Written by Sofia Quaglia
Uterine fibroids are very common. Although they don’t really go away over time, they often don’t cause any symptoms. On the off chance they do cause you symptoms, they can generally be treated, so try not to worry.
Here’s everything you need to know about fibroids — straight from two experts — including what they are, how to know if you have them, and whether they go away.
Fibroids are lumps made up of muscle and fibrous tissue that can grow around or inside your uterus. They are also called leiomyoma — or “myoma” for short — and can grow to various sizes. Some are as small as lentils; others can be as big as a carrot or larger. Although they’re technically tumors, they are benign — or harmless — so they aren’t cancerous and are usually nothing to worry about.
“I like to tell people that fibroids are sort of like moles on your skin,” says Dr. Barbara Levy, MD, former vice president in health policy of the American College of Obstetricians and Gynecologists National Leadership Institute. “Babies don’t have very many moles; in fact, they probably don’t have any, and as life goes on, exposure and life in general just creates little freckles and moles.”
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. If anything, they usually increase with age… just like moles or freckles.
“Fibroids are exquisitely common,” says Dr Levy. “In fact, if we do a very sensitive ultrasound, we can find fibroids in almost anybody, especially by the age of about 50.”
They start cropping up among women and people with a uterus after the age of 35, and up to 80% of women end up having fibroids by the age of 50. Clinical studies, including one from Finland that assessed more than 400,000 women, have shown that fibroids may be genetic. If your mother or sister has them, then you have an increased chance too. Ethnic origin has also been found to play a role; one U.S. study of more than 1,000 women found that uterine fibroids are more common among Black women than white women. The same study also showed that they tend to occur at a younger age in Black women.
You could have only fibroid, or you could have several, depending on their size and position. Unless they cause symptoms, you might never notice them.
“The number one message is that fibroids don’t mean anything. It’s your symptoms that matter,” says Dr. Levy.
Only a third of people with fibroids actually have any associated symptoms. Symptoms usually resemble a bad period, such as painful or heavy flow, stomach and lower back ache, constipation, or feeling the need to pee often because the fibroid is pressing on your bladder.
Fibroids do not cause weight gain, but they can make your belly swollen. In very rare cases, uterine fibroids can lead to more complications, like trouble with pregnancy. Very rarely — in less than 1 in 100,000 cases — what’s initially presumed to be a fibroid could be cancer (known as leiomyosarcoma). However, cancerous tumors generally come with other symptoms, including abdominal bloating, weight loss, fever, and nausea. So if you’re regularly getting checkups from a health care professional, there’s a good chance they’ll be able to spot anything concerning.
Clinicians don’t really know what triggers fibroids, but we know they are related to the hormones estrogen and progesterone, which are responsible for building your uterine lining. That said, there isn’t really anything that can be done to avoid them, according to Dr. Levy.
If you notice symptoms like the ones listed above, speak to your doctor They will be able to detect if you have fibroids, sometimes with a routine pelvic exam.
“A lot of people who have fibroids don’t have any symptoms at all from them, and they might only find out that they have them when they do an ultrasound for a different problem,” says Dr. Jennifer Boyle, MD, clinical instructor of obstetrics and gynecology, Harvard Medical School. “A lot of people find out during pregnancy when they’re having a pregnancy ultrasound.”
Fibroids typically don’t affect your ability to conceive (although they can cause complications during pregnancy). You can also safely take birth control if you have them. In fact, some forms of birth control are actually prescribed to help alleviate symptoms. Health care providers may recommend the birth control pill or progesterone-containing IUDs if you’re having heavy, painful bleeding, because the hormones contained in them regulate bleeding during the menstrual cycle.
Whether or not fibroids should be removed is a complicated question, and there’s not one general answer. As Dr. Boyle explains, it depends on the size of the fibroids, where the fibroids are, what symptoms they’re causing, and your reproductive plans.
Some fibroids may be pushing outside of the uterus and into the pelvis, while others may be growing inside of the walls of your uterus. They can also grow inside your uterus (these are known as submucosal fibroids). This type is the one to pay attention to if you’re trying to get pregnant, but it’s also the least common type of fibroid.
In cases of submucosal fibroids, your health care provider will likely recommend that they be surgically removed. This kind of intervention is called hysteroscopy and involves removing the fibroid without damaging the tissue. In this procedure, surgeons can reach the uterus through your vagina, without having to cut anything.
Every case is different and personal, and you can work with a health care professional to devise a tailored treatment plan. For example, if you’re pregnant and your fibroids are large, your doctor may recommend a cesarean section rather than a vaginal delivery.
If a health care professional finds fibroids, a couple of things you might want to ask includes: How many fibroids are there? What size and where are they located? Do they look like they’ll grow larger? Once you have all the information, you can run through treatment options with them, if necessary.