Learn About Fibroid Treatment Options and Information

Understanding What Fibroids Are and How They Form

Uterine fibroids are noncancerous tumors that grow in or on the uterus. They are also called leiomyomas or myomas. Fibroids vary greatly in size — some are as small as a pea, while others can grow as large as a grapefruit or bigger. A person may have just one fibroid or multiple fibroids at the same time.

Fibroids develop from the smooth muscle cells in the uterine wall. Doctors do not fully understand why fibroids form, but research suggests that hormones play a role. Estrogen and progesterone, the hormones that regulate the menstrual cycle, appear to promote fibroid growth. This is why fibroids often develop during a person's reproductive years and may shrink after menopause when hormone levels drop.

According to the National Institutes of Health, fibroids occur in 70 to 80 percent of women by age 50, though not all women with fibroids have symptoms. African American women are more likely to develop fibroids and tend to develop them at younger ages than white women. Genetic factors also play a role — if your mother or sister had fibroids, your risk is higher.

Fibroids are classified by their location in the uterus. Submucosal fibroids grow into the uterine cavity and can cause heavy bleeding. Intramural fibroids grow within the muscular wall of the uterus and may enlarge the uterus. Subserosal fibroids grow on the outside of the uterus toward the pelvis. The location and size of fibroids determine what symptoms you might experience and which treatments may work best.

Practical takeaway: Understanding your fibroid type and size helps you discuss treatment options with your healthcare provider. Ask your doctor to explain where your fibroids are located and how large they are, as this information directly affects which treatments are most suitable for your situation.

Recognizing Symptoms and When to Seek Medical Attention

Many people with fibroids experience no symptoms at all and discover fibroids only during a routine pelvic exam or ultrasound. However, when symptoms do occur, they can range from mild to severe. The most common symptom is abnormally heavy menstrual bleeding, sometimes lasting longer than a week. Some people pass blood clots larger than a quarter during their period.

Pelvic pain and pressure are also frequent symptoms. People may feel a constant ache, sharp pain, or pressure in the lower abdomen, lower back, or pelvis. This discomfort may worsen during menstruation. Large fibroids can make the abdomen feel full or bloated and may cause visible enlargement of the belly, similar to pregnancy.

Additional symptoms may include frequent urination, difficulty emptying the bladder, constipation, and pain during sexual intercourse. Some people experience fatigue and shortness of breath, often caused by anemia from prolonged heavy bleeding. In rare cases, fibroids can affect fertility or cause complications during pregnancy.

You should contact a healthcare provider if you experience heavy menstrual bleeding that affects your daily life, pelvic pain that lasts more than a few days, or pressure symptoms that do not improve with over-the-counter pain relievers. A doctor can perform a physical exam and order imaging tests to diagnose fibroids. Early evaluation helps you understand your condition and explore treatment options before symptoms worsen.

Practical takeaway: Keep a symptom diary for two to three months before visiting your doctor. Note the dates of your period, how many days you bleed, whether you pass blood clots, pain levels on a scale of 1 to 10, and how symptoms affect your work or daily activities. This record helps your doctor assess the severity of your fibroids and recommend appropriate treatments.

Overview of Medical Imaging and Diagnostic Tests

Diagnosing fibroids typically begins with a pelvic exam, where your doctor feels the uterus to detect lumps or irregular shapes. To confirm the diagnosis and determine the number, size, and location of fibroids, doctors use imaging tests. The most common test is a transvaginal ultrasound, where a small probe is inserted into the vagina to create detailed images of the uterus and fibroids. This test is painless and takes about 15 to 20 minutes.

Transabdominal ultrasound is another option, performed by moving a probe over the lower abdomen while you lie on your back. This test works well for detecting larger fibroids but provides less detail than transvaginal ultrasound. Both ultrasound types use sound waves and do not expose you to radiation.

If ultrasound images are unclear or your doctor needs more detailed information, an MRI (magnetic resonance imaging) scan may be ordered. MRI provides three-dimensional images and helps doctors understand the exact position and size of each fibroid, which is especially important for planning surgery. MRI scans take 30 to 45 minutes and are painless, though you must lie still inside a machine that makes loud humming noises.

Hysterosalpingography uses X-rays and dye to create images of the uterus and fallopian tubes. This test is sometimes used when fibroids may affect fertility. Sonohysterography involves injecting sterile fluid into the uterus during ultrasound to get a clearer view of submucosal fibroids. Blood tests may be ordered to check for anemia if you have heavy bleeding, as this affects treatment planning.

Practical takeaway: Before your diagnostic test, ask your doctor which test you will receive and why. Understand that multiple imaging tests may be needed to fully map your fibroids, and this information guides your treatment decisions. Request a copy of your test results and imaging reports to keep in your personal health records.

Nonsurgical Treatment Options for Fibroids

Many people manage fibroid symptoms without surgery, particularly if symptoms are mild or moderate. Over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen or naproxen reduce pain and heavy bleeding in some people. These medications work best when taken at the start of your period and continued for a few days. Iron supplements may help prevent or treat anemia caused by heavy menstrual bleeding.

Hormonal birth control methods are frequently used to manage fibroid symptoms. Oral contraceptive pills regulate the menstrual cycle and often reduce bleeding and pain. The hormonal IUD (intrauterine device) releases a small amount of the hormone levonorgestrel directly into the uterus, reducing bleeding by 80 to 90 percent in many cases. The hormonal IUD is effective for up to seven years and does not require daily attention like birth control pills.

GnRH agonists are prescription medications that lower estrogen and progesterone levels, causing fibroids to shrink. Leuprolide and goserelin are examples of GnRH agonists. These medications typically shrink fibroids by 40 to 60 percent over three to six months. However, they cause menopausal side effects such as hot flashes, vaginal dryness, and mood changes. Doctors usually prescribe GnRH agonists for short-term use before surgery or to manage severe symptoms, not for long-term treatment.

Tranexamic acid is an oral medication taken during menstruation that reduces heavy bleeding without affecting hormone levels. Studies show it can decrease menstrual bleeding by 30 to 60 percent. Lifestyle changes such as increasing iron intake through diet, managing stress, and regular exercise also help some people feel better while managing fibroid symptoms.

Practical takeaway: Nonsurgical treatments work best for symptoms rather than eliminating fibroids. If you try one treatment for three to six months without improvement, discuss alternative options with your doctor. Keeping track of whether symptoms improve on specific medications helps your doctor understand what approaches may work for your individual situation.

Surgical and Minimally Invasive Treatment Procedures

When nonsurgical treatments do not provide relief or fibroids are very large, surgical options become relevant. Myomectomy is a surgery that removes fibroids while preserving the uterus, making it suitable for people who wish to become pregnant or