Uterine Fibroids: Causes, Symptoms, Types, and Treatment Options

Overview: What Are Uterine Fibroids?

Uterine fibroids, also known as fibroid in the uterus, fibroids in uterus, myomas, or uterine myomas, are non-cancerous (benign) growths in the uterus made up of smooth muscle and fibrous connective tissue. These growths—sometimes described as a mass in the uterus—can range in size from tiny, pea-sized nodules to large tumors that distort the shape of the uterus.

Fibroids are very common among women of reproductive age, especially between 30 and 50 years old. In fact, 20–40% of women will develop fibroids at some point in their lives. Many women never notice them because fibroids often cause no symptoms. However, depending on their size and location, they may lead to heavy menstrual bleeding, pelvic pain, pressure symptoms, fertility problems, or bladder and bowel discomfort.

Understanding the meaning of fibroid uterus or simply “what is fibroid?” is important because the condition varies widely from woman to woman. While the exact cause is not fully known, hormonal factors—particularly estrogen and progesterone—and genetic predisposition play a significant role in the development of uterine fibroid growths.

The good news is that fibroids are treatable, and many do not require surgery. With early diagnosis and the right management approach, women can effectively control symptoms and maintain their comfort, health, and fertility. For anyone wondering “what is uterine fibroid?” or “what is myoma?”, the key takeaway is that fibroids are benign, manageable, and highly responsive to appropriate medical care.

Types of Uterine Fibroids

Fibroids are classified based on where they develop in or around the uterus. Understanding these types is important because location often determines symptoms, complications, and treatment choices.

1. Intramural Fibroids

• Location: Inside the muscular wall of the uterus (myometrium). When the fibroid grows in the front wall of the uterus, it may be referred to as an anterior myometrium fibroid.
• Common Symptoms: Heavy or prolonged menstrual bleeding, pelvic pain, pressure sensation.
• Impact: Can make the uterus feel larger and may cause discomfort during intercourse.

2. Submucosal Fibroids

• Location: Just under the inner lining of the uterus (endometrium), protruding into the uterine cavity.
• Common Symptoms: Very heavy menstrual bleeding, prolonged periods, anemia.
• Impact: Often linked to fertility problems and recurrent miscarriages because they can distort the uterine cavity.

3. Subserosal Fibroids

• Location: On the outer wall of the uterus. A fibroid in this position is often called a subserosal uterine fibroid.
• Common Symptoms: Pressure symptoms like frequent urination, constipation, or lower back pain.
• Impact: Usually do not cause heavy bleeding but can become large and press on surrounding organs.

4. Pedunculated Fibroids

• Location: Attached to the uterus by a thin stalk (can be inside or outside the uterus).
• Common Symptoms: Pain or sudden cramping if the stalk twists (torsion).
• Impact: Rare but may cause sudden severe pain requiring urgent medical care.

Key Insight: Many women may have more than one type of fibroid at the same time, and symptoms depend on size, number, and location.

What Causes Uterine Fibroids?

The exact cause of fibroids is not fully understood, but research points to a combination of genetic, hormonal, and lifestyle factors.

1. Hormonal Factors

• Estrogen and Progesterone: These two reproductive hormones play a major role in fibroid growth. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells, making them grow during the reproductive years.
• Fibroids tend to shrink after menopause due to the drop in hormone levels.
• Hormonal fluctuations during pregnancy may cause fibroids to grow temporarily.

2. Genetic Predisposition

• A family history of fibroids increases risk.
• Certain gene changes in uterine muscle cells may trigger fibroid development.
• Women of African descent tend to have fibroids more often, at younger ages, and with larger sizes compared to other populations.

3. Growth Factors and Tissue Changes

• Substances that help the body maintain tissues, such as insulin-like growth factor (IGF), may influence fibroid growth.
• The extracellular matrix (ECM)—the material that makes cells stick together—can be more abundant in fibroids, making them fibrous and firm.

Risk Factors for Developing Uterine Fibroids

While any woman can develop fibroids, certain factors increase the likelihood:

1. Age

• Most common in women between 30–50 years old.
• Rare before puberty and tend to shrink after menopause.

2. Family History

If your mother or sister had fibroids, your risk is higher.

3. Ethnicity

Women of African or African-American descent have a higher risk, tend to develop fibroids earlier, and often have more severe symptoms.

4. Hormonal Levels

Prolonged exposure to estrogen, such as early menstruation onset or late menopause, can increase risk.

5. Lifestyle and Diet

• High red meat consumption is linked to increased risk.
• Low intake of green vegetables and fruits may contribute.
• Obesity increases estrogen production, indirectly fueling fibroid growth.

6. Vitamin D Deficiency

Studies suggest that low vitamin D levels may be associated with increased fibroid risk. This is significant in countries like India, where many women have vitamin D deficiency despite abundant sunlight.

7. Medical Conditions

High blood pressure and polycystic ovary syndrome (PCOS) have been linked to fibroid risk.

8. Reproductive Factors

Women who have never been pregnant may have a higher risk compared to those who have had full-term pregnancies.

Signs & Symptoms of Uterine Fibroids

Uterine fibroids can present very differently from one woman to another. In fact, up to 50% of women with fibroids may have no symptoms at all, and the growths are often discovered only during a routine pelvic exam or ultrasound. When symptoms do appear, they can range from mild discomfort to significant, life-disrupting issues. The size, number, and location of the fibroid determine most fibroid in uterus symptoms.

Below are the most common uterus fibroid symptoms, also described as symptoms of fibroids, fibroids symptoms, or myoma symptoms (symptoms of myoma).

1. Heavy or Prolonged Menstrual Bleeding (Menorrhagia)

• One of the most common symptoms of fibroids.
• Women may experience extremely heavy periods (needing to change sanitary pads/tampons every 1–2 hours) or periods lasting more than 7 days.
• Heavy bleeding may lead to iron-deficiency anemia, causing fatigue, weakness, dizziness, or shortness of breath.

2. Pelvic Pain or Pressure

• A constant dull ache or pressure in the lower abdomen.
• Larger fibroids may create a feeling of fullness or heaviness in the pelvis.

3. Pain During Intercourse (Dyspareunia)

• Especially likely when fibroids are located near the cervix, vaginal wall, or lower part of the uterus.

4. Frequent Urination or Difficulty Emptying the Bladder

• Fibroids pressing on the bladder can cause a constant urge to urinate.
• Large fibroids can reduce bladder capacity, leading to very frequent bathroom visits or incomplete bladder emptying.

5. Constipation and Bloating

• Fibroids pressing against the rectum may cause bowel movement difficulty.
• Many women report abdominal bloating or discomfort.

---

6. Backache or Leg Pain

• Large fibroids can press on pelvic or spinal nerves, causing lower back pain or radiating pain down the legs.

7. Abdominal Enlargement

• In severe cases, fibroids can grow so large that they make the abdomen appear similar to pregnancy.

8. Fertility and Pregnancy-Related Symptoms

• Fibroids can sometimes interfere with conception.
• During pregnancy, fibroids may increase the risk of miscarriage, preterm birth, breech positioning, or the need for a C-section.

Important Note
The severity of uterus fibroid symptoms does not always correlate with fibroid size. A small fibroid in a sensitive location may cause more symptoms than a large fibroid elsewhere.

How Uterine Fibroids Are Diagnosed

Early detection is key in managing fibroids effectively and preventing complications. Diagnosis usually begins when a woman reports symptoms to her gynecologist, followed by a physical examination and imaging tests.

1. Pelvic Examination

• The doctor may feel an enlarged or irregularly shaped uterus during a routine pelvic exam.
• While this can suggest fibroids, imaging is needed for confirmation.

2. Ultrasound (Sonography)

• Most common first-line test.
• Uses sound waves to create an image of the uterus and detect fibroids.
• Can be performed abdominally (through the belly) or transvaginally (through the vagina).

3. Magnetic Resonance Imaging (MRI)

• Provides detailed images of fibroids, including size, location, and blood supply.
• Useful for complex cases or when planning surgery.

4. Hysterosonography (Saline Infusion Sonography)

• Involves injecting saline into the uterus during ultrasound to give a clearer view of the uterine lining.
• Helps detect submucosal fibroids that may cause infertility.

5. Hysterosalpingography (HSG)

• X-ray procedure using dye to highlight the uterus and fallopian tubes.
• Often used in fertility evaluations.

6. Hysteroscopy

• A thin, lighted scope is inserted through the cervix to directly view the inside of the uterus.
• Can confirm fibroids and sometimes treat them in the same procedure.

7. Blood Tests

• While blood tests cannot detect fibroids directly, they are used to check for anemia caused by heavy bleeding and to rule out other causes of abnormal bleeding.

Potential Complications of Uterine Fibroids

While fibroids are non-cancerous and often harmless, they can cause significant complications in certain cases, particularly if left untreated.

1. Severe Anemia

• Caused by prolonged heavy menstrual bleeding.
• Can lead to shortness of breath, fatigue, palpitations, and pale skin.
• In extreme cases, may require a blood transfusion.

2. Infertility and Pregnancy Problems

• Submucosal fibroids can distort the uterine cavity, preventing implantation.
• Large fibroids may block the fallopian tubes or interfere with sperm movement.
• During pregnancy, fibroids can increase risks of:
  • Miscarriage
  • Preterm labor
  • Cesarean delivery
  • Abnormal fetal position
  • Placental abruption (premature separation of placenta from the uterus)

3. Bladder and Bowel Dysfunction

• Pressure on the bladder can cause urinary urgency or retention.
• Pressure on the bowel can cause constipation or difficulty with bowel movements.

4. Fibroid Degeneration

• When a fibroid outgrows its blood supply, it may shrink and break down, causing severe pain and fever.

5. Rare Complication – Cancer

• While extremely rare (less than 1% of cases), a fibroid may develop into a malignant tumor called leiomyosarcoma.
• This is not believed to be caused by existing fibroids turning cancerous, but it’s why regular follow-ups are important.

When to Seek Medical Attention Immediately

You should see a doctor urgently if you experience:

• Severe pelvic pain that comes on suddenly.
• Very heavy bleeding (soaking more than one pad/hour).
• Fainting or dizziness due to blood loss.
• Fever and pelvic pain (possible infection or fibroid degeneration).
• Inability to urinate despite a full bladder.

Need Help for Uterine Fibroids?

For Indian users:

 

Call to Book a Gynecologist Appointment

 

For international users:

 

Call to Consult a Gynecologist

 

Treatment Options for Uterine Fibroids

Treatment for uterine fibroids depends on several factors — the size and location of the fibroids, severity of symptoms, your age, fertility goals, and overall health. Many women do not need immediate intervention. Fibroids that are small and symptom-free often require no active treatment apart from routine monitoring.

This section explains the different treatment of uterine fibroids options, ranging from observation to advanced surgery, including newer approaches for fibroid uterus treatment and fibroid treatment without major incisions.

1. Watchful Waiting (Observation)

• Recommended when fibroids are small, cause no symptoms, and are not affecting fertility.
• Regular check-ups and ultrasounds every 6–12 months help track growth and ensure timely action if symptoms develop.

This conservative approach is common for women who want minimal intervention in their treatment for fibroids.

2. Medications

Medicines do not eliminate fibroids, but they help manage symptoms like heavy bleeding, pain, and anemia.

a. Hormonal Treatments:

• GnRH agonists – Temporarily shrink fibroids by lowering estrogen and progesterone levels; often used before surgery or in severe cases.
• Oral contraceptives or progesterone-releasing IUDs – Help control heavy menstrual bleeding but do not reduce fibroid size.

b. Non-Hormonal Medicines:

• Tranexamic acid – Reduces heavy menstrual bleeding.
• NSAIDs (e.g., ibuprofen) – Help relieve pain but do not decrease bleeding.
• Iron supplements – Treat anemia caused by blood loss from heavy periods.

3. Minimally Invasive Procedures

These options are ideal for women looking for new treatment for fibroids without surgery or with minimal downtime.

a. Uterine Artery Embolization (UAE):

• Blocks the blood supply to fibroids, causing them to shrink gradually.
• Suitable for women not planning future pregnancies.

b. MRI-Guided Focused Ultrasound Surgery (FUS):

• A non-invasive treatment using high-intensity ultrasound waves to destroy fibroid tissue without incisions.
• Popular as a new treatment for fibroids without surgery.

c. Hysteroscopic Myomectomy:

• Removes fibroids located inside the uterine cavity using a hysteroscope inserted through the vagina and cervix.
• No abdominal cuts, minimal downtime, and fast recovery.

Minimally invasive approaches may be especially useful as subserosal fibroid treatment when fibroids protrude outward from the uterus.

4. Surgical Treatments

Surgery may be recommended when symptoms are severe, fertility is affected, or other treatments fail.

a. Myomectomy:

• Surgical removal of fibroids while preserving the uterus.
• Preferred for women who wish to retain fertility.
• Can be performed via laparoscopy, hysteroscopy, or open surgery, depending on fibroid size and location.

b. Hysterectomy:

• Complete removal of the uterus.
• A definitive cure for fibroids with zero chance of recurrence.
• Recommended only if symptoms are severe, fertility is not desired, and other treatment options have been ineffective.

Lifestyle & Self-Care Tips for Fibroid Management

While lifestyle changes cannot make fibroids disappear, they can help reduce symptoms, improve overall health, and possibly slow fibroid growth.

1. Maintain a Healthy Weight

• Obesity is linked to higher estrogen levels, which can promote fibroid growth.
• Aim for a BMI between 18.5–24.9.

2. Eat a Balanced Diet

• Increase: Fresh fruits, vegetables, whole grains, lean protein, legumes.
• Reduce: Red meat, processed foods, sugary drinks, and refined carbs.
• Limit alcohol and caffeine.

3. Stay Active

• Regular exercise helps balance hormones and maintain a healthy weight.
• Include 150 minutes/week of moderate-intensity activity like brisk walking, cycling, or swimming.

4. Manage Stress

• Stress can affect hormonal balance.
• Try yoga, meditation, breathing exercises, or hobbies you enjoy.

5. Monitor Your Symptoms

• Keep a menstrual diary noting bleeding patterns, pain levels, and other changes.
• Report worsening symptoms to your doctor promptly.

Prevention of Uterine Fibroids

Fibroids cannot always be prevented due to genetic and hormonal factors, but certain habits can help lower the risk or delay onset:

• Maintain a healthy weight.
• Eat a diet rich in green leafy vegetables and low in processed meats.
• Exercise regularly.
• Avoid unnecessary hormone therapy unless prescribed.
• Attend regular gynecological check-ups to catch problems early.

Frequently Asked Questions (FAQs) About Uterine Fibroids

Q1. What is uterine fibroid?

A uterine fibroid is a non-cancerous growth in or on the uterus made of muscle and fibrous tissue. Many women ask what is fibroid or what is myoma. All these terms refer to the same condition. The meaning of fibroid uterus simply describes the presence of these benign growths in the uterine wall.

Q2. What causes fibroids?

Fibroids develop due to hormonal factors, genetics, family history, pregnancy, and obesity. Estrogen and progesterone play a major role in stimulating fibroid growth.

Q3. Can fibroids turn into cancer?

No. Fibroids are almost always benign. The chance of a fibroid becoming cancerous is extremely low, less than one percent.

Q4. Which size of fibroid is normal or abnormal?

There is no single normal size. Fibroids can be very small or very large.
Small fibroids less than 3 to 4 cm usually cause no symptoms.
Larger fibroids above 5 cm, or fibroids that grow quickly, may need medical evaluation.
Location often matters more than size.

Q5. What are the symptoms of a fibroid in the uterus?

Common fibroid in uterus symptoms include heavy menstrual bleeding, pelvic pain, abdominal bloating, urinary frequency, constipation, back pain, and fertility problems. Symptoms vary depending on the type, such as subserosal fibroid, intramural fibroid, or submucosal fibroid.

Q6. Will fibroids come back after treatment?

Yes. Fibroids can return after medical therapy or myomectomy. Hysterectomy, which removes the uterus, is the only treatment that prevents recurrence.

Q7. Is there a new treatment for fibroids without surgery?

Yes. Modern non-surgical options include Uterine Artery Embolization, MRI-guided Focused Ultrasound, and certain medications. These options are suitable for women who prefer to avoid major surgery.

Q8. Can fibroids affect pregnancy?

Yes. Fibroids can cause difficulty conceiving and may increase the risk of miscarriage, preterm birth, or abnormal positioning of the baby. Many women with fibroids still have healthy pregnancies.

Q9. Does diet affect fibroid growth?

Diet cannot cure fibroids, but reducing red meat and processed foods and eating more fruits, vegetables, and whole grains may help slow fibroid growth.

Q10. Are there home remedies for fibroids?

Home remedies cannot shrink fibroids, but maintaining a healthy weight, eating antioxidant-rich foods, managing stress, and avoiding hormonal triggers may help reduce symptoms. Always speak to a doctor before using supplements.

Q11. Is surgery the only option for treating fibroids?

No. Many women manage symptoms with medicines or minimally invasive procedures. Surgery is recommended only when symptoms are severe or persistent.

Q12. Can fibroids shrink naturally?

Yes. Fibroids often shrink after menopause because estrogen levels fall.

Q13. How do I know if my fibroids need treatment?

Treatment is recommended if you have heavy bleeding, pelvic pain, fertility problems, pressure symptoms, or fibroids that are growing quickly.

Conclusion

Uterine fibroids are common, non-cancerous growths that can impact quality of life, fertility, and overall well-being. The good news is that with early diagnosis, appropriate treatment, and healthy lifestyle habits, most women can manage fibroids effectively and live symptom-free.

If you suspect you have fibroids or are experiencing symptoms like heavy periods, pelvic pain, or urinary problems, consult a gynecologist without delay. Timely medical guidance can help prevent complications and preserve reproductive health.