Let’s Chat About Transcervical Radiofrequency Ablation: Uterine Fibroid Treatment
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For many women, being told they have uterine fibroids brings tough decisions. Fibroids are noncancerous growths in the uterus, and about half of all women will get them at some point. For some, the symptoms are painful and disrupt daily life.
Until recently, the choices for treatment were limited: take medicine to manage symptoms or have major surgery, often a hysterectomy (removing the uterus). While surgery can bring relief, it also takes away the chance to have children and requires a long recovery.
But the story is starting to change. A new option, called Transcervical Radiofrequency Ablation (TFA), performed with the Sonata System, offers women a less invasive, incision-free way to treat fibroids while preserving their uterus.
Let’s look at five surprising facts about this treatment and why it may reshape the future of uterine health.out this treatment that are reshaping uterine health.
1. It’s Fast and Incision-Free—Even for Large Fibroids
One of the most exciting things about TFA is how quickly it works. For example, in a study of fibroids 5 cm or larger, the average treatment time was just about 9 minutes.
Compare that to laparoscopic surgery, which usually takes around 113 minutes—almost 2 hours—plus several incisions. With TFA, no cutting is needed, and recovery is much faster. This makes it a life-changing option for women who want relief without weeks of downtime.
2. Re-Treatment Doesn’t Mean Failure
A long-term study in the Netherlands showed that about 45% of women needed another procedure within 3 years. At first, that might sound like a bad result. But here’s the twist:
- 85% of women said they would recommend TFA to others.
- Many follow-up treatments were simpler, less invasive surgeries.
This suggests a new way to think about success. For some women, TFA may act like step one—shrinking large fibroids so a second, smaller procedure is easier later. More importantly, it gives women the chance to preserve their uterus, which many say is worth it.
In fact, a survey of almost 1,000 women with fibroids found:
- 79% wanted to avoid invasive treatment.
- 51% wanted to preserve their uterus.
Clearly, success isn’t just about one-and-done surgery. It’s about giving women more choices.
3. Pregnancy After Treatment Is Possible
For women who want children, the good news is growing. A 2024 review documented 89 pregnancies after TFA treatment. None of these cases reported dangerous complications like uterine rupture or stillbirth.
There have been both vaginal and C-section births, including one groundbreaking case where a woman previously labeled “infertile” became pregnant after TFA and later gave birth with help from fertility treatments.
TFA works by destroying fibroid tissue while preserving a healthy uterus. That precision may open doors for women who want to treat fibroids but keep the possibility of pregnancy alive.
4. Patient Satisfaction Is Extremely High
Numbers from the U.S. SONATA trial show that the benefits of TFA last well beyond the first year. At the 3-year mark:
- 94% of women were satisfied with their treatment.
- 88% saw fewer fibroid symptoms.
- Quality of life scores more than doubled.
- Symptom severity dropped by more than half.
Even better, only 9.2% of women needed another surgery after 3 years—much lower than the rates seen in some real-world studies. For the right patients, this procedure offers lasting relief without losing their uterus.
5. It Could Help Close a Major Health Gap
Fibroids affect women of all races, but Black women carry the heaviest burden:
- By age 50, over 80% of Black women will have fibroids (compared to about 70% of white women).
- Black women are also 2 to 3 times more likely to have a hysterectomy.
For decades, this has meant more invasive surgeries and fewer options for Black women. But minimally invasive treatments like TFA may help close that gap.
In fact, studies of a similar procedure (laparoscopic radiofrequency ablation) showed that while Black women started out with more severe symptoms, their results were just as favorable as those of white women by the 3-year follow-up.
That makes TFA not just a medical breakthrough—it’s also a step toward health equity.
What to Ask Your Doctor
If you are considering this treatment option, here are a few tips to help you prepare for your next appointment. Consider asking the following questions:
- Based on the size and location of my fibroids, am I a good candidate for any of these procedures?
- What are the risks and benefits of each option for me personally?
- What does recovery look like for the procedure you recommend?
- If I want to have children in the future, how does that affect my treatment options?
Self-Advocacy: How to Be Your Own Best Health Advocate
Your voice matters — especially when it comes to decisions about your body and fertility. Before agreeing to any fibroid treatment, take time to understand your options and speak up about what matters most to you. At Rooted in Violet & Co., we believe that you are the architect of your own health. While doctors bring clinical expertise, you bring the lived experience of your own body. When navigating fibroid treatments, use the ROOT Framework to move from uncertainty to a clear strategy for your healing.
T – Take Note & Follow-Up: Document every medical recommendation and your answers to questions. If a doctor tells you that a hysterectomy is your only option, write that down and then ask for a referral for a second opinion. Turning advocacy into a habit protects your health and ensures you are a partner in your own care.
R – Reveal What’s Going On: Don’t ignore the “heavy sigh” or the “flutter in your chest” that comes from the stress of living with pain. Start by tracking your symptoms in a journal. Note how many pads you use, the level of your pelvic pain, and how your symptoms affect your daily life and mood. Your body’s signals are valid and deserve a full investigation.
O – Offer Your Observations: When you meet with your provider, use your notes to clearly describe the patterns you’ve noticed. Instead of saying “I have heavy periods,” try saying, “I’ve noticed I have to change my protection every hour for three days straight.” Using specific, fact-based language helps your doctor understand the severity of your situation.
O – Outline What You Need: Be clear about your goals. If preserving your fertility or keeping your uterus is important to you, say it out loud. Ask specifically for the treatments you want to discuss, such as a robotic myomectomy, Uterine Fibroid Embolization (UFE), or the Acessa procedure. Remember, advocacy is a form of collaboration, not confrontation. When you take an active role in your healthcare, you create a partnership that leads to better outcomes, less stress, and more control over your reproductive health.
T – Take Note & Follow-Up: Document every medical recommendation and your answers to questions. If a doctor tells you that a hysterectomy is your only option, write that down and then ask for a referral for a second opinion. Turning advocacy into a habit protects your health and ensures you are a partner in your own care.
A Cautionary Tale
While knowing your medical options is the first step, seeing those options in action can change your entire perspective on what’s possible for your body. For many Black women, the word ‘fibroids’ is often followed immediately by the word ‘hysterectomy’—but that doesn’t have to be the end of your story. In the video below, you’ll meet Briana Johnson, a woman who was told by multiple doctors that she would have to lose her pregnancy and her fertility to treat a massive fibroid. Her journey to find a specialist who would truly listen and provide a life-saving myomectomy is a powerful reminder that your voice and your choice matter. Watch her story to see why a second opinion isn’t just a right—it’s a necessity
Conclusion: A New Chapter in Uterine Health
TFA with the Sonata System represents more than just a new treatment. It changes the way we define success in fibroid care. Instead of choosing between living with symptoms or losing the uterus, women now have a third option:
- Fast, incision-free treatment
- Durable symptom relief
- Preserved fertility and organ health
- A step toward equity in women’s health
This marks a new chapter in how women can discuss their bodies, choices, and futures. As more women learn about incision-free treatments, one big question remains: How will this shift the lifelong conversation about uterine health—and women’s power to choose?