One-third of American women experience some type of pelvic health disorder by the time they’re 60. And about 600,000 women every year have a hysterectomy — removing their uterus to relieve troubling symptoms. Overall, an estimated 20 million women have had a hysterectomy.

But if you have painful periods with excessive bleeding, fibroids, endometriosis, or another pelvic health problem, you should know that there are alternatives to hysterectomy to consider.

Uterine Fibroids

These tumors, usually benign, are generally found on the smooth muscles of the uterus, and can cause pelvic pain, infertility, and heavy menstrual bleeding. Uterine fibroids are a major reason why women have hysterectomies, accounting for between 177,000 and 366,000 of the annual total.

If your fibroids are causing no symptoms, it’s entirely reasonable to adopt a strategy called “watchful waiting” — monitoring their status with your doctor and not having any surgery unless problems develop. But if you are experiencing pain, discomfort, or pressure, there are several less-invasive options for treating fibroids:

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