Uterine Fibroids

Uterine fibroids, also called leiomyomas, are noncancerous (benign) growths in the uterus. The growths almost never develop into cancer.

They range in size from that of a seed to large masses that distort the size and shape of the uterus. Uterine fibroids affect three out of four women in their childbearing years.

Most women with uterine fibroids don’t have symptoms. But about 1 in 4 women do have symptoms that are serious enough to need treatment.

 

What are signs and symptoms of uterine fibroids?

Many women with uterine fibroids experience no symptoms. For those who do, abnormal menstrual bleeding is the most common. Fibroids can cause other symptoms depending on their size, location, and proximity to other organs:

  • Heavy menstrual bleeding
  • Prolonged menstrual periods
  • Anemia
  • Pelvic pain
  • Lower back pain
  • Pain during sex
  • Difficulty urinating or frequent urination
  • Constipation

What are the distinct types of uterine fibroids?

Uterine fibroids are often classified by their location:

  • Intramural fibroids - Located within the wall of the muscular uterus
  • Submucosal fibroids - Sit just under the inner lining of the uterus. They extend into the uterine cavity.
  • Sub serosal fibroids - Grow beneath the outer layer of the uterus. They can be found on the outer surface of the uterus.
  • Pedunculated fibroids - Grow on stalks into the cavity of the uterus or out from the surface of the uterus

How do you diagnose uterine fibroids?

A noninvasive pelvic ultrasound (US) allows doctors to evaluate the bladder and reproductive organs. If additional imaging is needed, an MRI of the uterus may be performed, which typically takes about 25 minutes.

How are uterine fibroids treated?

The best treatment for uterine fibroids depends on several factors. These include the size and location of the fibroids, how severe your symptoms are, and your plans for pregnancy.

Non-surgical treatments are commonly prescribed for uterine fibroids.

Watchful Waiting

The best treatment for uterine fibroids depends on several factors. These include the size and location of the fibroids, how severe your symptoms are, and your plans for pregnancy.

If fibroid symptoms disrupt your life, lead to anemia, or affect your ability to get pregnant, you may want to explore a more aggressive treatment option. If there's any concern about cancer, it's also important to look into your options.

Medication

Medication can be used to control symptoms and shrink or slow the growth of the tumors.

  • Over-the-counter pain relievers and birth control pills can help relieve pain and heavy bleeding.
  • GnRH agonists (a type of medication) stop the body from making estrogen, which can shrink fibroids.
    • Cause menopause-like side effects (hot flashes, bone thinning)
    • Are usually used for short periods (3–6 months)
    • Fibroids may grow back after stopping the medication
    • Surgery might be needed later

Minimally invasive and surgical procedures are available for uterine fibroids.

Uterine Fibroid Embolization

Uterine fibroid embolization (UFE) shrinks fibroids by cutting off their blood supply. It helps relieve symptoms without needing major surgery or causing side effects. Your uterus remains intact, too.

  • There are no big incisions. Just a tiny opening in the wrist or groin area.
  • Shorter recovery times. Patients generally go home the same day and return to work in a few days.
  • It works well for 85% to 90% of patients. They often feel significant or total relief from heavy bleeding or pain. Pregnancy after this procedure is possible.

Myomectomy

A myomectomy surgically removes the fibroids but leaves the uterus intact. Your doctor may suggest this option if you wish to get pregnant in the future. If you’ve had trouble with fertility, getting rid of the growths might help you conceive. However, fibroids may grow back after myomectomy.

When comparing UFE and myomectomy, the best treatment depends on your needs and health. For many patients, UFE is a good choice. It works well for those with multiple fibroids or who want to skip surgery. Recovery from UFE usually takes 7-10 days. Most women can return to normal activities within two weeks. Myomectomy recovery can range from a few days to six weeks. Your provider will talk about the benefits of each option. Then, they will suggest a treatment plan just for you.

Vaginal Natural Orifice Transluminal Endoscopic Surgery

We also offer a new no-incision procedure at SSM Health St. Mary's Hospital - St. Louis. The procedure uses radiofrequency ablation to target and shrink fibroids over several months. Each outpatient procedure takes about 40 minutes and has positive outcomes.

If you’re struggling with the symptoms of uterine fibroids, schedule a consultation with your gynecologist today to determine if you are a candidate for this procedure.

Hysterectomy

A hysterectomy, the surgical removal of the uterus, is the only way to make sure the fibroids do not return. This surgery will relieve your symptoms, but you will not be able to get pregnant afterwards.

Common questions about uterine fibroids:

Yes—if the uterus is preserved, fibroids can recur. Only hysterectomy guarantees they will not return.

Fibroids don’t burst like cysts. However, they can degenerate or rupture blood vessels. This can lead to sudden, severe pain, bleeding, or inflammation. This is rare but requires urgent care.

Yes. Most pregnancies are healthy. Large or poorly placed fibroids can raise the risk of preterm labor. They may also lead to C-sections or complications during labor.

  • Fibroid behavior varies:
    • Growth may occur during pregnancy
    • After menopause, fibroids often shrink
    • Around 20–30% grow during pregnancy, sometimes causing pain

Yes. Fibroids can cause pelvic pressure and cramping. They may also lead to back pain. If they grow too big, they might lose their blood supply and start to degenerate, which can result in sharp pain.

No. Polyps do not directly cause weight gain. Bloating can feel like weight gain, but real weight increase usually comes from fibroids, not polyps.

Fibroids in the uterine cavity can raise the risk of miscarriage. They are usually removed before pregnancy. For others, timing depends on:

  • Symptom severity
  • Fibroid size and location
  • Future birth plans (e.g., some myomectomies require C-section delivery later)

Page reviewed by: K.Michael Schraff, MD, February 2026