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What Are Uterine Fibroids?

Types and Symptoms

Uterine fibroids are fibrous, solid, noncancerous tumors of the uterus. They are also known as uterine leiomyomas or myomas.

Fibroids are estrogen-dependent tumors that may impact as many as 50% to 80% of people with a uterus during their reproductive years, from teens through menopause. Fibroids stop growing after menopause when estrogens naturally diminish. Fibroids do not increase your risk of gynecological cancers, such as uterine, cervical or ovarian cancers.

"So many patients have uterine fibroids, but not every patient requires treatment," says Angela Chaudhari, MD, chief of Gynecology and Gynecologic Surgery at Northwestern Medicine.

Uterine Fibroid Types

Fibroids vary in size from tiny masses that are not easily detectable to large growths that can be felt through the abdominal wall. They are categorized by where they are located in the uterus, and that location often dictates the symptoms they create.

  • Subserosal: Arise within the muscle wall of the uterus and sit externally on the uterus, potentially pushing on other structures
  • Intramural: Within the muscle wall, causing the uterus to enlarge as they grow
  • Submucosal: Touching the lining or endometrium of the uterus
  • Pedunculated: Grow on the surface of the uterus and are connected to the uterine wall by a stalk

Symptoms

"Many patients with fibroids are completely asymptomatic, and their fibroids are discovered incidentally at the time of a routine pelvic exam," says Dr. Chaudhari. "Other patients may be very symptomatic, with heavy bleeding, bloating, pressure and symptoms of anemia, or low blood counts."

Symptoms often fall into two categories:

  • Bleeding: Menstrual cycles that are very heavy and longer than normal, or bleeding between normal cycles
  • Pressure: Pain or pressure created by the fibroids pushing on surrounding structures such as the bladder, bowels or muscles of the lower abdomen

More specific symptoms may include:

  • Heavy and prolonged periods, sometimes with clots
  • Anemia (low blood count) due to heavy bleeding
  • Fatigue
  • Frequent urination
  • Pelvic pressure or a feeling of heaviness in your pelvis
  • Painful intercourse
  • Pain in the lower back, thigh or hip area
  • Constipation and bloating
  • An enlarged abdomen, which may be mistaken for weight gain or pregnancy

Treatments for Uterine Fibroids

"If you are diagnosed with uterine fibroids and have no symptoms, there might be no need for treatment," says Dr. Chaudhari. "Your physician may simply monitor their growth at your annual exams or more frequently if needed."

Your physician may recommend treatment if you:

  • Have fibroid-related heavy menstrual bleeding, pain or pressure that interferes with your daily life
  • Are trying to get pregnant, and the fibroids are located in an area that may impact getting or staying pregnant

Talk to your physician about your treatment options.