Fibroids may not need treatment if they’re small or don’t produce symptoms. Your outlook will depend on the size and location of your fibroids.
Fibroids are abnormal growths that develop in or on the uterus.
Sometimes these tumors become quite large and cause severe abdominal pain and heavy periods. In most cases, they cause no signs or symptoms at all.
The growths are typically benign, or noncancerous. The cause of fibroids is unknown.
Fibroids are also known by the following names:
- uterine fibroids
- fibromas
- myomas
- leiomyomas
- uterine myomas
According to the Office on Women’s Health,
There are various types of fibroids. The types differ depending on their location in or on the uterus.
- Intramural fibroids: Intramural fibroids are the most common type. They appear within the muscular wall of the uterus. Intramural fibroids may grow larger and can stretch your uterus.
- Subserosal fibroids: Subserosal fibroids form on the outside of your uterus, which is called the serosa. They may grow large enough to make your uterus appear bigger on one side.
- Pedunculated fibroids: Subserosal fibroids can develop a stem, a slender base that supports the tumor. When they do, they’re known as pedunculated fibroids.
- Submucosal fibroids: These types of tumors develop in the myometrium, the middle muscle layer of your uterus. Submucosal tumors aren’t as common as other types.
- Cervical fibroids: Cervical fibroids develop on the cervix, which connects the uterus to the vagina. They’re also rare.
Your symptoms will depend on the number of tumors you have as well as their location and size. For instance, submucosal fibroids may cause heavy menstrual bleeding and trouble conceiving.
If your tumor is very small or you’re going through menopause, you may not have any symptoms. Fibroids may even shrink during menopause and after menopause. This is because your estrogen and progesterone levels drop during menopause. These hormones stimulate fibroid growth.
Symptoms of fibroids may include:
- heavy bleeding between or during your periods
- menstrual clots
- menstruation that lasts longer than usual
- increased menstrual cramping
- pain in the pelvis or lower back
- pressure or fullness in your lower abdomen
- swelling or enlargement of the abdomen
- increased urination
- pain during intercourse
It’s unclear why fibroids develop. A couple of different factors may influence their formation:
- Hormones: The ovaries produce estrogen and progesterone. These hormones cause the uterine lining to regenerate during each menstrual cycle and stimulate the growth of fibroids.
- Family history: Fibroids may run in the family. If your mother, sister, or grandmother has a history of this condition, you may develop it as well.
People are at greater risk of developing fibroids if they have one or more of the following risk factors:
- a family history of fibroids
are 30 years old or older - a high body weight
People who are African American are also at a higher risk of fibroids than people of other ethnicities.
Ovarian cysts are another type of growth that can develop within the female reproductive system. These fluid-filled sacs are noncancerous and often asymptomatic, just like fibroids.
When symptoms do occur, they can also result in pelvic pain, bloating, and changes to the menstrual cycle. Learn more about how fibroids compare with cysts.
Pregnancy increases your body’s production of estrogen and progesterone. Fibroids may develop and grow rapidly while you’re pregnant.
That said, people who are pregnant are still less likely to develop fibroids than people who aren’t pregnant. According to a 2020 study, fibroids affect 20% to 40% of all women and only 0.1% to 3.9% of pregnant women. Learn more about the connection between fibroids and pregnancy.
For a proper diagnosis, you’ll need to see a gynecologist for a pelvic exam. During this exam, they’ll check the condition, size, and shape of your uterus.
You may also need imaging tests.
An ultrasound uses high-frequency sound waves to produce images of your uterus on a screen. This will allow a doctor or healthcare professional to see the internal structures of your uterus as well as any fibroids.
A transvaginal ultrasound, in which an ultrasound wand is inserted into the vagina, may provide clearer images because it’s closer to the uterus during the procedure.
A pelvic MRI is an in-depth test that produces images of your uterus, ovaries, and other pelvic organs.
A doctor will develop a treatment plan based on your age, the size of your fibroids, and your overall health. You may receive a combination of treatments.
Home remedies and natural treatments
Certain home remedies and natural treatments can have a positive effect on fibroids, including:
- acupuncture
- exercises such as yoga
- massage
- Gui Zhi Fu Ling Tang, a traditional Chinese medicine formula
- applying heat for cramps (avoid heat if you experience heavy bleeding)
Dietary changes can help, too.
Avoid meats and high calorie foods. Instead, opt for:
- foods and drinks that are high in flavonoids
- green vegetables
- green tea
- cold-water fish such as tuna and salmon
Managing your stress levels and aiming for a moderate weight if you are overweight can also be beneficial.
Medications
Medications to regulate your hormone levels may be prescribed to shrink the fibroids.
Gonadotropin-releasing hormone (GnRH) agonists, such as leuprolide acetate (Lupron Depot), will cause your estrogen and progesterone levels to drop. This will eventually stop menstruation and shrink your fibroids.
GnRH antagonists also help to shrink fibroids. These medications work by stopping your body from producing follicle-stimulating hormone and luteinizing hormone. Examples include:
- cetrorelix acetate (Cetrotide), an injectable drug
- ganirelix acetate (Fyremadel), an injectable drug
- elagolix, which is present in the oral drug elagolix/estradiol/norethindrone acetate (Oriahnn)
Other options that can help control bleeding and pain but won’t shrink or eliminate fibroids include:
- over-the-counter anti-inflammatory pain relievers such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Anaprox DS)
- birth control pills
- an intrauterine device (IUD) that releases the hormone progestin
Noninvasive or minimally invasive procedures
Forced ultrasound surgery is a newer and completely noninvasive surgical procedure. You lie down inside a special MRI machine that allows a doctor to visualize the inside of your uterus. High-energy, high-frequency sound waves are directed at the fibroids to ablate, or destroy, them.
Myolysis procedures (such as Acessa) shrink fibroids using heat sources, such as an electric current or laser, while cryomyolysis freezes the fibroids. During endometrial ablation, a healthcare professional inserts a special instrument into your uterus to destroy the uterine lining using heat, an electric current, hot water, or extreme cold.
Another nonsurgical option is uterine fibroid embolization. In this procedure, small particles are injected into the uterus to cut off the fibroids’ blood supply.
Surgery
You may have surgery to remove very large growths or multiple growths. This procedure is known as a myomectomy.
During an abdominal myomectomy, a surgeon makes a large incision in the abdomen to access the uterus and remove the fibroids. A myomectomy can also be performed laparoscopically. During a laparoscopic procedure, a surgeon makes a few small incisions and inserts surgical tools and a camera through those incisions.
Fibroids might grow back after a myomectomy.
If your condition worsens or no other treatments work, a surgeon may perform a hysterectomy. However, this means that you’ll not be able to give birth in the future.
Your outlook will depend on the size and location of your fibroids. Fibroids may not need treatment if they’re small or don’t produce symptoms.
If you’re pregnant and have fibroids, or become pregnant and have fibroids, a doctor will carefully monitor your condition. In most cases, fibroids don’t cause problems during pregnancy. Speak with a doctor if you expect to become pregnant and have fibroids.