Uterine fibroids are noncancerous growths that develop in or around the wall of the uterus. They are extremely common in women of childbearing age, with estimates suggesting up to 80 percent of women may develop them by age 50. Many women have fibroids without ever knowing it, since they often cause no symptoms at all. When symptoms do appear, they range from mild to significantly disruptive, and in some cases fibroids can affect fertility.
At Kofinas Fertility Group, we look closely at fibroid location, size, and number, since these factors, not just the presence of fibroids, determine what symptoms show up and whether treatment is recommended.
Common Symptoms of Uterine Fibroids
Symptoms depend largely on where a fibroid is located and how large it has grown. Reported symptoms often include:
Heavy or prolonged menstrual bleeding, sometimes with clots
Bleeding between periods
Pelvic pressure or pain, or a feeling of fullness in the lower abdomen
Frequent urination, caused by a fibroid pressing on the bladder
Lower back pain
Pain during sex
Constipation, in some cases
Reproductive challenges such as difficulty conceiving, pregnancy loss, or complications during pregnancy or delivery
Many women with fibroids have no symptoms at all, and fibroids are sometimes discovered incidentally during a routine exam, prenatal ultrasound, or fertility workup.
Why Location Matters
Fibroids are generally classified by where they grow:
Submucosal fibroids grow just under the lining of the uterus and project into the uterine cavity. These are the type most closely linked to heavy bleeding and fertility challenges, since they can interfere with implantation.
Intramural fibroids grow within the muscular wall of the uterus. Depending on size, these can also affect the uterine cavity and fertility.
Subserosal fibroids grow on the outer surface of the uterus. These are less likely to affect fertility directly but can cause pressure symptoms depending on size.
Pedunculated fibroids grow on a stalk, either inside or outside the uterus.
Periods that are significantly heavier or longer than your usual pattern
Bleeding between periods
Pelvic pain or pressure that persists
Difficulty conceiving after 6 to 12 months of trying, depending on your age
Seek emergency care immediately for sudden, severe abdominal pain that does not respond to pain medication, or very heavy bleeding accompanied by weakness, lightheadedness, or fatigue. In very rare cases, a fibroid can rupture, which is a medical emergency.
How Fibroids Are Diagnosed
Diagnosis typically starts with a pelvic exam, followed by imaging such as ultrasound. In some cases, additional imaging like a saline infusion sonogram, MRI, or hysteroscopy may be used to get a clearer picture of a fibroid’s exact location and its relationship to the uterine cavity. An HSG may also be used if fertility is a concern. Learn more about HSG testing.
Treatment Options
Not every fibroid needs treatment. Many fibroids are simply monitored, especially if they cause no symptoms. When treatment is recommended, especially for women hoping to preserve or improve fertility, options may include:
Myomectomy, a fertility-sparing surgery to remove fibroids while preserving the uterus
Hysteroscopic removal, for fibroids that project into the uterine cavity
Medical management to reduce symptoms, depending on your goals and fibroid characteristics
Our surgical team specializes in fertility-preserving approaches, so treatment decisions are made with your family-building goals in mind.
Fibroids often shrink after menopause, and some smaller fibroids may shrink over time even before menopause. However, fibroids generally do not disappear on their own during the reproductive years.
No. Fibroids that grow into the uterine cavity, such as submucosal fibroids, are more likely to affect fertility than those that grow on the outer surface of the uterus.
Fibroids are extremely common in women of reproductive age, with estimates suggesting up to 80 percent of women develop them by age 50. Many go undiagnosed because they cause no symptoms.
Not necessarily. Many fibroids do not require treatment. When treatment is needed, a specialist can help you choose the least invasive option appropriate for your case.
Many women with fibroids conceive without difficulty. Whether fibroids affect your fertility depends largely on their size, number, and location.
Imaging such as ultrasound, and sometimes MRI or hysteroscopy, helps confirm fibroid location and guide treatment planning. An HSG may also be recommended to check the uterine cavity and fallopian tubes.
Heavy or prolonged bleeding can lead to anemia over time. Sudden, severe bleeding accompanied by weakness or lightheadedness needs emergency evaluation right away.
A myomectomy is a surgery to remove fibroids while preserving the uterus, often chosen by patients who want to maintain the option of future pregnancy.
Not every treatment approach eliminates the possibility of new fibroids developing over time. Your care team can discuss monitoring appropriate for your situation.
