Uterine fibroids: symptoms, causes, diagnosis and treatment

Uterine fibroids are a common gynaecological condition that affects many women during their reproductive years. Although the term “fibroid” can sound worrying, the good news is that most uterine fibroids are noncancerous and do not always require treatment. However, depending on their size, number and location, they can sometimes cause heavy menstrual bleeding, pelvic pain, abdominal swelling and other symptoms that interfere with everyday life.

Some women discover they have fibroids during a routine gynaecological examination or an ultrasound scan, while others seek medical advice because of painful periods, frequent urination or difficulty conceiving.

Understanding uterine fibroids can help you recognise possible warning signs, know when to consult a gynaecologist and make informed decisions about diagnosis and treatment.

In this guide, we explain what uterine fibroids are, why they develop, the symptoms to look out for, how they are diagnosed and the treatment options available.

What are uterine fibroids?

Uterine fibroids are noncancerous growths that develop in or around the muscular wall of the uterus, also known as the womb. They are medically called leiomyomas or myomas.

Fibroids are made up of smooth muscle cells and connective tissue. They can develop as a single growth or appear in multiple locations within the uterus. Their size varies considerably, ranging from tiny growths that are difficult to detect without imaging to large fibroids that enlarge the abdomen.

Some fibroids remain small and stable for years, while others gradually increase in size. Their behaviour depends on several factors, including hormonal influences and individual characteristics.

Uterine fibroids are almost always benign, meaning they are not cancerous. They are not the same as uterine cancer, and malignant growths known as leiomyosarcomas are considered distinct conditions rather than the usual transformation of a fibroid.

Not every woman with fibroids experiences symptoms. Many women continue with their normal routines without knowing they have them.

What are the different types of uterine fibroids?

Uterine fibroids are generally classified according to where they grow in relation to the uterine wall.

1. Intramural fibroids

Intramural fibroids develop within the muscular wall of the uterus. They are among the most common types and may enlarge the uterus as they grow.

Depending on their size and location, they can cause heavy menstrual bleeding, pelvic pressure, abdominal discomfort or an enlarged lower abdomen.

2. Submucosal fibroids

Submucosal fibroids develop just beneath the inner lining of the uterus and may protrude into the uterine cavity.

Even relatively small submucosal fibroids can cause heavy menstrual bleeding or prolonged periods. Depending on their location, they may also affect fertility or increase the risk of certain pregnancy complications.

3. Subserosal fibroids

Subserosal fibroids grow on the outer surface of the uterus and extend towards the pelvic cavity.

Larger growths may press against nearby organs, such as the bladder or bowel, causing frequent urination, constipation, lower abdominal discomfort or a feeling of fullness.

4. Pedunculated fibroids

Pedunculated fibroids are attached to the uterus by a narrow stalk. They can develop on the outer surface of the uterus or project into the uterine cavity.

Depending on their position, they may cause pressure or discomfort. In uncommon cases, twisting of the stalk can cause sudden, severe pain.

What is the reason for uterine fibroids?

The exact reason why uterine fibroids develop is not fully understood. Research suggests that a combination of genetic changes, hormones and other biological factors contributes to their development and growth.

Several factors may increase the likelihood of developing fibroids.

Hormonal influences

The hormones estrogen and progesterone play an important role in the growth of uterine fibroids. These hormones regulate the menstrual cycle and help prepare the uterine lining for pregnancy.

Fibroids often grow during the reproductive years, when these hormones are active. They frequently shrink after menopause as hormone levels decline, although this does not happen in every case.

Genetic factors and family history

Fibroids may run in families. Having a close relative, such as a mother or sister, with uterine fibroids may increase your likelihood of developing them.

Researchers have also identified genetic changes within fibroid tissue that may contribute to abnormal cell growth.

Age and reproductive stage

Fibroids are particularly common during the reproductive years and are frequently diagnosed in women in their 30s and 40s. They can, however, occur at other ages as well.

Their growth patterns may change over time, particularly during pregnancy and around menopause.

Other possible risk factors

Research has associated fibroids with several additional factors, including:

• Being overweight or having obesity.
• High blood pressure.
• Having a family history of fibroids.
• Certain genetic and biological characteristics.
• Differences in hormonal exposure over a person’s lifetime.

These are risk factors rather than definite causes. Having one or more of them does not mean you will necessarily develop fibroids.

It is also important to understand that uterine fibroids are not caused by poor personal hygiene, and developing them does not mean you have done anything wrong.

What are the symptoms of fibroids in females?

The symptoms of uterine fibroids can vary significantly from one woman to another. Some women have no noticeable symptoms, while others experience problems that affect their menstrual cycle, bladder, bowel or general comfort.

The symptoms usually depend on the size, number and location of the fibroids.

Heavy or prolonged menstrual bleeding

One of the most common symptoms is heavy menstrual bleeding. Periods may last longer than usual, become more frequent or involve passing blood clots.

Heavy bleeding can sometimes lead to iron-deficiency anaemia, which may cause fatigue, weakness, dizziness, headaches or breathlessness.

Pelvic pain or pressure

Fibroids may cause a feeling of heaviness, fullness or pressure in the lower abdomen. Some women experience persistent pelvic discomfort, menstrual cramps or lower back pain.

Larger fibroids may create more noticeable pressure on surrounding structures.

Frequent urination

A fibroid that presses against the bladder can reduce the amount of urine the bladder comfortably holds. This may cause frequent urination or the need to pass urine at night.

In some cases, a large fibroid may make it difficult to empty the bladder completely.

Constipation and bowel discomfort

Fibroids that press against the rectum or bowel may cause constipation, difficulty passing stools or a feeling of pressure in the pelvic region.

Pain during sexual intercourse

Depending on their size and location, fibroids may cause discomfort or pain during sexual intercourse.

Fertility and pregnancy-related problems

Many women with uterine fibroids conceive naturally and have healthy pregnancies. However, certain fibroids, particularly those that distort the uterine cavity, may affect fertility or increase the likelihood of pregnancy complications.

The impact depends on individual circumstances, and not every fibroid needs to be removed before pregnancy.

No symptoms at all

It is worth remembering that fibroids do not always cause noticeable symptoms. They may be discovered incidentally during an ultrasound performed for another reason or during a routine pelvic examination.

What does a fibroid belly look like?

A “fibroid belly” is an informal term used to describe abdominal enlargement or a protruding lower abdomen caused by uterine fibroids.

When fibroids grow large enough to enlarge the uterus, the lower abdomen may appear rounded, swollen or fuller than usual. Some women notice that their clothes feel tighter around the waist or that their abdomen appears persistently enlarged.

However, there is no single appearance that identifies a fibroid belly.

Small fibroids usually do not change the external appearance of the abdomen. Larger fibroids, particularly those growing on the outer surface of the uterus or within its muscular wall, may produce a visible bulge or a feeling of abdominal heaviness.

An enlarged abdomen can also result from other conditions, including weight gain, bloating, pregnancy, ovarian cysts and other pelvic masses. Appearance alone cannot confirm whether fibroids are present.

If you notice persistent abdominal enlargement, a growing lower belly, pelvic pressure or unexplained changes in your waistline, consult a healthcare professional. A clinical examination and appropriate imaging can help determine the cause.

What happens when you have fibroids?

Having uterine fibroids does not necessarily mean you will develop health problems. Their effects depend on their size, location, number and whether they cause symptoms.

For some women, fibroids remain small and require only periodic monitoring. Others may experience heavy periods, pelvic discomfort or pressure on nearby organs.

The main concerns associated with symptomatic fibroids include the following.

Iron-deficiency anaemia

Repeated heavy menstrual bleeding can reduce the body’s iron stores and lead to anaemia. This may cause tiredness, weakness, dizziness and reduced exercise tolerance.

Pressure on nearby organs

Large fibroids may press against the bladder or bowel, resulting in frequent urination, difficulty emptying the bladder or constipation.

Fertility difficulties

Some fibroids can interfere with conception, particularly when they distort the uterine cavity. However, fertility problems have many possible causes, so fibroids should not automatically be considered the reason for difficulty getting pregnant.

Pregnancy complications

Depending on their size and location, fibroids may be associated with certain pregnancy complications, including pain, miscarriage, abnormal fetal positioning, preterm birth or an increased likelihood of caesarean delivery.

Many women with fibroids nevertheless have uncomplicated pregnancies. Individual assessment is important when planning a pregnancy or receiving antenatal care.

Emotional and everyday impact

Persistent bleeding, pain and uncertainty about fertility can affect sleep, work, physical activity and emotional well-being. Seeking medical advice can help identify suitable ways to manage these concerns.

When should you worry about fibroids?

Most uterine fibroids are not emergencies, but certain symptoms deserve medical attention. You should arrange a gynaecological consultation if you experience:

• Periods that are unusually heavy, prolonged or increasingly painful.
• Bleeding between periods or after sexual intercourse.
• Persistent pelvic pain or pressure.
• A progressively enlarging abdomen.
• Frequent urination or difficulty emptying your bladder.
• Persistent constipation associated with pelvic pressure.
• Unexplained fatigue, weakness or dizziness that could indicate anaemia.
• Difficulty conceiving or concerns about fibroids during pregnancy.

Seek urgent medical care if you experience very heavy vaginal bleeding, fainting, severe weakness or sudden, severe pelvic or abdominal pain.

Bleeding after menopause also requires prompt medical assessment. Although fibroids can cause bleeding, other conditions must be considered and excluded.

Fibroids rarely become cancerous, and an apparent increase in size does not automatically indicate cancer. Nevertheless, new or changing symptoms should be evaluated rather than assumed to be caused by an existing fibroid.

How are uterine fibroids diagnosed?

Diagnosis usually involves reviewing your symptoms, medical history and menstrual patterns, followed by a clinical examination and appropriate investigations.

Medical history and pelvic examination

Your healthcare professional may ask about the duration and heaviness of your periods, pelvic pain, urinary symptoms, family history and pregnancy plans.

A pelvic examination may identify an enlarged or irregularly shaped uterus, although small fibroids may not be detectable through examination alone.

Pelvic ultrasound

Ultrasound is one of the most commonly used tests for detecting uterine fibroids.

It uses sound waves to produce images of the uterus and surrounding pelvic structures. Depending on the clinical situation, the examination may be performed through the abdomen or using a transvaginal probe.

An ultrasound can help assess the number, size and location of fibroids and whether they distort the uterine cavity.

For many women, a pelvic ultrasound provides the information needed to confirm the diagnosis and guide further management.

Blood tests

If you have heavy menstrual bleeding, your doctor may recommend a complete blood count to check for anaemia. Iron studies may also be advised when iron deficiency is suspected.

Additional investigations

In selected cases, further tests may be required. These can include magnetic resonance imaging (MRI), saline infusion sonography or hysteroscopy.

The choice depends on the ultrasound findings, symptoms and whether further information is needed for treatment planning.

What are the treatment options for uterine fibroids?

Treatment is individualised. Not every fibroid needs to be treated, and the best approach depends on symptoms, fibroid size and location, age, general health and future pregnancy plans.

Monitoring without immediate treatment

If fibroids are small and do not cause symptoms, your doctor may recommend observation with follow-up appointments when appropriate.

Monitoring can help determine whether symptoms develop or the fibroids change over time.

Medicines

Certain medicines may help manage heavy menstrual bleeding, painful periods or other symptoms. Depending on the situation, hormonal treatments, non-hormonal medicines or specific fibroid-directed medications may be considered.

Some medicines control symptoms without removing fibroids. Others may temporarily reduce their size. The benefits, limitations and potential side effects should be discussed with your doctor.

Myomectomy

Myomectomy is a procedure that removes fibroids while preserving the uterus.

It may be considered for women with significant symptoms, particularly when future pregnancy is desired. The appropriate surgical approach depends on the size, number and location of the fibroids.

Uterine artery embolisation

Uterine artery embolisation is a minimally invasive procedure that reduces the blood supply to fibroids, causing them to shrink over time.

It may be suitable for selected women who want to manage fibroid symptoms without undergoing conventional surgery. Its suitability depends on individual circumstances, including reproductive plans.

Other minimally invasive procedures

Selected patients may be offered techniques such as radiofrequency ablation, which uses heat to destroy fibroid tissue and encourage shrinkage.

Availability, eligibility and long-term considerations vary by procedure.

Hysterectomy

Hysterectomy involves surgical removal of the uterus. It is a definitive treatment for uterine fibroids because fibroids cannot recur in a uterus that has been removed.

However, it permanently ends the ability to carry a pregnancy. It is generally considered after discussing other suitable options, the severity of symptoms and the patient’s preferences.

No single treatment is right for everyone. A gynaecologist can explain the benefits, risks and limitations of the available options.

Can uterine fibroids be prevented?

There is currently no guaranteed way to prevent uterine fibroids. Their development is influenced by genetic, hormonal and other biological factors that cannot always be controlled.

Maintaining a healthy weight, eating a balanced diet, staying physically active and managing conditions such as high blood pressure can support overall health. However, these measures cannot guarantee that fibroids will not develop or grow.

Regular medical assessment is particularly important if you experience heavy periods, pelvic discomfort or persistent changes in your menstrual cycle.

The aim is to recognise symptoms early, identify any associated complications and choose an appropriate management plan rather than attempting unproven home remedies.

Why is ultrasound important in evaluating uterine fibroids?

Ultrasound plays an important role in the assessment of suspected uterine fibroids because it provides information about the uterus without using ionising radiation.

A pelvic ultrasound can help identify fibroids, estimate their size, determine their location and assess whether the uterine cavity is affected. These findings can help the treating doctor decide whether observation, medication or further evaluation may be appropriate.

Ultrasound findings should always be interpreted alongside symptoms, medical history and clinical examination. The presence of a fibroid does not automatically mean treatment is necessary.

At Sparsh Diagnostic Centre, appropriate diagnostic investigations can help support the evaluation of gynaecological concerns. If you have symptoms suggestive of fibroids, consult your gynaecologist to determine which tests are suitable for you.

Frequently asked questions about uterine fibroids

1. Are uterine fibroids cancerous?

Most uterine fibroids are benign, noncancerous growths. They are distinct from rare malignant tumours of the uterine muscle. New symptoms or concerning changes should still be assessed by a healthcare professional.

2. What is the main cause of uterine fibroids?

There is no single confirmed cause. Genetic changes, hormonal influences, particularly oestrogen and progesterone, and other biological factors are believed to contribute to their development.

3. What are the first signs of uterine fibroids?

Some women notice heavier or longer periods, increased menstrual cramps, pelvic pressure or frequent urination. Others have no symptoms, and fibroids are discovered during an ultrasound or routine examination.

4. Can fibroids cause weight gain?

Fibroids do not usually cause generalised body weight gain. However, a large fibroid or an enlarged uterus may increase the size or fullness of the lower abdomen, making it appear as though the abdomen has become larger.

5. What does a fibroid belly look like?

A fibroid belly may appear as a rounded, protruding or enlarged lower abdomen when fibroids significantly enlarge the uterus. Smaller fibroids may cause no visible changes. Abdominal appearance alone cannot diagnose fibroids.

6. Can fibroids go away on their own?

Fibroids may remain stable, change in size or shrink naturally, particularly after menopause when hormone levels decline. However, they do not always disappear completely. Management depends on symptoms and individual circumstances.

7. Can I get pregnant if I have uterine fibroids?

Yes. Many women with fibroids conceive naturally and have healthy pregnancies. Some fibroids, particularly those that distort the uterine cavity, may affect fertility or pregnancy outcomes. If you are planning a pregnancy, discuss your ultrasound findings with your gynaecologist.

8. Is an ultrasound enough to diagnose uterine fibroids?

In many cases, pelvic ultrasound is sufficient to identify fibroids and assess their size and location. Additional investigations may be recommended when the findings are unclear or more detailed information is needed.

9. When should fibroids be treated?

Treatment may be considered when fibroids cause heavy bleeding, anaemia, persistent pain, pressure symptoms, fertility concerns or other complications. Small fibroids that cause no symptoms may only require monitoring.

10. Can uterine fibroids shrink after menopause?

Yes. Fibroids often shrink after menopause because oestrogen and progesterone levels decline. However, persistent or new symptoms after menopause should not automatically be attributed to fibroids and need medical assessment.

11. Can fibroids cause frequent urination?

Yes. Fibroids located near the bladder may press against it, causing frequent urination or discomfort. Large fibroids may occasionally make it difficult to empty the bladder completely.

12. Do all fibroids require surgery?

No. Many fibroids do not require surgery or any immediate treatment. Depending on symptoms and individual circumstances, monitoring, medicines, minimally invasive procedures or surgery may be considered.

Uterine fibroids are common, and most are noncancerous. While some women experience no symptoms, others may develop heavy menstrual bleeding, pelvic pressure, abdominal enlargement, urinary problems or fertility-related concerns.

Understanding the symptoms and recognising when to seek medical advice can help prevent complications and reduce unnecessary anxiety. Pelvic ultrasound is an important investigation for identifying fibroids and assessing their size and location.

If you have persistent menstrual changes, pelvic pain or unexplained abdominal enlargement, consult a qualified healthcare professional. With appropriate evaluation, many women can manage fibroids effectively and choose a treatment approach suited to their health needs and future plans.

Medical disclaimer: This article is intended for general educational purposes and does not replace professional medical advice, diagnosis or treatment. Consult a qualified healthcare professional for an assessment of your symptoms and individual treatment options.

To consult a Gynecologist at Sparsh Diagnostic Centre for treatment of Uterine Fibroids, call our helpline numbers +91 98301 17733 and +91 83350 49501.

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Sources and further reading

The article is based on information from established medical organisations and clinical literature. These resources support the discussion of symptoms, causes, diagnosis and treatment.

1. Cleveland Clinic — Uterine fibroids: Overview, symptoms, diagnosis and treatment.
https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids

2. Mayo Clinic — Uterine fibroids: Symptoms and causes.
https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288

3. U.S. Food and Drug Administration (FDA) — Uterine fibroids: Symptoms, risk factors, diagnosis and treatment options.
https://www.fda.gov/consumers/womens-health-topics/uterine-fibroids

4. American College of Obstetricians and Gynecologists (ACOG) — Uterine fibroids: Frequently asked questions.
https://www.acog.org/womens-health/faqs/uterine-fibroids

5. Office on Women’s Health, U.S. Department of Health and Human Services — Uterine fibroids: Causes, symptoms and treatment.
https://womenshealth.gov/a-z-topics/uterine-fibroids

6. UpToDate — Uterine fibroids: Beyond the basics.
https://www.uptodate.com/contents/uterine-fibroids-beyond-the-basics/print

7. PubMed Central (National Library of Medicine) — Published scientific literature on uterine fibroids.
https://pmc.ncbi.nlm.nih.gov/articles/PMC9277653/

Medical review

This article on uterine fibroids has been medically reviewed and verified by Dr. Shubhayu Som to support the accuracy and reliability of the health information presented.

Medical reviewer: Dr. Shubhayu Som
Qualification: MBBS
Specialisation: General Physician
Medical registration: West Bengal Medical Council (WBMC), Registration No. 81060
Date reviewed: 29th October 2026