At Mayo Clinic in Arizona, gynecologist Megan Wasson, D.O., is part of a quiet revolution in how women are treated for two of the most common gynecological conditions: endometriosis and uterine fibroids. Where previous generations of women were routinely told hysterectomy was their only option, today's patients have choices—minimally invasive procedures, fertility-preserving surgeries, and emerging treatments like vaccines that could prevent disease altogether.
Uterine fibroids, benign growths in the uterus, can range from microscopic to grapefruit-sized masses that fill the pelvis and abdomen. Many women don't know they have them until a routine pelvic exam, but for others, the impact is severe: heavy painful periods, pelvic and abdominal pain, constant bathroom trips as fibroids press on the bladder, or constipation from fibroids compressing the bowel. Some women reach a point where their pants no longer fit due to abdominal bloating. "These are not just little inconveniences," Wasson explains. "These are very large, very significant masses, and they can really impact quality of life."
The shift away from hysterectomy has been dramatic. Today, interventional radiologists can perform uterine fibroid embolization—blocking blood supply to fibroids so they shrink—with patients typically going home the same day. Radiofrequency ablation uses energy to destroy fibroid tissue. Robotic or laparoscopic myomectomy removes fibroids while preserving the uterus itself. For women who want to bear children, these advances are transformative.
Endometriosis presents a different puzzle. In this condition, tissue similar to the uterine lining grows outside the uterus, causing pelvic pain, heavy periods, and painful intercourse. What makes it particularly significant is that it increases the risk of ovarian cancer and can cause infertility—often the reason women discover they have it in the first place. Symptoms typically begin much earlier in life than fibroids, often in a woman's teens or twenties, making early detection critical.
Conservative surgical approaches now use minimally invasive laparoscopy, sometimes aided by robotic technology, to remove endometriosis tissue while protecting the uterus and ovaries. But Wasson and her colleagues are thinking even further ahead. They're developing a vaccine to prevent endometriosis before it starts—a game-changing possibility that could spare thousands of women from years of pain and fertility struggles. Simultaneously, researchers are exploring medical imaging techniques that could make endometriosis visible by causing it to "light up" during scans, transforming diagnosis from a challenge into a clarity.
What ties these advances together is a fundamental shift in medical philosophy: recognizing that women's reproductive health matters beyond symptom relief. Fertility preservation, quality of life, and preventive medicine are now central to how gynecologists approach these conditions. Both fibroids and endometriosis can run in families and neither is preventable—yet—but the next generation of treatments promises to change that calculus. While their symptoms can overlap and present differently, both conditions are now recognized as serious enough to warrant individualized, sophisticated care rather than the one-size-fits-all solution of the past.