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Uterine Fibroids

Uterine fibroids are benign (non-cancerous) tumors that grow on or within the lining of the uterus. They can range in size from as small as a grape to as large as a cantaloupe. Approximately 20-40% of women over age 35 have fibroids, and African-American women are at a greater risk for developing them.1

uterine fibroids
types of fibroids

Types of Uterine Fibroids

Fibroids can develop in different areas of the uterus, which can influence symptoms and treatment options.

  • Intramural fibroids – grow within the uterine wall
  • Submucosal fibroids – grow inside the uterine cavity and often cause heavy menstrual bleeding
  • Subserosal fibroids – grow on the outer surface of the uterus
  • Pedunculated fibroids – attached by a stalk

Other Risk Factors for Uterine Fibroids

Beyond age and ethnicity, there are several other risk factors for developing uterine fibroids which include:2

  • Vitamin D deficiency
  • Being overweight
  • High blood pressure
  • Lifestyle/diet (e.g. high red meat and high alcohol consumption)
  • Early menstruation
  • Not having children
  • Environmental chemical exposure

Symptoms of Uterine Fibroids

Fibroids can result in pelvic pain or discomfort, urinary incontinence, frequent urination and heavy menstrual bleeding. The location and size of uterine fibroids can affect the severity of these symptoms and impact your quality of life.3 The list of potential symptoms for uterine fibroids includes, but is not limited to:

  • Menstrual changes (heavy bleeding, periods lasting more than a week and bleeding during periods)
  • Pelvic pressure and/or pain
  • Bladder and bowel issues
  • Enlarged abdomen/increased waist size
  • Lower back or leg pain
  • Fatigue (resulting from anemia from blood loss)
  • Potential infertility or pregnancy complications

Conditions with Similar Symptoms

Many conditions share similar symptoms with uterine fibroids, which is why proper diagnosis is important.

These may include:

  • Fibroids vs. adenomyosis
  • Fibroids vs. endometriosis
  • Fibroids vs. ovarian cysts
  • Fibroids vs. uterine polyps
  • Fibroids vs. uterine cancer

How Are Uterine Fibroids Diagnosed?

Fibroids may be diagnosed with a combination of pelvic exams (your doctor may actually feel the fibroids) or imaging tests. The most often used imaging tests are ultrasound or MRI, and occasionally a diagnostic hysteroscopy (a thin, lighted tube with a camera inserted into the uterus) may be used.4

The Impact of Fibroids on Fertility

Uterine fibroids can affect fertility depending on their size and location.5

  • Some fibroids interfere with implantation
  • Others may impact pregnancy outcomes
  • Many women with fibroids are still able to conceive

If fertility is a concern, it’s important to discuss treatment options that preserve the uterus.

Uterine Fibroid Treatments

If your fibroid symptoms are mild, treatment with medication or hormone therapy may be recommended.
Medications

These may help manage symptoms but do not eliminate fibroids.

Surgical Options

  • Hysterectomy – removal of the uterus
  • Myomectomy – removal of fibroids while preserving the uterus

However, surgery is expensive, requires a long and sometimes painful recovery, and results in scarring. There are also risks and long-term considerations—especially with hysterectomy. With myomectomy, fibroids returning within a few years is common.6

Other Options

Some OB/GYNs offer radiofrequency ablation, which uses heat to shrink fibroids. While effective for some patients, fibroids can return and repeat treatments may be needed.

A Minimally Invasive Alternative

Fortunately, there is a highly effective, minimally invasive option offered by the doctors at PrecisionIR: Uterine Fibroid Embolization (UFE). This non-surgical treatment targets fibroids directly without removing the uterus.

Take our quiz to see if you qualify for UFE »

You can listen to Dr. Vartanian discuss fibroids and UFE with the Mason and Starr Morning Show on our blog.

Uterine Fibroids FAQs

No. Fibroids are benign and do not increase cancer risk.

Yes, many women can—but it depends on size and location.

They may continue to grow and symptoms may worsen over time.

This is very rare, but fibroids can degenerate and cause pain.

Yes, family history can increase your risk.

They may shrink after menopause but typically do not disappear completely.

Large fibroids can contribute to abdominal enlargement or a feeling of weight gain.

References

  1. Stewart, Elizabeth A., et al. “Uterine Fibroids.” The Lancet, vol. 393, no. 10185, 2019, pp. 293–306.
  2. Laughlin-Tommaso, Shannon K., et al. “Uterine Leiomyomas: Individualizing the Approach to a Heterogeneous Condition.” Obstetrics & Gynecology, vol. 133, no. 5, 2019, pp. 889–900.
  3. Bulun, Serdar E. “Uterine Fibroids.” New England Journal of Medicine, vol. 369, no. 14, 2013, pp. 1344–1355.
  4. American College of Obstetricians and Gynecologists. “Management of Symptomatic Uterine Leiomyomas.” ACOG Practice Bulletin No. 228, 2021.
  5. Pritts, Elizabeth A., et al. “Fibroids and Infertility: An Updated Systematic Review.” Fertility and Sterility, vol. 91, no. 4, 2009, pp. 1215–1223.
  6. Parker, William H. “Uterine Myomas: Management.” Fertility and Sterility, vol. 88, no. 2, 2007, pp. 255–271.
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