Uterine fibroids are common. As many as one in five women may have fibroids during their childbearing years, and more than 70% of women will have fibroids during their lifetime.

The exact cause of uterine fibroids is unknown, though factors like family history and diet can raise your risk. Uterine fibroids can range in size from so tiny that you need a microscope to see them to large enough to fill the entire uterus and weigh several pounds or kilograms. Although it’s possible for just one fibroid to develop, most often there is more than one.

Fibroids can grow:

  • In the muscle wall of the uterus (myometrial)
  • Just under the surface of the uterine lining (submucosal)
  • Just under the outside lining of the uterus (subserosal)
  • On a long stalk on the outside the uterus or inside the uterus (pedunculated)

Uterine Fibroid Symptoms

Though common, uterine fibroids can cause pain, cramping and other uncomfortable symptoms. One of the most common symptoms of uterine fibroids is abnormal bleeding, including: 

  • Heavy bleeding during your period, sometimes with blood clots
  • Periods that may last longer than normal
  • Bleeding between periods

If uterine fibroids are large enough, they can also cause what’s called bulk symptoms, or feelings of weight or pain in your uterus. These symptoms can lead to:

  • Needing to urinate more often
  • Pelvic cramping or pain with periods
  • Feeling fullness or pressure in your lower belly
  • Pain during intercourse

You can also have fibroids and not have any symptoms. Your health care provider may find them during a physical exam or other test. 

Diagnosing Uterine Fibroids

Your provider may perform a pelvic exam, which can show that you have a change in the shape of your uterus or womb.

Because fibroids are not always easy to diagnose, you may also need additional testing to look for fibroids, including:

  • Ultrasound, which uses sound waves to create a picture of the uterus
  • MRI, which uses powerful magnets and radio waves to create a picture
  • Saline infusion sonogram (hysterosonography), where saline is injected into the uterus to make it easier to see the uterine lining on an ultrasound
  • Hysteroscopy, where a long, thin tube is inserted through the vagina and into the uterus to look inside of the uterus
  • Endometrial biopsy, where a small piece of the lining of the uterus is removed to check for cancer if you have unusual bleeding

Uterine Fibroid Treatment

If you’re diagnosed with a uterine fibroid, your doctor will create a treatment plan that’s customized for you. What type of treatment you have depends on:

  • Your age
  • Your general health
  • Your symptoms
  • Type of fibroids
  • If you are pregnant
  • If you want children in the future

Treatment for the symptoms of fibroids may include:

  • Birth control pills to help control heavy periods
  • Intrauterine devices (IUDs) that release hormones to help reduce heavy bleeding and pain
  • Tranexamic acid to reduce the amount of blood flow
  • Iron supplements to prevent or treat anemia due to heavy periods
  • Pain relievers such as ibuprofen or naproxen for cramps or pain
  • Hormone therapy shots to help shrink fibroids (done only for a short time)
  • Combination hormone therapy pills to control bleeding, without shrinking your fibroids
  • Watchful waiting. You may have pelvic exams or ultrasounds every once in a while to check the fibroid's growth

Surgery and procedures used to treat fibroids include:

  • Sonata radiofrequency ablation: This is an incisionless procedure that treats the fibroids without removing them. Sonata treatment helps decrease the size of the fibroid and amount of bleeding over time.
  • Myomectomy: This procedure removes fibroids from the uterus. It may be a good choice if you want to have children as it will not prevent fibroids from growing again. It can be performed in the following ways:
    • Hysteroscopically (using a camera in the uterus): This approach removes fibroids from the lining of the uterus
    • Minimally invasively (laparoscopically or robotically): A small incisions on the abdomen to remove fibroids in the uterus that are not accessible hysteroscopically
    • Abdominally: An incision on the abdomen to remove fibroids
  • Hysterectomy: This surgery removes the uterus completely. It may be an option if you do not want children, medicines do not work, and you cannot have any other procedures.
  • Uterine fibroid embolization: This procedure stops the blood supply to the fibroid, causing it to shrink.