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Uterine fibroids

Uterine fibroids are benign growths arising from uterine smooth muscle. Many cause no symptoms, while others can lead to heavy menstrual bleeding, anemia, pelvic pressure or pain, urinary or bowel symptoms and reproductive problems.

At a glance

Quick facts

Condition snapshot
Also called
Leiomyomas · myomas
Nature
Benign uterine growths
Symptoms
Often none
Common problems
Heavy bleeding · pressure · pain
Diagnosis
Pelvic exam + ultrasound
Treatment
Observation · medication · procedures · surgery

Names & terminology

How this entity may be named or searched

Canonical name
Uterine fibroids.
Medical terms
Leiomyoma and myoma are common synonyms.
Cancer distinction
Fibroids are benign growths; they are not the same as uterine sarcoma.
Location terms
Submucosal, intramural and subserosal describe where fibroids sit in relation to the uterine wall and cavity.

Structured entity profile

Clinical profile

Condition data
ClassificationBenign smooth-muscle tumors of the uterusFibroids can be single or multiple and vary greatly in size.
SymptomsOften asymptomaticSymptomatic disease commonly involves bleeding, pain or pressure.
Bleeding impactHeavy or prolonged menstruationChronic blood loss can contribute to iron-deficiency anemia.
Pressure effectsBladder or bowel symptomsLarge or strategically located fibroids can cause frequency, constipation or pelvic fullness.
FertilityMay affect fertility in some casesLocation, especially distortion of the uterine cavity, can matter.
CourseHormone-responsiveFibroids often shrink after menopause but patterns vary.

Overview

Fibroids develop from the muscle tissue of the uterus and are the most common type of pelvic growth described in ACOG patient guidance. They may be located within the uterine wall, project into the uterine cavity or grow toward the outer surface. Size and number vary widely. [1]

Many fibroids are discovered incidentally and need no treatment. Management is driven by symptoms, anemia, size/location, reproductive goals and uncertainty about the diagnosis rather than by the mere presence of a fibroid on imaging. [1] [2]

Symptoms and warning signs

Possible symptoms include heavy or prolonged menstrual bleeding, menstrual pain, bleeding between periods, pelvic pressure or pain, frequent urination, constipation, pain during sex and lower-back discomfort. Blood loss can lead to anemia. Many people have no symptoms at all. [1] [2]

SYMPTOM MATRIX

Bleeding, pressure and pain are the main symptom groups

Symptoms depend heavily on fibroid size and location.

Gynecology
Bleeding
  • Heavy menstrual bleeding
  • Longer or more frequent periods
  • Bleeding between periods
  • Iron-deficiency anemia from blood loss
Pressure / pain
  • Pelvic fullness or pressure
  • Lower abdominal or back pain
  • Frequent urination
  • Constipation or rectal pressure
  • Pain during sex
Needs prompt assessment
  • Very heavy bleeding with dizziness or weakness
  • Severe sudden pelvic pain
  • Rapidly worsening symptoms
  • Bleeding after menopause

These symptoms need evaluation because not all bleeding or pelvic masses are caused by fibroids.

Diagnosis

Fibroids may first be suspected on pelvic examination. Ultrasound is commonly used to confirm uterine masses and define size and location. Depending on the clinical question, hysteroscopy, saline sonography, hysterosalpingography or MRI may be used. CT is rarely needed specifically to evaluate fibroids. [1]

Evaluation also addresses the consequences of symptoms, such as checking for anemia when heavy bleeding is present. The diagnostic process should not assume that every uterine or pelvic mass is a fibroid when imaging or clinical features are atypical. [1] [2]

Diagnostic pathway

Confirm anatomy and connect it to symptoms

The most useful test depends on whether the clinical question is bleeding, pressure, fertility or procedural planning.

Pelvic imaging
1Clarify symptoms and goalsCharacterize bleeding, pain, pressure, anemia symptoms and fertility priorities.
2Pelvic examinationAssess uterine size, tenderness and other possible pelvic pathology.
3UltrasoundDefine whether fibroids are present and estimate number, size and location.
4Targeted additional testingUse hysteroscopy, saline sonography or MRI when cavity detail or procedural planning is needed.
First-line imagingUltrasoundcommon initial test
Blood test when bleedingCBC / iron assessmentto assess anemia

Fibroids and fertility

Fibroids can be associated with infertility, miscarriage or pregnancy complications, but many people with fibroids conceive and have uncomplicated pregnancies. Whether a fibroid is likely to affect fertility depends on size and location, especially whether the uterine cavity is distorted. Other causes of infertility should also be assessed rather than assuming fibroids are responsible. [1] [2]

Treatment and management

Fibroids that do not cause symptoms or significant problems may be monitored without active treatment. For symptomatic fibroids, options range from medicines that reduce bleeding or pain to procedures and surgery. Choice depends on symptom severity, fibroid anatomy, age, general health and whether future pregnancy is desired. [1] [2]

Medication can control bleeding and pain but may not remove the fibroids. Myomectomy removes fibroids while preserving the uterus. Hysterectomy removes the uterus and is definitive for uterine fibroids but ends the possibility of carrying a pregnancy. Other procedures, including uterine artery embolization and selected image-guided approaches, may be appropriate for some patients. [1] [2]

Treatment & care hub

Treat symptoms and anatomy — not the scan alone

The best option depends on symptoms, location and reproductive goals.

Individualized care
ObservationNo/mild symptoms

Watchful waiting

Routine follow-up may be enough when symptoms are absent or minor, particularly near menopause.

MedicationSymptom control

Bleeding and pain treatment

Hormonal methods, tranexamic acid and other therapies may reduce bleeding or pain without removing fibroids.

Uterus-sparingSelected patients

Myomectomy / procedures

Myomectomy removes fibroids; other minimally invasive procedures may be options depending on anatomy and pregnancy goals.

Definitive surgerySelected patients

Hysterectomy

Removal of the uterus definitively treats fibroids but is not compatible with future pregnancy.

Measure impact→Map anatomy→Match treatment→Reassess

Symptoms, fertility plans and reproductive goals materially affect the choice between observation, medicines, procedures and surgery. Source [1]

When symptoms need reassessment

New heavy bleeding, anemia symptoms, rapidly changing pelvic pressure or pain, or bleeding after menopause should be assessed rather than attributed automatically to known fibroids. Fibroids can coexist with other gynecologic conditions, so a change in the symptom pattern deserves review. [1] [2]

Epidemiology context

Fibroids are common, but prevalence estimates vary

Age, population, imaging method and whether asymptomatic fibroids are counted produce very different prevalence estimates.

ACOG uterine fibroids FAQ ↗
Population patternVery commonmany cases are asymptomatic
Peak clinical frequency30s–40s
After menopauseoften shrink
Why no single percentage? Published prevalence varies substantially depending on age, race/ethnicity, population selection and whether ultrasound screening detects asymptomatic fibroids. This page avoids presenting one number as a universal global prevalence.

Common questions

Frequently asked questions

Reference content

Sources

  1. ACOG — Uterine Fibroids FAQ, last reviewed December 2025
  2. NICHD — Uterine fibroids: symptoms and treatment information

This article is based on trusted medical sources and is awaiting clinician review. It is not a substitute for personalized medical advice.