Uterine fibroids are one of the most common gynecological conditions that women encounter at different ages. For some, they are discovered incidentally during an ultrasound examination, for others they cause pain or heavy periods, and for some women they may remain completely unnoticed for years. This often leads to anxiety – what it is, whether it is dangerous, and whether something needs to be done urgently.
It is important to understand that uterine fibroids do not always mean surgery or serious limitations in daily life. In many cases, they grow slowly, do not affect well-being, and only require monitoring. In other situations, fibroids may cause symptoms, interfere with pregnancy planning, or reduce quality of life – and then the approach to treatment will be different.
In this article, I will explain in simple terms what uterine fibroids are, why they develop, which symptoms may be associated with them, how they can be potentially dangerous, and in which cases treatment is truly necessary. This will help you better understand the diagnosis, calmly ask your doctor questions, and see which decisions are right for you.
What Are Uterine Fibroids
Uterine fibroids are benign (non-cancerous) growths that develop from the muscular wall of the uterus. They are also referred to as fibromyomas or leiomyomas – these are simply medical “synonyms” that mean the same thing.
It is important to understand two key points.
Fibroids are very common. In many women, they are discovered incidentally during an ultrasound examination, when there is no pain and the menstrual cycle remains stable.
Fibroids are not a verdict and not a reason to panic. They can be different – small or large, single or multiple, “silent” or symptomatic. And it is precisely these factors that determine the approach – monitoring, treatment, pregnancy planning, or discussing surgery.
Where Fibroids Can Develop
The uterus is a muscular organ, and fibroids can develop in different layers of its wall. The location largely determines the symptoms.
- Intramural (within the muscle layer) – grows within the thickness of the uterine wall. It often affects menstruation (heaviness, duration) and may cause a sensation of pressure.
- Submucosal (beneath the lining) – grows closer to the uterine cavity, inward. This type is most commonly associated with very heavy periods, abnormal bleeding, and sometimes difficulties with conception.
- Subserosal (outer surface) – grows outward, toward the abdominal cavity. It may cause pressure on nearby organs (the bladder or intestines) and a feeling of heaviness, but does not always affect menstruation.
In some cases, a fibroid grows on a stalk, meaning it is attached by a narrow base. In most situations, this is not dangerous on its own, but under certain circumstances it may cause pain due to impaired blood supply to the fibroid.
Is a Fibroid a Tumor?
The word “tumor” can be alarming, but in this context it simply means a “mass” or “growth.” Fibroids are almost always benign. The risk that a malignant process is hidden behind a fibroid is low in the general population, and a physician evaluates this risk based on a combination of factors – age, growth rate, symptoms, ultrasound / MRI findings, and laboratory tests.
Why Fibroids Develop
In short, fibroids most often develop due to the sensitivity of uterine tissues to hormones (primarily estrogen and progesterone), with genetics and the way receptors function in the myometrium (the muscular layer of the uterus) also playing a role. This does not mean that “hormones are bad” – it means that in some women, uterine tissue responds more actively, and over time a fibroid may form.
What Causes Uterine Fibroids
When a woman is diagnosed with fibroids, a logical question almost always arises – why did this happen to me and what caused it. There is no single clear factor; fibroids develop under the influence of several contributing factors.
Hormonal Sensitivity of Uterine Tissue
Fibroids are considered hormone-dependent growths. This means that in some women, the cells of the uterine muscle layer are particularly sensitive to female sex hormones – estrogen and progesterone.
Important: this does not necessarily mean a “hormonal imbalance.” Hormone levels in blood tests may be completely normal, but the uterine tissue responds more actively – and over time, a fibroid node may begin to grow in one area.
Genetic Predisposition
If a mother, grandmother, or sisters have had uterine fibroids, the likelihood of developing them is higher. This does not mean that fibroids will обязательно develop, but genetic predisposition does play a role.
Age and Reproductive Period
Fibroids are most often diagnosed in women of reproductive age – roughly from 25–30 years until the onset of menopause. This is because hormonal activity is highest during this period.
After menopause, fibroid nodes usually stop growing and may even decrease in size.
Associated Gynecological Factors
The development of fibroids may be influenced by:
- inflammatory diseases of the pelvic organs
- frequent intrauterine procedures
- endocrine disorders
- absence of pregnancies throughout life
These are not direct causes, but factors that may create favorable conditions for fibroid growth.
Important to Remember
Uterine fibroids are not the result of a woman’s mistakes, lifestyle choices, or “incorrect behavior.” They can develop in an active, healthy, athletic woman just as easily as in someone who rarely visits a doctor. Therefore, the main focus should not be on finding someone to blame, but on understanding the situation and proper monitoring.
Symptoms of Uterine Fibroids
Uterine fibroids can behave differently. In some women, they cause no symptoms and are discovered incidentally during an ultrasound examination, while in others they lead to noticeable symptoms. This is normal – the severity of symptoms depends on the size of the fibroids, their location, and the rate of growth.
When Fibroids Cause No Symptoms
Quite often, fibroids are asymptomatic. In such cases, a woman feels well, the menstrual cycle remains regular, and there is no pain. This is why fibroids are frequently found “incidentally” during a routine examination or an ultrasound performed for another reason.
In this situation, it is important not to panic, but to understand that the absence of symptoms often means that active treatment is not required, and monitoring is sufficient.
Main Symptoms of Uterine Fibroids
If fibroids begin to affect the function of the uterus or neighboring organs, the following signs may appear:
- heavy and prolonged menstrual periods
- bleeding outside the menstrual cycle
- a feeling of pressure or heaviness in the lower abdomen
- increase in abdominal volume without weight gain
- frequent urination or constipation
Most often, these symptoms are associated with the fibroid either deforming the uterine cavity or compressing surrounding tissues.
Relationship Between Symptoms and Fibroid Type
Symptoms directly depend on the location of the fibroids:
- submucosal fibroids more often cause heavy periods and bleeding
- intramural fibroids may affect the menstrual cycle and cause aching sensations
- subserosal fibroids more often manifest as a feeling of pressure rather than menstrual disturbances
This is why women with the same diagnosis may experience very different symptoms.
When Symptoms Are a Reason to See a Doctor
You should definitely consult a gynecologist if the following symptoms appear or worsen in the presence of fibroids:
- menstrual periods become noticeably heavier or longer
- weakness, dizziness, or rapid fatigue appear (possible signs of anemia)
- new pain develops or the nature of existing pain changes
- symptoms gradually intensify over time
Even if fibroids have already been diagnosed, any change in well-being is a signal that the situation should be reassessed and monitored dynamically, rather than simply continuing observation “out of habit.”
Do Uterine Fibroids Cause Pain and What Kind of Pain Is Possible
One of the most common questions I hear during consultations is whether fibroids can cause pain. The short answer is: yes, they can, but not always. The nature of pain associated with fibroids can vary.
When Fibroids Do Not Cause Pain
In many cases, uterine fibroids do not cause pain at all. Even if a fibroid is not small, a woman may not feel any discomfort. This is especially typical for fibroids that grow slowly and do not interfere with the function of neighboring organs.
Therefore, the absence of pain does not mean that fibroids are not present, and conversely, having fibroids does not guarantee a pain syndrome.
What Kind of Pain May Be Associated With Fibroids
If fibroids do cause pain, it is most often described as:
- pulling or aching pain in the lower abdomen
- a feeling of fullness or pressure
- discomfort that intensifies before menstruation
- pain during or after physical activity
Such pain is usually not sharp, but rather background in nature – it may appear and disappear, becoming more intense on certain days of the menstrual cycle.
When Pain Is a Warning Sign
There are situations in which pain requires closer attention:
- sudden, sharp pain
- pain that intensifies and does not subside
- pain accompanied by fever
- pronounced pain in the presence of already diagnosed fibroids
In rare cases, pain may be associated with impaired blood supply to a fibroid, especially if the fibroid is located on a stalk. This is not a common situation, but it is precisely why sudden pain should not be endured and medical attention should be sought.
It Is Important Not to Guess
Lower abdominal pain may be caused not only by fibroids – similar sensations can occur with endometriosis, inflammatory conditions, or disorders of the intestines or bladder. Therefore, the presence of pain alone does not allow for a diagnosis and requires calm and thorough evaluation.
How Dangerous Are Uterine Fibroids
The word “dangerous” is often alarming, which is understandable. It is important to clarify the main point right away: uterine fibroids are not a malignant condition. However, in some cases they can indeed affect health and quality of life, especially if they are not monitored and symptoms are ignored.
Heavy Bleeding and Anemia
One of the most common problems associated with fibroids is heavy and prolonged menstrual bleeding. Due to regular blood loss, anemia may develop – a condition in which hemoglobin levels decrease.
Women often report the following symptoms:
- persistent fatigue
- weakness
- dizziness
- reduced work capacity
In some cases, anemia becomes the first reason for examination, after which fibroids are discovered.
Pressure on Nearby Organs
Large fibroids or those growing outward may compress neighboring pelvic organs:
- the bladder – resulting in frequent urination
- the intestines – causing constipation or a sensation of incomplete bowel emptying
These symptoms are not dangerous in themselves, but they can significantly reduce daily comfort.
Impact on Reproductive Function
Depending on the location of the fibroid, it may:
- make conception more difficult
- increase the risk of complications during pregnancy
- affect embryo implantation
It is important to emphasize that having fibroids does not mean infertility. Much depends on the size of the fibroids, their type, and their location.
Growth and Structural Changes of Fibroids
In some women, fibroids may gradually increase in size. Rapid growth is not normal and always requires medical attention. In such cases, it is important to rule out other causes and determine the optimal treatment strategy.
What Is Important to Remember
The danger of uterine fibroids lies not in their mere presence, but in the potential consequences of lack of monitoring. Regular check-ups and follow-up allow changes to be detected in time and well-considered decisions to be made – without haste or unnecessary stress.
What Happens If Uterine Fibroids Are Not Treated
This question is asked at almost every appointment. Here it is important to say honestly and calmly: not every fibroid requires active treatment. In some cases, observation is sufficient. However, there are situations in which the absence of treatment may lead to undesirable consequences.
When Fibroids May Not Require Treatment
If a fibroid is small, not growing, does not cause symptoms, and does not interfere with pregnancy plans, a physician may recommend a monitoring approach. This includes:
- regular medical examinations
- follow-up ultrasound examinations
- assessment of fibroid growth dynamics
This approach is considered safe and justified when the condition remains stable.
What May Happen Without Treatment
If fibroids are symptomatic or prone to growth, the absence of treatment may lead to the following scenarios:
- worsening menstrual bleeding
- development or progression of anemia
- increasing pain and pressure sensations
- enlargement of the uterus
Over time, this may significantly affect well-being and quality of life.
Risks Associated With Fibroid Growth
The larger a fibroid becomes, the more difficult it may be to choose a conservative treatment option. Large fibroids can limit available treatment methods and may require more extensive intervention than at earlier stages.
In addition, growing fibroids more often affect the function of neighboring organs and reproductive health.
Why Monitoring Is Important Rather Than Ignoring
“Not treating” does not mean forgetting about the diagnosis. Even if active treatment is not required, fibroids should remain under control. This allows changes to be detected in time and treatment to be initiated when it is truly needed and most effective.
Diagnosis of Uterine Fibroids
Diagnosing uterine fibroids is usually straightforward and, in most cases, begins with a routine visit to a gynecologist. The main goal of the evaluation is to confirm the presence of fibroids, determine their type, size, and location, and understand whether they affect a woman’s health.
Gynecological Examination
During the appointment, the physician asks about symptoms, menstrual cycle characteristics, pregnancy plans, and overall well-being. A bimanual examination may sometimes suggest uterine enlargement or the presence of fibroids, but this alone is not sufficient for definitive conclusions.
The examination is the first step that helps determine the next direction of evaluation.
Pelvic Ultrasound
The primary and most informative method for diagnosing uterine fibroids is ultrasound examination.
With ultrasound, the physician can:
- visualize fibroid nodes
- determine their number and size
- assess their location in relation to the uterine walls and cavity
- evaluate changes over time during follow-up
Most often, transvaginal ultrasound is used, as it provides the most accurate assessment.
Additional Methods When Needed
In some situations, additional diagnostic tests may be required:
- MRI – in cases of complex fibroid location or uncertainty in diagnosis
- hysteroscopy – to assess the uterine cavity when submucosal fibroids are suspected
These methods are not used for everyone, but only when indicated.
Why Accurate Diagnosis Matters
Fibroids may look similar but behave differently. Management decisions – observation, medical therapy, or discussion of surgical treatment – depend on accurate diagnosis. Therefore, it is important not just to “see a fibroid,” but to assess it correctly in the context of symptoms and a woman’s plans.
Uterine Fibroids and Pregnancy
The topic of pregnancy in women with uterine fibroids often causes significant concern. The good news is that many women with fibroids conceive and have normal pregnancies. However, there are nuances that should be considered in advance.
Do Uterine Fibroids Affect Conception
The impact of fibroids on the ability to conceive depends primarily on their location and size.
- small fibroids that do not distort the uterine cavity most often do not interfere with conception
- submucosal fibroids may make embryo implantation more difficult
- large fibroids can sometimes impair uterine blood supply
When planning pregnancy, it is important to assess these factors together with a physician.
How Fibroids Behave During Pregnancy
During pregnancy, hormonal changes occur, and fibroids may:
- remain stable
- increase slightly in size
- less commonly – decrease in size
Fibroid growth is not always accompanied by symptoms, but in some cases it may cause pulling pain or a feeling of tension in the lower abdomen. In such situations, closer monitoring is required.
Possible Risks During Pregnancy
With certain types of fibroids, the risk of the following may increase:
- threatened miscarriage
- abnormal fetal position
- preterm birth
It is important to emphasize that risk is assessed individually, and the presence of fibroids does not mean that these complications will necessarily occur.
Should Fibroids Be Treated Before Pregnancy
The decision to treat fibroids before pregnancy is based not simply on their presence, but on a combination of factors – fibroid type, size, symptoms, and a woman’s reproductive plans.
In some cases, removing fibroids before pregnancy does improve the chances of successful gestation. In other situations, no intervention is required.
When Is Surgery Needed for Uterine Fibroids
Surgery for uterine fibroids is not always necessary. In many cases, observation or conservative treatment is sufficient. The decision to proceed with surgery is made when the benefits of intervention outweigh the potential risks and no other effective options are available.
Main Indications for Surgery
Surgical treatment of uterine fibroids may be considered in the following situations:
- significant and recurrent bleeding leading to anemia
- rapid growth of fibroid nodes
- severe pain or pressure on neighboring organs
- distortion of the uterine cavity
- infertility or pregnancy loss associated with fibroids
It is important to note that this is not about a single symptom, but about a combination of factors.
Size and Location Matter
There is no universal “critical size” at which fibroids must be surgically removed. What matters much more is:
- where the fibroid is located
- how it affects the uterine cavity
- what symptoms it causes
Sometimes a small submucosal fibroid requires treatment sooner than a large external fibroid that causes no symptoms at all.
Surgery Is Not the Goal, but a Tool
Modern gynecology aims to preserve the uterus and reproductive function, especially in women planning pregnancy. Therefore, surgical treatment is considered one of the tools, not a mandatory step for every diagnosis of fibroids.
Before making a decision, the physician evaluates the woman’s age, reproductive plans, fibroid growth dynamics, and overall health.
Why It Is Important Not to Delay the Decision
If surgery is truly indicated, postponing it may lead to further fibroid growth and a more complex procedure. In such cases, earlier treatment often allows for a less traumatic and more conservative approach.
How Uterine Fibroids Are Treated
Treatment of uterine fibroids is always individualized. There is no single “correct” option for everyone, because fibroids differ in size, location, symptoms, and impact on a woman’s life. The physician’s task is to choose an approach that is effective while remaining as gentle as possible.
Observation Without Active Treatment
If fibroids are small, not growing, and do not cause symptoms, observation may be the most reasonable option. In this case:
- the woman visits a gynecologist regularly
- follow-up ultrasound examinations are performed
- changes in fibroid size are monitored over time
This approach helps avoid unnecessary intervention while keeping the situation under control.
Medical Treatment
Medical therapy may be used to:
- reduce symptoms
- manage menstrual bleeding
- temporarily slow fibroid growth
It is important to understand that medications do not always lead to fibroid disappearance, but they can significantly improve well-being and quality of life. The choice of medications depends on the clinical situation and is always discussed individually.
Surgical Treatment
Surgical treatment is considered when other methods are ineffective or unsuitable. Modern surgical approaches aim to:
- remove fibroid nodes
- preserve the uterus
- minimize tissue trauma
The surgical method is selected based on fibroid location, number of nodes, and the woman’s reproductive plans.
Key Points About Fibroid Treatment
Uterine fibroids are a condition that can and should be managed calmly and thoughtfully. In most cases, treatment is not urgent, and women have time to review options, ask questions, and make a balanced decision together with their physician.
Frequently Asked Questions About Uterine Fibroids
Can Uterine Fibroids Stop Growing on Their Own
Yes, this is possible. In some women, fibroids remain stable for a long time and do not increase in size. This is especially common with small fibroids and in situations where hormonal balance is relatively stable. That is why not every fibroid requires immediate treatment – sometimes observation with follow-up ultrasound is sufficient.
If a Fibroid Is Growing, Does That Mean Surgery Is Needed
Not necessarily. Fibroid growth alone is not the only criterion for surgery. What matters is how fast it grows, what symptoms it causes, and where it is located. In some cases, even a growing fibroid can be monitored or managed medically if it does not affect well-being or reproductive plans.
Can Fibroids Shrink or Disappear Without Surgery
Complete disappearance of fibroids is rare, but a reduction in size is possible. Sometimes fibroids decrease in size due to hormonal changes or after childbirth. After menopause, fibroids most often stop growing and may shrink.
Why Doctors May Give Different Recommendations for Fibroids of the Same Size
Because size is only one of many factors. A physician always evaluates fibroids as a whole: their location, number of nodes, impact on the uterine cavity, symptoms, the woman’s age, and her pregnancy plans. That is why fibroids of the same size in centimeters may require completely different approaches in different women.
Can You Exercise With Uterine Fibroids
In most cases – yes. Moderate physical activity is not contraindicated and can even be beneficial. Restrictions usually apply only in specific situations – for example, in cases of significant pain, very large fibroids, or heavy bleeding. Individual recommendations are best discussed with a physician rather than relying on universal rules.
Can Fibroids “Turn Into” Cancer
This concern is very common. Uterine fibroids almost always remain benign. The risk of malignancy is low, and a physician evaluates it based on a combination of factors – clinical presentation, growth dynamics, ultrasound findings, and other studies. That is exactly why regular follow-up is important.
Is Treatment Necessary if There Is No Pain
Not always. The absence of symptoms is an important argument in favor of observation. However, even in this case, fibroids should remain under control to avoid missing changes. Treatment decisions are made based on real indications, not “just in case.”
When to See a Doctor
Even in the absence of significant symptoms, regular contact with a physician remains an important part of uterine fibroid management. There are situations when consultation is needed not because of urgency, but for proper orientation and calm planning of next steps.
You should see a doctor if:
- fibroids were diagnosed earlier but have not been monitored for a long time
- you are unsure whether observation is sufficient or treatment should be discussed
- you are planning pregnancy and know that you have fibroids
- new symptoms have appeared or your general well-being has changed
- you want to understand how fibroids may behave in the future and what to expect
Why It Is Important Not to Delay Consultation
Uterine fibroids rarely require emergency decisions, but timely evaluation helps choose the most conservative path. At early stages, observation or minimal intervention is often sufficient, whereas advanced situations may limit treatment options.
An Individual Approach Matters
Two women with the same fibroid diagnosis may need completely different management strategies. That is why it is important to consider not only fibroid size, but also symptoms, lifestyle, pregnancy plans, and personal expectations.
A thoughtful consultation helps not just “treat fibroids,” but create a clear and calm action plan – without unnecessary anxiety or imposed decisions.
Conclusion
Uterine fibroids are a condition that millions of women live with today. In most cases, they do not require urgent decisions and certainly should not be a source of constant fear. What matters far more is understanding what kind of fibroid you have, how it behaves, and what it means specifically for your situation.
Clarity reduces anxiety. It becomes easier to understand whether observation is sufficient, whether something should be changed now, or whether treatment options should be discussed. That is exactly what consultation is for – not to “schedule surgery,” but to calmly sort things out and build a clear plan.
If you already have a diagnosis of uterine fibroids, have developed symptoms, or are planning pregnancy, a conversation with a gynecologist helps put everything into perspective. Without rush, without pressure, and with full consideration of your goals and expectations.
Self-care begins not with radical decisions, but with informed dialogue and trust in a specialist.
