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Uterine Fibroids

From the FDA Office of Women's Health

Invisible Pain: What Are Uterine Fibroids? 

There are many unknowns about fibroids, including what they are and how they are treated. Learn more about fibroids, who is affected, common symptoms and options for treatment.

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What are fibroids?

Uterine fibroids are the most common benign (not cancerous) tumors, or growths, in women of childbearing age. They grow in and around the muscular wall of the uterus (womb). They can grow as a single tumor or there can be many. They can be as small as an apple seed or as big as a grapefruit. Fibroids can grow or stay about the same size over time. Another medical term for fibroids is leiomyoma or just “myoma”.

The Power of Your Story: Meet La-Anna

How can uterine fibroids impact you? Meet La-Anna, who has navigated life with fibroids for many years.

What are the symptoms of fibroids?

Fibroids do not always cause symptoms. People who have symptoms may find fibroids hard to live with. Symptoms of fibroids can include changes in menstruation (your period), heavy bleeding, vaginal bleeding between periods, painful periods, anemia (low red blood cell count, resulting from excessive bleeding), fullness or pressure in the lower abdominal area, frequent urination, pain the belly or lower back, and pain during sex. Fibroids can cause other reproductive problems, such as infertility, miscarriages, and obstetrical problems such as early labor and/or increased likelihood of Cesarean section.

What causes fibroids?

No one knows for sure what causes fibroids. Researchers think more than one factor could play a role. These factors include age, having a family member with fibroids, race/ethnic origin, being overweight or obese, having high blood pressure, and/or certain dietary factors and/or hormones.

How do I know if I have fibroids?

Unless you have symptoms, you might not know if you have fibroids. In some cases, a healthcare provider will find fibroids during a routine pelvic exam. Your provider may also order medical imaging like a pelvic ultrasound to see a picture of the fibroids. Imaging tests might include: 

  • Ultrasound – uses sound waves to make a picture; the ultrasound probe may be placed on the abdomen (belly) or inside the vagina
  • Saline infusion sonohysterography (SIS or SHG) or saline ultrasound – uses a small amount of saline (salt solution) placed in the uterus (womb) to help “see” inside of the uterus on an ultrasound 
  • Magnetic resonance imaging (MRI) – uses magnets and radio waves to make a picture of the inside of your body
  • Computed tomography (CT) or computer-assisted tomography (CAT) scan – scans the body with X-rays from many angles to form a more complete picture than a plain x-ray 

Other tests your healthcare provider may order include:

  • Complete blood count (CBC) – blood test to check for signs of anemia (low red blood cell count)
  • Blood levels of iron - blood test to measure the iron levels and confirm if iron-deficiency anemia exists

Surgery (i.e. hysteroscopy) can confirm the ultrasound diagnosis of fibroids and provide additional information like the location of the fibroids.

How are fibroids treated?

If you have fibroids but do not have symptoms, you may not need medical intervention. If you have symptoms, there are medical treatments that may help. Talk with your healthcare provider about the best way to treat your fibroids. Your provider can check during regular exams and with imaging to see if your fibroids have grown. 

Contact your healthcare provider if you have any of the following symptoms:

  • Heavy bleeding or bleeding between periods
  • Significant cramping or pain with periods
  • A full or heavy feeling in or near your belly
  • Frequent urination or difficulty with urination

If you have moderate or severe symptoms from your fibroids, your provider may recommend medical treatment, surgery or other interventional procedures depending on your symptoms and history. Medical treatments include hormonal medical treatments such as birth control pills, vaginal contraceptive rings, or intrauterine devices with hormone(s), which can help control heavy menstrual bleeding associated with fibroids. Newer medicines have been approved to manage heavy menstrual bleeding associated with fibroids in premenopausal women. Surgical options include removal of the fibroid(s) (myomectomy), destruction of the fibroid(s) without removal, or removal of the uterus (hysterectomy). These procedures can be performed using different methods, ranging from minimally invasive procedures to vaginal or open abdominal surgery. The type of surgery/procedure will depend on how many fibroids are present, where the fibroids are located and whether children are desired in the future. 

Talk with your provider about all your medical treatment options and their risks and benefits. Your provider can answer all your questions and together you can decide which treatment is right for you.

Diverse Women in Clinical Trials campaign

Clinical trials can help doctors learn more about safe treatments for fibroids. The FDA Office of Women's Health is partnering with the NIH Office of Research on Women's Health to raise awareness about diverse women of different ages, races, ethnic backgrounds, and health conditions participating in clinical trials.

Visit the Women in Clinical Trials webpage to learn more about participating in a clinical trial and find a study here.

For resources and materials on other women's health topics, visit www.fda.gov/womens.

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