(Fibroids; Leiomyoma; Myoma; Fibromyoma)
Fibroids are benign (noncancerous) growths in the wall of the uterus (womb). The uterus is the organ where a fetus grows during pregnancy.
Fibroids are common. They may be very small or they could grow to 8 or more inches in diameter. Most fibroids remain inside the uterus. Sometimes, they may stick out and affect nearby organs. It is common for there to be more than 1 fibroid.
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The cause of fibroids is unknown.
Fibroid growth is stimulated by female reproductive hormones. As a result:
- Fibroids grow larger during pregnancy and shrink after childbirth.
- Fibroids become less of a problem after menopause. However, symptoms may return with hormone replacement therapy (HRT).
Genetics may make some women more prone to fibroids. Substances that control blood vessel growth may also affect fibroid growth.
African American women are at increased risk. Other factors that affect your risk of fibroids include:
- Risk increases with age until menopause
- Family history
There may be no symptoms, or they may be mild or severe. This depends on the size and location of the growths.
Symptoms may include:
- Pelvic pain or pressure
- Heavy menstrual bleeding
- Clots in menstrual flow
- Long periods
- Bleeding between periods
- Increased cramping during periods
- Pain during sex
- Frequent need to urinate
- Abdominal swelling
- Low back or leg pain
- Infertility by blocking the fallopian tubes
If menstrual bleeding is heavy, you may be develop iron-deficiency anemia. Symptoms of iron-deficiency anemia include fatigue and exercise intolerance. If you experience these symptoms, talk to your doctor.
Most fibroids are found during routine pelvic exams.
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Most women with fibroids do not have symptoms and do not need treatment. Your doctor may recommend monitoring any changes on a regular basis. Treatment may be done later if needed.
The doctor may advise:
- Over-the-counter pain relievers to ease mild symptoms
- Nonsteroidal anti-inflammatory drugs (NSAIDs) to reduce inflammation and relieve cramping
- Prescription pain medication—if pain cannot be managed with medications above
Hormone medications may be an option for those who are not trying to become pregnant. These medications can shrink fibroids, reduce abnormal bleeding, and lessen pain. However, fibroids can return after these medications are stopped. These medications may be used to make fibroids smaller just before surgery.
Surgery may be considered if:
- The uterus becomes extremely large
- The fibroids are interfering with fertility
- Symptoms are severe
Surgical procedures include:
- Myomectomy —The fibroids are removed from the uterus through open or laparoscopic surgery. This can also be done using hysteroscopy, in which a long, thin telescope with a camera along with other surgical tools are used to remove the fibroids.
- Hysterectomy —The entire uterus is removed. You will be unable to have children if you have this surgery.
Other options include:
- Uterine fibroid embolization—This is a minimally invasive procedure. It blocks blood flow to the fibroids. This will make the fibroids shrink.
- Focused ultrasound therapy—Energy is centered on the fibroid to destroy it. This procedure may not be ideal for those who are overweight, have very large fibroids, or have extensive scars from prior abdominal surgeries.
There are no current guidelines to prevent uterine fibroids.
American Congress of Obstetricians and Gynecologists
The International Council on Infertility Information Dissemination, Inc.
The Society of Obstetricians and Gynaecologists of Canada
Women's Health Matters
Fibroids. Healthy Women website. Available at: http://www.healthywomen.org/condition/fibroids. Accessed December 11, 2017.
Uterine fibroid embolization (UFE). Radiological Society of North America Radiology Info website. Available at: http://www.radiologyinfo.org/en/info.cfm?pg=ufe. Updated June 24, 2016. Accessed December 11, 2017.
Uterine leiomyoma. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T115612/Uterine-leiomyoma. Updated April 15, 2016. Accessed December 11, 2017.
Last reviewed November 2018 by Beverly Siegal, MD, FACOG Last Updated: 12/20/2014