Uterine fibroids
Leiomyomas, myomas
Chronic conditionNoncancerous growths of the uterine muscle. Many cause no symptoms, but some cause heavy periods, pelvic pressure, and anemia.
For education only — this guide can't diagnose you. If these signs sound familiar, talk with a healthcare provider. Book a consult
What happens
Fibroids grow from smooth muscle cells in the wall of the uterus. They range from the size of a seed to large masses, and can sit inside the uterine cavity, within the wall, or on the outer surface. Estrogen and progesterone fuel their growth, so they tend to grow during the reproductive years and shrink after menopause. Fibroids are almost never cancer.
Who gets it
Fibroids are very common, and most women have them by 50. They are more common in Black women, and tend to appear earlier and grow larger. Risk is higher with a family history, an early first period, high blood pressure, and low vitamin D.
Signs worth getting checked
- Heavy or long periods, sometimes with clots
- Fatigue, shortness of breath, or dizziness from low iron
- Pelvic pressure, fullness, or a swollen belly
- Frequent urination or trouble emptying your bladder
- Constipation
- Low back or pelvic pain
- Pain with sex
- Trouble getting pregnant or miscarriage in some cases
Labs to ask about
- Pelvic exam
- Pelvic ultrasound
- CBC and ferritin
- Saline sonogram or hysteroscopy for fibroids inside the cavity
- MRI before some procedures
- TSH, since thyroid problems can also cause heavy bleeding
Treatments your doctor may discuss
- Watchful waiting if fibroids cause no symptoms
- Medicines for bleeding, such as NSAIDs, tranexamic acid, a hormonal IUD, or birth control
- GnRH-blocking combination medicines to reduce heavy bleeding
- Uterus-sparing procedures, such as fibroid embolization, radiofrequency ablation, or myomectomy
- Hysterectomy if you don't plan a future pregnancy and other options haven't helped
Supportive steps to discuss with your provider
- Track your bleeding, including how often you change pads or tampons and the size of clots.
- Rebuild iron based on your labs.
- Ask about vitamin D. Some studies link low vitamin D with fibroid growth.
- Ask about every option, including uterus-sparing ones, before deciding on surgery. A second opinion is reasonable.
See a doctor promptly if you have
- Bleeding that soaks through a pad or tampon every hour for 2 hours or more, or feeling faint: go to the emergency room
- Sudden, severe pelvic pain or pain with fever: get same-day care
- You can't urinate or empty your bladder
- Any bleeding after menopause, or a fibroid that grows after menopause
- Signs of anemia, such as shortness of breath or a racing heart with activity
Related conditions
Ready to find the root cause?
Dr. Lesher is a Naturopathic Doctor who focuses on autoimmune and chronic conditions in women. Since 2020, she's helped hundreds of patients stop managing symptoms and start healing.