’t enough research on that front yet.

That said, as successful as it is, the procedure is not cheap. It generally runs between Rs400,000 to Rs1,000,000—at least twice the price of a myomectomy or hysterectomy. Yet, for a majority of the women I met during my journey, money was never the deciding factor, autonomy over their bodies was.

Hence the question arises: why don’t women know about the treatment? Part of the answer is structural. The procedure is performed by interventional radiologists and technologists, not gynaecologists. Research on the question backs this too: even as favourable outcome data for the treatment grew, many gynaecologists still did not routinely offer it as an alternative to hysterectomy or myomectomy, and patients seeking less invasive options sometimes had to bypass their gynaecologist altogether, going directly to an interventional radiologist themselves or getting referred by a primary care doctor.

The American College of Obstetricians and Gynaecologists gives Uterine Artery Embolisation a Level-A recommendation as a legitimate alternative for women who want to keep their uterus. Yet, hysterectomy remains what one industry publication called the “gold standard from payers’ perspectives”, largely because it is a one-time, definitive procedure that’s simpler for insurers to process than an evolving, sometimes-repeated embolisation course.

None of this involves a doctor telling a patient her uterus is good for nothing. It points to a referral gap built into the way medicine is structured and paid for. The fix then is awareness, not blame.

Years back, when my gynaecologist told me to get my uterus removed, I had said no because I was educated and stubborn enough to keep asking the same question: is there any other way to treat this condition? But not every woman walking into a clinic today has the means, the confidence, or the information to do the same. That’s the gap I am trying to close.

Header art by Mohsin Alam

Note: This piece is based on personal experience and should not be taken as medical advice. Please consult a qualified doctor to confirm your diagnosis before considering any treatment, including Uterine Artery Embolisation.