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How serious are uterine fibroids?

Uterine fibroids are the most common type of growth in a female’s pelvis and develop on the muscle tissue inside the uterus. While uterine fibroids are benign (noncancerous), they can cause health complications depending on their size and location, says Oluwaseun Cole, M.D., a Piedmont obstetrician and gynecologist.

Uterine fibroid risk factors

You may have a higher risk of developing uterine fibroids if you:

  • Are between ages 30 and 40

  • Are Black

  • Have a family history of fibroids

Uterine fibroid symptoms

Dr. Cole says uterine fibroids can cause the following symptoms:

  • Menstrual cramps

  • Heavier, longer, more frequent periods

  • Vaginal bleeding when you’re not menstruating

  • Anemia from blood loss

  • Pain during sex

  • Abdominal or lower back pain

  • Abdominal cramps

  • Constipation

  • Difficulty during bowel movements

  • Rectal pain

  • Enlarged uterus or abdomen

  • Infertility

  • Miscarriage

How are uterine fibroids different from uterine cancer?

“Uterine fibroids are benign growths, meaning they aren’t cancerous,” she says. “In very rare cases, fibroids can become cancerous.”

How are uterine fibroids diagnosed?

Uterine fibroids can be diagnosed during a physical exam or pelvic ultrasound. Your physician can determine if imaging is needed.

Your doctor may also recommend further evaluation if it’s unclear if the growth is a uterine fibroid or a tumor.

How are uterine fibroids treated?

“Treatment depends on the symptoms you experience,” Dr. Cole says. “There’s no one-size-fits-all approach.”

You may need treatment if you experience:

  • Pelvic pain

  • Heavy or painful periods that lead to anemia or a disruption in your daily life

  • Rapid growth of the fibroid

  • Infertility

  • Bleeding between periods

Treatment options can include:

  • Watchful waiting (monitoring the fibroids to see if they grow)

  • Hormone therapy like birth control pills or a progestin-releasing intrauterine device (IUD)

  • Tranexamic acid to treat heavy bleeding

  • Gonadotropin-releasing hormone agonists to stop your menstrual cycle and decrease the size of fibroids

  • Uterine artery embolization (a procedure to cut off blood flow to the fibroids, causing them to shrink)

  • Myomectomy (surgery to remove the fibroids only)

  • MRI-guided ultrasound surgery to destroy the fibroids

  • Radiofrequency ablation to shrink the fibroids

  • Hysterectomy (surgical removal of the uterus)

“If you remove only the fibroid, and you haven’t gone through menopause, you’re at risk of the fibroids returning,” she says. “Once you’re through menopause, the fibroids won’t continue to grow, so you may not require treatment.”

When to see your healthcare provider

“If you have abnormal menstrual cycles, definitely speak to your gynecologist,” Dr. Cole says. “Uterine fibroids can be present for years with patients having heavy cycles that they think are normal, but after a workup, they are actually severely anemic. An OB/GYN should assess any of the symptoms mentioned.”

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