Uterine fibroids: Symptoms, causes and treatment options

Uterine fibroids are a common health condition that many people assigned female at birth experience during their reproductive years. By age 50, about 20 percent to 80 percent of women develop uterine fibroids.¹ If you’ve been diagnosed with fibroids — or think you may have them — you’re not alone. The good news: fibroids are typically noncancerous and are treatable.²

Uterine fibroids are growths that form in or on the wall of the uterus. A person can have one single fibroid or many in the uterus. They’re made of muscle and tissue and can be different sizes. Some are so small they’re hard to see, while others may grow big enough to change the shape of the uterus. You may hear fibroids also called “leiomyomas” or “myomas.”²

The exact cause of fibroids isn’t known, but several factors may increase your risk:²

• Hormones: Estrogen and progesterone — the hormones that regulate your menstrual cycle — appear to help fibroids grow
• Genetics: If your parent or sibling had fibroids, you may be more likely to have them too
• Race: Black women are more likely to develop fibroids, often at younger ages and with more severe symptoms¹
• Other factors: Starting your period early, obesity, using birth control, having a diet low in fruits and vegetables or drinking alcohol — including beer — may play a role³

Some people don’t have any symptoms of uterine fibroids at all. But when symptoms are present, they can be impacted by the size, number and location within the uterus of the fibroids.²

Symptoms can include:

• Heavy or prolonged periods
• Pelvic pain or pressure
• Frequent urination
• Trouble emptying the bladder
• Constipation
• Pain during sex
• Lower back pain
• A visibly enlarged stomach
• Infertility

A doctor may discover fibroids during a routine pelvic exam. If fibroids are suspected, they may recommend imaging tests such as:^{2, 4}

• Ultrasound: A common and painless way to get a closer look at your uterus
• MRI: This test provides more detailed images and may be used if an ultrasound doesn't provide enough information.  It is more commonly used in people with larger uteruses and those in perimenopause
• Hysteroscopy or saline infusion sonogram: These allow a closer look inside the uterus using a small scope

Many people with fibroids do not have symptoms. If you have fibroids, and do not have any symptoms, your doctor may check during your regular exams to see if they have grown. Treatment for uterine fibroids depends on if you have symptoms, if you are having difficulty getting pregnant, the size and location of the fibroids and your proximity to menopause.² Options may include:

• Monitoring: If you don't have symptoms, your doctor may just watch the fibroids over time
• Medications: Certain drugs may help shrink fibroids or manage symptoms. These can include hormonal treatments or medications to control bleeding.⁴
• Minimally invasive procedures: Options like uterine artery embolization (UAE) or MRI-guided focused ultrasound surgery can shrink or destroy fibroids without major surgery⁴
• Surgery: Procedures like myomectomy (removal of fibroids only) or hysterectomy (removal of the uterus) may be needed if other treatments don’t work^{2, 4}

Yes, many people with fibroids go on to have healthy pregnancies. However, fibroids can sometimes make it harder to get pregnant or lead to pregnancy complications like miscarriage, preterm birth or Cesarean delivery.² If you have fibroids and are experiencing fertility challenges, talk to your doctor to see if you need further evaluation or possible treatment.⁴

There’s no sure way to prevent fibroids, but some healthy habits may help lower your risk:³

• Eating a balanced diet rich in fruits and vegetables
• Maintaining a healthy weight
• Limiting alcohol, including beer

Regular preventive care checkups may also help catch fibroids early.

Uterine fibroids are almost always benign, which means they aren’t cancerous.² In very rare cases, a cancerous fibroid-like growth called a leiomyosarcoma may occur — but this is extremely uncommon and isn’t believed to develop from existing fibroids.^1,2

If you’re having symptoms or have questions about fibroids, a primary care provider, gynecologist or women’s health specialist is a good place to start. They can help you explore treatment options and recommend next steps.⁴