Uterine fibroids are benign tumors arising from uterine smooth muscle. Estrogen and progesterone promote growth, and risk is higher with family history, obesity, and in people of African ancestry. Diagnosis relies on pelvic exam and imaging (usually transvaginal ultrasound). Management ranges from watchful waiting and medical therapy to minimally invasive procedures (uterine artery embolization, focused ultrasound) and surgery (myomectomy or hysterectomy). Treatment choice depends on symptoms, fibroid location, size, and fertility desires.

What are fibroids?

Fibroids, medically called uterine leiomyomas, are benign (noncancerous) tumors that arise from the smooth muscle of the uterus. They vary widely in size - from tiny nodules only seen on imaging to large masses that distort the uterus. Many fibroids cause no symptoms and are found incidentally during a pelvic exam or imaging.

What causes fibroids?

The exact cause is unknown, but hormones and genetics play important roles. Estrogen and progesterone tend to stimulate fibroid growth, so fibroids usually appear during a woman's reproductive years and often shrink after menopause. Family history, race (people of African ancestry develop fibroids more often and at younger ages), obesity, and early onset of periods increase risk.

Types of fibroids

  • Submucosal: project into the uterine cavity and often cause heavy bleeding.
  • Intramural: develop within the uterine wall and are the most common type.
  • Subserosal: project to the outside of the uterus and may cause bulk symptoms.
  • Pedunculated: attach to the uterus by a stalk; they can be subserosal or submucosal.
Other descriptions (for example parasitic or interligamentous) describe uncommon locations or behavior but the three main categories above guide most care.

How are fibroids diagnosed?

Clinicians begin with a history and pelvic exam. Imaging confirms the diagnosis and maps size and location. Transvaginal ultrasound is the most common first test. Saline infusion sonography, MRI, and hysteroscopy give more detail when planning treatment or evaluating abnormal bleeding.

Symptoms that prompt treatment

Many women need no treatment. When symptoms occur, they most often include heavy or prolonged menstrual bleeding, pelvic pain or pressure, urinary frequency, constipation, and fertility problems (especially with submucosal fibroids). Rarely, very large fibroids can cause anemia from blood loss or significant pelvic bulk symptoms.

Treatment options today

Treatment depends on symptoms, fibroid size and location, patient age, and desire for future fertility.

  • Expectant management (watchful waiting) is appropriate for asymptomatic or mildly symptomatic fibroids.
  • Medical therapy can reduce bleeding and temporarily shrink fibroids. Options include hormonal contraceptives, intrauterine devices releasing levonorgestrel, and short-term use of gonadotropin-releasing hormone (GnRH) modulators. Newer oral GnRH antagonists with add-back therapy offer another non-surgical option for symptom control.
  • Minimally invasive procedures include uterine artery embolization (UAE) and MRI-guided focused ultrasound for selected patients seeking uterine preservation.
  • Surgical options include myomectomy (removal of fibroids while preserving the uterus) for women who want future fertility, and hysterectomy (removal of the uterus) for definitive treatment.
  • Endometrial ablation is effective for heavy bleeding when fibroids are small and confined to the uterine cavity but is not a fertility-preserving solution.
Discuss individual risks and benefits with a gynecologist. For example, power morcellation during minimally invasive surgery carries a small risk of spreading an unexpected cancer, so surgeons use containment strategies and patient counseling.

When to see a doctor

Seek evaluation for heavy menstrual bleeding that causes anemia, severe pelvic pain, rapidly growing pelvic mass, or fertility concerns. Early diagnosis helps match the treatment to personal goals and reproductive plans.

FAQs about Fibroid Tumors

Are fibroids cancerous?
No. Fibroids (leiomyomas) are benign. Malignant transformation to leiomyosarcoma is rare, but clinicians discuss this possibility when planning surgery.
Can fibroids cause infertility?
Some fibroids can affect fertility, particularly submucosal fibroids that distort the uterine cavity. Myomectomy can improve fertility for selected patients.
Will fibroids always need surgery?
Not always. Many fibroids are asymptomatic and require no treatment. Medical therapy or minimally invasive procedures can control symptoms for many women.
What treatments preserve the uterus?
Myomectomy, uterine artery embolization (in many cases), and MRI-guided focused ultrasound are uterine-preserving options. Choice depends on fibroid characteristics and future fertility plans.
Do fibroids go away after menopause?
Fibroids often shrink after menopause because of reduced hormone levels, though exceptions occur.

News about Fibroid Tumors

Heart disease risk 81% higher for women with uterine fibroids, study finds - NBC News [Visit Site | Read More]

5 Types of Pain That May Signal Uterine Fibroids - Health: Trusted and Empathetic Health and Wellness Information [Visit Site | Read More]

Uterine fibroids linked to risk for atherosclerotic heart disease - Healio [Visit Site | Read More]

Uterine Fibroids & Abnormal Bleeding - University of Michigan Health [Visit Site | Read More]

The epidemiology and pathogenesis of uterine fibroids - Munro - 2025 - International Journal of Gynecology & Obstetrics - Wiley Online Library [Visit Site | Read More]

Editorial: Uterine fibroid surgery in gynecology and obstetrics and reproduction: lights and shadows - Frontiers [Visit Site | Read More]