What Are Fibroids?

Uterine fibroids are noncancerous growths that develop in or around the uterus, most commonly during the reproductive years. Also known as leiomyomas or myomas, they are not linked to an increased risk of uterine cancer but can impact quality of life.

Fibroids can range widely in size and number—from tiny growths to large masses that can distort the shape of the uterus or even make the abdomen appear enlarged, similar to pregnancy.

70-80% of women will have fibroids at some point in their life, but they often go unnoticed because they rarely cause symptoms. In many cases, fibroids are discovered incidentally during a routine pelvic exam or imaging, such as an ultrasound during pregnancy.

Fibroids become a problem when they grow to be very large and put pressure on other organs or cause heavy bleeding.

Pathophysiology

Uterine fibroids form when smooth muscle cells in the uterus grow abnormally, creating firm, fibrous tumors. Their growth is driven mainly by the hormones estrogen and progesterone, which make the fibroid cells multiply faster than normal.

Genetic changes and excess growth factors also contribute, while an overproduction of collagen and other structural proteins makes fibroids dense and firm. They can distort the shape of the uterus, affect blood flow, and lead to symptoms such as heavy bleeding, pain, or pressure.

Fibroids usually grow during the reproductive years and often shrink or remain stable after menopause when hormone levels decline.

Common Symptoms

Many people with fibroids have no symptoms, but when they do occur, they may include:

  • Heavy or long menstrual periods

  • Pelvic pain or pressure

  • Frequent urination or trouble emptying the bladder

  • Constipation or bloating

  • Pain during sex

  • Lower back pain

  • Abdominal swelling or fullness

In some cases, fibroids can cause fertility issues or pregnancy complications.

Treatment Options

Fibroid treatment depends on symptoms, size, and personal goals such as fertility. Options include:

  • Watchful Waiting: If fibroids cause few or no symptoms, regular monitoring may be all that’s needed.

  • Medications: Hormonal therapies and other medicines can help control heavy bleeding, pain, or temporarily shrink fibroids.

  • Minimally Invasive Procedures: Techniques like uterine artery embolization, radiofrequency ablation, or focused ultrasound can shrink or destroy fibroids without major surgery.

  • Surgical Treatments: Myomectomy removes fibroids while preserving the uterus, while hysterectomy removes the uterus entirely for permanent relief.

  • Lifestyle Support: Maintaining a healthy weight, exercising, and managing stress can help reduce symptoms and improve overall well-being.