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What You Need to Know About Fibroids

Many women have them and don’t even know it.

Nurse Discussing Records With Senior Female Patient During Home Visit Sitting On Sofa

Medically reviewed in September 2022

Updated on September 19, 2022

Fibroids are benign tumors that grow within the wall of the uterus. They are common, with as many as 80 percent of women developing them by the age of 50, according to some estimates. Most of the time, however, fibroids do not cause symptoms, so you may not know you have them. 

While fibroids can be worrisome, especially for women of childbearing age, they are treatable. Here’s what you need to know.

What are fibroids?
Fibroids, also known as leiomyomas, are tumors that grow in or on the uterus. They are almost always benign, and having fibroids doesn’t increase a person’s risk of uterine cancer. Women may have one or multiple fibroids. Fibroids can be smaller than a pea or grow as large as a cantaloupe.  

Who gets fibroids?
Any person with a uterus can develop fibroids, but these factors may place you at increased risk:

  • You’re older than 30 and haven't begun menopause.
  • You have a family history of fibroids.
  • You’re African American.
  • You’re overweight.
  • You don't eat enough fruit and vegetables.

Healthcare providers (HCPs) don’t know for sure what causes fibroids, but it may have to do with elevated hormone levels. Fibroids tend to grow during pregnancy when hormones are high. They often shrink after menopause or when a woman takes anti-hormone medications. 

What are the symptoms?
Fibroids don’t always cause symptoms, but when they do, the following may occur:

  • Heavy, prolonged, or more frequent menstruation
  • Vaginal bleeding when you don’t have your period
  • Enlargement of the uterus and abdomen
  • Frequent urination
  • Constipation, bowel movement problems, or rectal pain
  • Pain during sex
  • Pain in the abdomen or lower back
  • Pregnancy and delivery complications
  • Reproductive issues
  • Anemia

Your HCP may feel fibroids during a pelvic exam and will confirm the diagnosis using ultrasound or other imaging tests. Fibroids without symptoms are often found incidentally, while examining or imaging for another condition.

How are fibroids treated?
Not everyone needs treatment. It depends on your symptoms, the location and size of the fibroids, your age, and if you want to have children. If the fibroids aren’t bothersome and you don’t plan on becoming pregnant, you may not need to do anything.
     
For mild symptoms, HCPs often suggest ibuprofen or acetaminophen to relieve pain and discomfort. Another first-line medicine, also used to treat heavy periods, is tranexamic acid. It prevents the breakdown of blood clots and reduces heavy flow. Tranexamic acid is taken for up to four days when a woman is menstruating. Low-dose birth control methods can also be used for heavy bleeding, though this added amount of hormone may trigger some additional fibroid growth. 

Other hormone-type drugs, like gonadotropin-releasing hormone (GnRH) agonists, may be used to temporarily shrink fibroids before surgery. GnRH agonists often come with side effects, so your HPC may prescribe “add-back therapy” (low-dose progestin or estrogen) to curb them.
     
If fibroids are especially large or cause severe pain, you may have several treatment options. A myomectomy is a procedure that removes the fibroids while preserving the uterus. After undergoing myomectomy, you may need another procedure if more fibroids grow. 
     
A hysterectomy is another option. It’s a surgery that removes the fibroids and the uterus, with or without the ovaries. People contemplating myomectomy should also know that they may need a hysterectomy in the years after surgery if the fibroids come back.

Another procedure, called uterine fibroid embolization (UFE), is nonsurgical and preferred by many patients. It’s performed by an interventional radiologist, a physician specially trained in image-guided procedures that replace the need for traditional surgery. Compared to surgical approaches, UFE is typically safer, less invasive, less expensive, and has a much shorter recovery time—up to four weeks versus six to eight weeks. What’s more, it enables a patient to keep their uterus. 

Other procedures such as endometrial ablation and myolysis are done in certain cases, but they do not have as long a track record of efficacy as the previous three options. Talk to your HCP about all your options, and together, you can come up with the best treatment plan for you.

Article sources open article sources

Baird DD, Dunson DB, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107.
Yu O, Scholes D, et al. A US population-based study of uterine fibroid diagnosis incidence, trends, and prevalence: 2005 through 2014. Am J Obstet Gynecol. 2018;219(6):591.e1-591.e8.
Freytag D, Günther V, et al. Uterine Fibroids and Infertility. Diagnostics (Basel). 2021 Aug 12;11(8):1455.
Tinelli A, Vinciguerra M, et al. Uterine Fibroids and Diet. Int J Environ Res Public Health. 2021 Jan 25;18(3):1066.
De La Cruz MS, Buchanan EM. Uterine Fibroids: Diagnosis and Treatment. Am Fam Physician. 2017;95(2):100-107.
American College of Obstetrics and Gynecologists. Uterine Fibroids Frequently Asked Questions. Last reviewed: November 2021.
Mayo Clinic. Uterine Fibroids Symptoms and Causes. September 16, 2021.
Mayo Clinic. Uterine Fibroids Diagnosis and Treatment. September 16, 2021.
NHS. Fibroids Treatment. Last reviewed: September 17, 2018.
Alberta Health Services. Uterine Fibroid Embolization: What to Expect at Home. May 2, 2022.
Johns Hopkins Medicine. Is Uterine Fibroid Embolization (UFE) the Right Treatment for You? Accessed on August 17, 2022.
Mayo Clinic. Tranexamic Acid (Oral Route). Last updated February 1, 2022.
Office on Women’s Health. Uterine fibroids. Last updated February 19, 2021.
Marsh EE, Al-Hendy A, et al. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt). 2018 Nov;27(11):1359-1367.

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