Overview
What are uterine fibroids? A Mayo Clinic expert explains
Learn more about uterine fibroids from Michelle Louie, M.D., a minimally invasive gynecologic surgeon at Mayo Clinic.
I'm Dr. Michelle Louie, a minimally invasive gynecologic surgeon at Mayo Clinic. In this video, we'll cover the basics of uterine fibroids. What is it? Who gets it? The symptoms, diagnosis, and treatment. Whether you're looking for answers for yourself or someone you love. We're here to give you the best information available. Uterine fibroids, also called leiomyomas or myomas, are growths that appear in the uterus. They're made of uterine muscle. They're noncancerous and extremely common. In fact, 75 to 80% of people with a uterus will be diagnosed with fibroids at some point in their lives. These growths often show up during the reproductive years, most commonly in your 20s to 30s. They can range in quantity, size and growth rate. So each case is a bit different.
Who gets it?
We believe uterine fibroids occur when one cell of muscle divides repeatedly to create a firm, rubbery mass of tissue. Scientists are not yet sure exactly what sparks this behavior, but we're looking into specific genes. We do know a couple of risk factors that may make someone more likely to get fibroids. First, race. For reasons that are unclear, fibroids are more prevalent and more severe among black patients compared to other racial groups. Second, family history. If your mother or sister had fibroids, you're at increased risk for developing them, too. And more studies look into other risk factors like obesity, lifestyle choices, and diet.
What are the symptoms?
Most people with fibroids don't have symptoms at all. That's why they're often found unintentionally during a routine checkup. If a patient does have symptoms, heavy, prolonged, or painful menstrual bleeding is a common problem. Periods that lasts more than one week or cause soaking through pads or tampons every hour or large blood clots are also considered abnormal. If fibroids get very large, they can cause your belly to bulge like a pregnancy or press on nearby organs causing constant pelvic pressure, frequent urination, or difficulty passing bowel movements. In some cases, fibroids can make it harder to get pregnant or cause problems during pregnancy or childbirth. If you're experiencing any of these symptoms, talk to your doctor.
How is it diagnosed?
Fibroids are often found during a routine pelvic exam. If your doctor feels an irregularity in the shape of the uterus or if you come in with symptoms, they'll probably order a diagnostic test like an ultrasound. Beyond that, your doctor may need more information, especially if you're trying to get pregnant or at risk for uterine cancer. They might order blood tests or imaging studies like an MRI. Sometimes other unique imaging studies that use water to see inside the uterus or dye to check the fallopian tubes are needed if you're trying to get pregnant. Even hysteroscopy, in which a small camera is guided through the vagina, is sometimes used to see inside the uterus where some fibroids can be located. All these tests are done in service of getting a better, clearer picture of what's going on or to check for other problems.
How is it treated?
There are many ways in which we treat uterine fibroids. If you have no or only mild symptoms, as many women do, the best treatment may be no treatment at all. We call this watchful waiting where we keep a careful eye on your fibroids until further action is needed. Medication or birth control is another option which can relieve symptoms like heavy, irregular or painful periods. For some more severe cases, surgery may be needed. The kind of surgery we recommend depends on the size, number, and location of fibroids, as well as your personal goals, feelings about pregnancy and surgery, and general health. A hysterectomy is where the uterus and the fibroids are removed together. And it is a great option for those who have no desire for pregnancy as it guarantees no more period bleeding and the fibroids cannot return in the future. A myomectomy is a surgery in which we remove the fibroids through the vagina or the abdominal wall. Uterine fibroid embolization is a more minor procedure in which we blocked the blood supply to the fibroids, causing them to shrink but not go away completely. A radiofrequency fibroid ablation is where a probe is inserted into the fibroid and heats the tissue, so it shrinks. Magnetic resonance-guided focused ultrasound passes energy through the abdomen to destroy the fibroid. Lastly, an endometrial ablation is a procedure in which a device is inserted through the vagina to treat the uterine lining, and stop heavy period bleeding due to fibroids. But this does not treat the fibroids themselves.
What now?
Fibroids are common, noncancerous and often don't need treatment. Whether or not you do end up needing treatment, know that there are many options that can address your concerns and give you a great quality of life. Talk to your doctor or get a referral to a fibroid specialist to ensure that you are offered all the treatment options. If you'd like to learn more about fibroids, watch our other related videos, or visit mayoclinic.org. We wish you well.
Fibroid locations
Fibroid locations
There are three major types of uterine fibroids. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus. Some submucosal or subserosal fibroids may be pedunculated — hanging from a stalk inside or outside the uterus.
Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.
Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight.
Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.
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Symptoms
Many women who have fibroids don't have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids.
In women who have symptoms, the most common signs and symptoms of uterine fibroids include:
- Heavy menstrual bleeding
- Menstrual periods lasting more than a week
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying the bladder
- Constipation
- Backache or leg pains
Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die.
Fibroids are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus.
When to see a doctor
See your doctor if you have:
- Pelvic pain that doesn't go away
- Overly heavy, prolonged or painful periods
- Spotting or bleeding between periods
- Difficulty emptying your bladder
- Unexplained low red blood cell count (anemia)
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.
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Causes
Doctors don't know the cause of uterine fibroids, but research and clinical experience point to these factors:
- Genetic changes. Many fibroids contain changes in genes that differ from those in typical uterine muscle cells.
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Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids.
Fibroids contain more estrogen and progesterone receptors than typical uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
- Other growth factors. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
- Extracellular matrix (ECM). ECM is the material that makes cells stick together, like mortar between bricks. ECM is increased in fibroids and makes them fibrous. ECM also stores growth factors and causes biologic changes in the cells themselves.
Doctors believe that uterine fibroids develop from a stem cell in the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue.
The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own.
Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to its usual size.
Risk factors
There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. Factors that can have an impact on fibroid development include:
- Race. Although all women of reproductive age could develop fibroids, black women are more likely to have fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they're also likely to have more or larger fibroids, along with more-severe symptoms.
- Heredity. If your mother or sister had fibroids, you're at increased risk of developing them.
- Other factors. Starting your period at an early age; obesity; a vitamin D deficiency; having a diet higher in red meat and lower in green vegetables, fruit and dairy; and drinking alcohol, including beer, appear to increase your risk of developing fibroids.
Complications
Although uterine fibroids usually aren't dangerous, they can cause discomfort and may lead to complications such as a drop in red blood cells (anemia), which causes fatigue, from heavy blood loss. Rarely, a transfusion is needed due to blood loss.
Pregnancy and fibroids
Fibroids usually don't interfere with getting pregnant. However, it's possible that fibroids — especially submucosal fibroids — could cause infertility or pregnancy loss.
Fibroids may also raise the risk of certain pregnancy complications, such as placental abruption, fetal growth restriction and preterm delivery.
Prevention
Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a small percentage of these tumors require treatment.
But, by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, you may be able to decrease your fibroid risk.
Also, some research suggests that using hormonal contraceptives may be associated with a lower risk of fibroids.
By Mayo Clinic Staff
Sept. 21, 2022
FAQs
What are the main causes of fibroids? ›
Starting your period at an early age; obesity; a vitamin D deficiency; having a diet higher in red meat and lower in green vegetables, fruit and dairy; and drinking alcohol, including beer, appear to increase your risk of developing fibroids.
What symptoms can uterine fibroids cause? ›- Heavy or prolonged periods.
- Bleeding between periods.
- Abdominal discomfort and/or fullness.
- Pelvic pain.
- Lower back pain.
- Bladder symptoms, such as frequent urination or difficulty emptying the bladder.
- Bowel symptoms, such as constipation or excessive straining with bowel movements.
Uterine fibroids are a common type of noncancerous tumor that can grow in and on your uterus. Not all fibroids cause symptoms, but when they do, symptoms can include heavy menstrual bleeding, back pain, frequent urination and pain during sex.
What causes fibroids to grow in the uterus? ›Researchers are learning more about the causes of uterine fibroids and have identified estrogen, progesterone, growth hormones, genetics, and misplaced cells present in the body before birth as potential contributors to their development and growth.
Are fibroids caused by stress? ›Stress is the body's biochemical response to life challenges. To handle stress, the brain tells our body to produce extra hormones. As a result, hormone levels rise, which stimulates fibroid growth and causes symptoms to flare up. Stress can cause fibroids that were once asymptomatic to grow at an alarming rate.
What lifestyle causes fibroids? ›Other growth factors: Obesity, insulin like growth factors, also appeared to be the reason causing fibroids in uterus. Lifestyle: Alcohol consumption, low fruit and vegetable intake in diet, lack of vitamins, early start of periods, stress etc. are also associated with uterine fibroids.
Can uterine fibroids cause other health problems? ›Fibroids can cause heavy bleeding, debilitating abdominal pain, and pelvic pressure. While the complications they cause typically aren't life-threatening, fibroids can change the structure of your uterus and affect fertility. Only a medical professional can determine whether your fibroids are a cause for concern.
What is the best treatment for fibroids? ›Myomectomy. A myomectomy is an operation to remove fibroids while preserving the uterus. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best treatment option. Myomectomy is very effective, but fibroids can re-grow.
What happens if uterine fibroids go untreated? ›If left untreated, fibroids can continue to grow, both in size and number. As these tumors take over the uterus the symptoms will become worse. The fibroids pain will increase. The heavy bleeding will become heavier and it may be accompanied by severe cramping.
How do your body feel when you have fibroids? ›Women with large fibroids may feel heaviness or pressure in their lower abdomen or pelvis. Often this is described as a vague discomfort rather than a sharp pain. Sometimes, the enlarged uterus makes it difficult to lie face down, bend over or exercise without discomfort. Pelvic pain.
Do fibroids make you tired? ›
Fatigue. Fatigue is especially easy to miss as a symptom of fibroids because it's not caused by overwork or a lack of sufficient sleep at night, but is mainly due to the loss of blood from heavy periods. This blood loss leads to anemia and an iron deficiency from the lack of red blood cells.
Should I worry if I have fibroids? ›Fibroids are pretty common — between 20-70 percent of women will develop fibroids during their reproductive years. And they're almost always (99 percent of the time) harmless. But that doesn't mean you should ignore them. Fibroids can cause complications like excessive bleeding and reproductive problems.
What deficiency causes fibroids? ›Fibroids are a type of non-cancerous tumor that develops in the uterus or on the walls of the uterus. A vitamin D deficiency has been linked to the growth of fibroids.
Do fibroids cause weight gain? ›Common Symptoms of Uterine Fibroids
Fibroids cause weight gain and bloating due to a hormonal imbalance or the size of the fibroid. Larger fibroids may cause a woman to gain weight in the abdomen, giving the appearance of normal belly fat. Simply put, the more a fibroid grows, the heavier it will become.
Medications include: Gonadotropin-releasing hormone (GnRH) agonists. Medications called GnRH agonists treat fibroids by blocking the production of estrogen and progesterone, putting you into a temporary menopause-like state. As a result, menstruation stops, fibroids shrink and anemia often improves.
What organ is affected by fibroids? ›Many women have benign (non-cancerous) growths known as fibroids in or on their womb (uterus). Most fibroids are small and don't cause any problems. They are usually discovered by chance. Depending on where fibroids are located, they may cause period pain, heavy menstrual bleeding or other symptoms.
Can low vitamin D cause fibroids? ›Some studies have recently shown that vit D deficiency is an important risk factor for uterine fibroids (14-16) and uterine fibroids express lower levels of vit D receptor (VDR) compared with myometrium (17).
Do fibroids cause gas and bloating? ›CAN UTERINE FIBROIDS CAUSE BLOATING? Yes, bloating can be caused by fibroids. Because Fibroids can appear as a single large benign tumour, or a cluster of small benign tumors, if a fibroid grows in size, it can cause the abdomen to bloat and become visibly swollen.
What do fibroids feed on? ›They can be useful when estrogen is needed, but when it is not they are a problem for women with fibroids. Fibroids feed off estrogen, so more estrogen triggers tumor growth.
Who is most likely to get fibroids? ›Women who are nearing menopause are at the greatest risk for fibroids. Fibroids are most often found during a routine pelvic exam. Symptoms may include heavy and prolonged periods, bleeding between periods and pelvic pain. There are a variety of treatment options available.
What hormone shrinks fibroids? ›
Gonadotropin-releasing hormone agonists (GnRHa)
Your doctor may prescribe a GnRHa to shrink fibroids before surgery or to treat anemia caused by heavy bleeding.
A hysterectomy may be recommended if you have large fibroids or severe bleeding and you do not want to have any more children.
What shrinks fibroids fast? ›- Do nothing (Watchful Waiting) ...
- Have a baby. ...
- Mifepristone. ...
- Ulipristal. ...
- Leuprolide. ...
- Myolysis. ...
- Uterine artery embolization (UAE) ...
- Focused ultrasound (FUS)
A bioflavonoid in green tea called EGCG may help reduce the size and number of fibroids. This may be due to its ability to reduce inflammation and remove toxins from your body.
What should you avoid if you have fibroids? ›Don't eat a diet full of processed foods, red meats, and high-fat dairy. Studies show that eating these foods can make your fibroids worse. The same goes for alcohol and caffeine. Don't skip your workouts.
Do fibroids get worse with age? ›“Once you go through menopause, fibroids start shrinking because they don't have the hormones that were being produced by the ovaries that help them grow,” Dr. Bhagavath says. After menopause, into your 60s and beyond, your fibroids will continue to decrease in size.
What size should fibroids be removed? ›Most experts believe that about 9-10 centimeters (about 4 inches) diameter is the largest size fibroid that should be removed laparoscopically.
Can fibroids cause bowel issues? ›Women can experience pressure on the bowel and/or bladder due to fibroids. This can cause constipation, frequent urination and incontinence.
What is fibroid belly? ›Fibroid Belly Bulge
As fibroids grow, the uterus sometimes needs to expand to accommodate them. Your uterus is a muscular organ that can transform from the size of a fist to that of a baby, and even larger. Many women first notice an expanding waistline when clothing begins to fit differently.
Diarrhea is not a common symptom for uterine fibroids, but it can be one of the symptoms you could experience. Depending on your stomach sensitivity will determine if you experience diarrhea and how severe it could become.
What is the average age for fibroids? ›
Fibroids are most common in women age 30 to 40, but they can occur at any age. Fibroids occur more often in Black women than in White women. They also seem to occur at a younger age and grow more quickly in Black women.
Can fibroids turn cancerous if left untreated? ›Uterine fibroids do not turn into cancer—they are entirely benign tumours arising from smooth muscle tissues within the uterus. Fibroids are the most common pelvic tumours in women and they are non-cancerous.
What foods melt fibroids? ›- cooked and raw vegetables.
- cooked, raw, and dried fruit.
- whole grain bread and pasta.
- cruciferous vegetables.
- oats.
- lentils.
- barley.
- beans.
- Vitamin D. Studies have found a correlation between people with a Vitamin D deficiency and fibroids. ...
- Vitamin A. Vitamin A is high in antioxidants and can help cells rebuild and it is particularly helpful for the reproduction of red blood cells. ...
- Iron. ...
- Green Tea.
The recommended dose is 400-800 IU per day for adults, although some claim 1000-4000 IU is needed to maintain adequate levels. It is not recommended that individuals take more than 4000 IU per day of D vitamins to shrink fibroids without consulting their doctor due to the risk of toxicity.
Can fibroids cause stomach to grow? ›Broadly speaking, the larger a fibroid becomes, the more it presses against other abdominal organs (think pelvic pain, discomfort, bloated feeling), and the more likely it is that your stomach will appear distended or “pregnant.”
What is the best sleeping position for fibroids? ›Lie down and put a pillow under your knees. Or lie on your side and bring your knees up to your chest. These positions may help relieve belly pain or pressure.
Do fibroids need to be removed? ›When do fibroids need to be treated? Uterine fibroids usually need treatment when they cause: Anemia from heavy fibroid bleeding. Ongoing low back pain or a feeling of pressure in the lower belly.
Do uterine fibroids ever go away on their own? ›Fibroids might increase or decrease in size according to what hormonal phase your body is in, for instance, shrinking during menopause. But in general, they don't really ever go away.
What foods cause fibroids to grow? ›Refined Carbohydrates: While foods such as pasta, white bread, white rice, cakes, and cookies have been known to alter estrogen levels, causing fibroids to increase in size.
How can I reduce fibroids naturally? ›
- Follow a Mediterranean diet. Add plenty of fresh and cooked green vegetables, fresh fruit, legumes, and fish to your plate. ...
- Cut back on alcohol. ...
- Balance estrogen. ...
- Lower blood pressure. ...
- Get enough vitamin D. ...
- A note about smoking and diet.
A 2019 trial followed 69 women who had fibroids as well as a vitamin D deficiency. After the women started taking vitamin D supplements, researchers noted that the size of their fibroids was significantly reduced. As a result, the study authors concluded that you could treat fibroids with vitamin D supplements.
What to drink to get rid of fibroids? ›Green Tea And Fibroids
Studies have revealed that there is a link between the reduction of fibroid growth and green tea extract.
GnRH agonists (Lupron)
GnRH agonists are a class of medications that temporarily shrink fibroids and stop heavy bleeding by blocking production of the female hormone, estrogen. Lupron is the most well known of these drugs.
At the end of the 90 days, there was a significant reduction in the mean size of the fibroids, with a 17.8% overall mean decrease (P = 0.03) and a 37.3% mean decrease in individual fibroids (P = 0.015).