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Uterine fibroids

Leiomyoma; Fibromyoma; Myoma; Fibroids; Uterine bleeding - fibroids; Vaginal bleeding - fibroids

Uterine fibroids are tumors that grow in a woman's womb (uterus). These growths are typically not cancerous (benign), and do not become cancerous.

Images

Pelvic laparoscopy
Female reproductive anatomy
Fibroid tumors
Uterus

Causes

Uterine fibroids are common. As many as one in five women may have fibroids during their childbearing years. Half of all women have fibroids by age 50.

Fibroids are rare in women under age 20. They are more common in African Americans than White, Hispanic, or Asian women.

No one knows exactly what causes fibroids. They are thought to be caused by:

Fibroids can be so tiny that you need a microscope to see them. They can also grow very large. They may fill the entire uterus and may weigh several pounds or kilograms. Although it is possible for just one fibroid to develop, most often there is more than one.

Fibroids can grow:

Symptoms

Common symptoms of uterine fibroids are:

Often, you can have fibroids and not have any symptoms. Your health care provider may find them during a physical exam or other test. Fibroids often shrink and cause no symptoms in women who have gone through menopause. A recent study also showed that some small fibroids shrink in premenopausal women.

Exams and Tests

Your provider will perform a pelvic exam. This may show that you have a change in the shape and size of your womb.

Fibroids are not always easy to diagnose. Being obese may make fibroids harder to detect. You may need these tests to look for fibroids:

Treatment

What type of treatment you have depends on:

Treatment for the symptoms of fibroids may include:

Medical or hormonal therapies that may help shrink fibroids include:

Surgery and procedures used to treat fibroids include:

Newer treatments, such as the use of focused ultrasound, are being evaluated in clinical studies.

Outlook (Prognosis)

If you have fibroids without symptoms, you may not need treatment.

If you have fibroids, they may grow if you become pregnant. This is due to the increased blood flow and higher estrogen levels. The fibroids usually return to their original size after your baby is born.

Possible Complications

Complications of fibroids include:

If you are pregnant, there's a small risk that fibroids may cause complications:

When to Contact a Medical Professional

Contact your provider if you have:

Related Information

Tumor
Infertility
Uterine artery embolization
Hysterectomy - abdominal - discharge
Hysterectomy - laparoscopic - discharge
Hysterectomy - vaginal - discharge
Uterine artery embolization - discharge

References

Bulun SE. Physiology and pathology of the female reproductive axis. In: Melmed S, Auchus, RJ, Goldfine AB, Koenig RJ, Rosen CJ, eds. Williams Textbook of Endocrinology. 14th ed. Philadelphia, PA: Elsevier; 2020:chap 17.

Dolan MS, Hill CC, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Gershenson DM, Lentz GM, Valea FA, Lobo RA, eds. Comprehensive Gynecology. 8th ed. Philadelphia, PA: Elsevier; 2022:chap 18.

Manyonda I, Belli AM, Lumsden MA, et al. Uterine-artery embolization or myomectomy for uterine fibroids. N Engl J Med. 2020 ;383(5):440-451. PMID: 32726530 pubmed.ncbi.nlm.nih.gov/32726530/.

Moravek MB, Bulun SE, Stewart EA, Orellana M. Uterine fibroids and adenomyosis. In: Robertson RP, ed. DeGroot's Endocrinology. 8th ed. Philadelphia, PA: Elsevier;2023:chap 126.

Verpalen IM, Anneveldt KJ, Nijholt IM, et al. Magnetic resonance-high intensity focused ultrasound (MR-HIFU) therapy of symptomatic uterine fibroids with unrestrictive treatment protocols: a systematic review and meta-analysis. Eur J Radiol. 2019;120:108700. doi: 10.1016/j.ejrad.2019.108700. PMID: 31634683 pubmed.ncbi.nlm.nih.gov/31634683/.

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Review Date: 1/10/2022  

Reviewed By: John D. Jacobson, MD, Department of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda, CA. Internal review and update on 07/25/2023 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

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