Uterine Fibroids: Symptoms, Causes, and Treatment Options
Uterine fibroids are growths in the wall of the uterus, and they are almost always not cancer. Many women have them and never know. For others they cause heavy periods, pain, or pressure that affects daily life.
This article explains the symptoms, who is more likely to get fibroids, how they are found, and the treatment options. If your main problem is heavy bleeding, you can also read Heavy Periods: What’s Normal?.
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Quick Answer
Fibroids are muscular growths in the wall of the uterus. About 20% to 80% of women develop them by age 50, according to the Office on Women’s Health (1). Many cause no symptoms. When they do, the most common problems are heavy or painful periods, pelvic pressure, and frequent urination. Treatment depends on your symptoms and plans for pregnancy (3).
What Fibroids Are
Fibroids can be a single growth or many. Doctors describe them by where they grow. Some grow into the cavity of the uterus, some within the wall of the uterus, and some on the outside of the uterus (1). Fibroids are most common in women in their 40s and early 50s.
Fibroids are almost always benign. A cancerous fibroid is very rare, less than 1 in 1,000, and doctors believe that having fibroids does not raise the risk of this cancer (1).
Symptoms
Most fibroids cause no symptoms. When symptoms appear, the NICHD lists (2):
- Heavy bleeding or painful periods.
- Bleeding between periods.
- Anemia, which means too few red blood cells.
- Pain during sex.
- Lower back pain.
- Pressure or a feeling of fullness in the lower belly.
- Frequent urination, when a fibroid presses on the bladder.
Heavy bleeding can be heavy enough to cause anemia (1). If your periods are heavy and you feel tired, see Iron Deficiency in Women: Why It’s So Common. Other conditions can cause similar symptoms, such as endometriosis, so a proper exam matters.
Who Is More Likely to Get Fibroids
The Office on Women’s Health says that the risk rises with age and with a family history of fibroids. Obesity also raises the risk, and African-American women are more likely to develop fibroids than white women (1). Eating a lot of red meat and ham is linked to a higher risk, and green vegetables seem to protect (1).
How Fibroids Are Found
A doctor may feel fibroids during a pelvic exam. An ultrasound, which uses sound waves to make a picture, can confirm them. Other options include MRI and CT scans, and in some cases a doctor looks inside the uterus with a thin camera (1). For when to book an exam, see When to See a Gynecologist.
Treatment Options
Fibroids without symptoms may not need treatment. The NICHD says the choice depends on your age, general health, symptoms, the size and place of the fibroids, and your plans for pregnancy. Your provider can check the fibroids at routine exams, and they often shrink during and after menopause (3).
Medicine
For mild symptoms, over-the-counter pain relievers and iron supplements can help (1). Low-dose birth control pills do not make fibroids grow and can help control heavy bleeding. The Mirena hormone IUD is another option for bleeding (1). For an overview of birth control methods, see Birth Control Options Explained.
A group of medicines called GnRH agonists can shrink fibroids, but they have side effects, and fibroids usually grow back after you stop taking them (1).
Procedures and Surgery
Several procedures can treat fibroids without removing the uterus. Uterine fibroid embolization blocks the blood supply to the fibroids, and endometrial ablation treats the uterine lining to reduce bleeding (1). A surgery called myomectomy removes the fibroids but keeps the healthy part of the uterus, so it is an option if you want children (1).
A hysterectomy removes the uterus. The Office on Women’s Health says it is the only sure way to cure fibroids (1). It is a big decision, and a second opinion is always a good idea if your questions have not been answered completely (1).
Fibroids and Pregnancy
Most women with fibroids have a normal pregnancy. Their risk of a C-section is six times higher, and a breech baby, problems in labor, and early delivery are also more likely (1). The NICHD also lists infertility and repeated miscarriages (2). Tell your obstetrician if you have fibroids and become pregnant.
When to See a Doctor
Consider speaking with a healthcare professional if:
- Your periods are heavy, long, or painful enough to disrupt your life.
- You bleed between periods.
- You feel pressure in your lower belly or need to urinate much more often.
- You have pain during sex.
- You feel very tired, weak, or short of breath, which can be signs of anemia.
- You want to become pregnant and know that you have fibroids.
Seek urgent care for sudden severe pelvic pain or very heavy bleeding. Do not wait for your next appointment.
Conclusion
Fibroids are very common, almost always not cancer, and often cause no symptoms. When they do cause problems, heavy periods, pelvic pressure, and frequent urination are the most common.
Medicine can control bleeding, and procedures or surgery can remove or shrink the fibroids. The best choice depends on your symptoms, your age, and your plans for pregnancy. See a doctor if your periods are heavy or your symptoms affect daily life, because treatment can help.
