Uterine Fibroids: Symptoms, Causes, Diagnosis, and Treatment

Uterine fibroids, also called leiomyomas or myomas, are noncancerous growths in the muscular wall of the uterus. They range from tiny nodules to large masses that change the uterus shape. Many women have fibroids, and symptoms depend on size, number, and location.

Types of uterine fibroids

Clinicians classify fibroids by where they grow:

• Intramural fibroids grow inside the uterine wall and are the most common. They can enlarge the uterus and cause pressure or pelvic pain.
• Submucosal fibroids form just under the uterine lining and can enter the uterine cavity. These often cause heavy bleeding and can affect fertility. Reproductive issues are more likely with this type.
• Subserosal fibroids grow on the uterus outer surface and may push outward. They sometimes cause pelvic pressure without heavier periods.
• Pedunculated fibroids attach to the uterus by a stalk, and can be subserosal or submucosal in nature.

What causes fibroids?

The exact cause is unclear, but common contributors include:

• Hormones: Estrogen and progesterone promote fibroid growth. Fibroids often shrink after menopause when hormone levels fall.
• Genetics: A family history raises risk.
• Ethnicity: Women of African descent have higher rates and may develop fibroids earlier.
• Lifestyle factors: Obesity, diets high in red meat and low in fruits and vegetables, and alcohol can increase risk.

Symptoms to watch for

Some women have no symptoms. When symptoms appear, they commonly include:

• Heavy or prolonged menstrual bleeding, which can lead to anemia and fatigue. (See product linked for heavy bleeding: Women’s excessive bleeding remedy (BM27).)
• Pelvic pain or pressure, a dull ache, or sharp cramping depending on fibroid size and location.
• Irregular menstrual cycles or spotting between periods.
• Pain during sex if fibroids press on sensitive areas.
• Urinary symptoms such as frequent urination, urgency, or incomplete emptying when fibroids press on the bladder. (See related product: Renecured.)
• Constipation or rectal pressure when fibroids press on the bowel.
• Enlarged abdomen or bloating when the uterus grows noticeably.
• Fertility and pregnancy issues if fibroids block fallopian tubes or distort the uterine cavity; they can increase the risk of miscarriage or preterm labor in some cases.

If you have these symptoms, get a medical evaluation. Not all fibroids need treatment, but options exist to reduce symptoms and improve quality of life.

How fibroids are diagnosed

Diagnosis uses history, exam, and imaging:

• Your provider will review symptoms, menstrual history, and reproductive plans.
• A pelvic exam can detect an enlarged or irregular uterus, though small or deep fibroids may be missed.
• Imaging confirms diagnosis and maps size and location. Ultrasound (transabdominal or transvaginal) is common. MRI offers detailed images for complex cases. CT is less common for fibroids.
• Additional blood tests may check for anemia from heavy bleeding or evaluate hormones if indicated. See more on anemia: anemia and treatment.

BM36 is useful for myoma, frequently increased menstruation, bleeding between periods, painful coitus, increased vaginal discharge, ovarian cysts, and swelling without pain in the lower abdomen.

After diagnosis, your provider will recommend treatment based on symptoms, fibroid characteristics, and whether you want future pregnancies.

Treatment options

Options range from watchful waiting to surgery:

Watchful waiting

If fibroids are small and symptoms are mild, regular monitoring with pelvic exams and ultrasound may be appropriate.

Medications

• Hormonal therapies, such as combined oral contraceptives, progestin IUDs, or GnRH agonists, can reduce bleeding and shrink fibroids temporarily.
• NSAIDs, like ibuprofen or naproxen, relieve pain but do not shrink fibroids.

Other procedural and surgical options include uterine-sparing procedures and hysterectomy, chosen based on symptom severity and fertility goals. Talk through risks and recovery with your provider to choose the right plan.

If you suspect fibroids or your symptoms change, schedule a medical appointment. Early evaluation helps you pick the treatment that fits your health and life plans.