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Fibroids

Fibroids are round growths that develop in the uterus. They are almost always benign, or non-cancerous. Fibroids range in size from as small as a pea to as large as a melon. They are also called leiomyomas or myomas.

Fibroids are very common, affecting an estimated 20 to 50 percent of all women. They are most likely to affect women in their 30s and 40s, and for reasons we don't understand, occur more frequently in African-Americans. Many women with fibroids have family members who also have them.

Some fibroids grow steadily during the reproductive years, while others stay the same size for many years. All fibroids should stop growing after menopause. If your fibroids grow after menopause, you should consult your doctor.

Usually, fibroids cause no symptoms and don't require treatment. But if symptoms occur, you should seek medical attention.

At UCSF, the Comprehensive Fibroid Center offers a wide range of treatments. There are many effective ways to treat fibroids, and the type of treatment chosen will depend on the severity of your symptoms and the fibroid size, number and location. Your preference and desire for future childbearing also enters into the treatment discussion. Not all treatments are recommended for all women.

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Types of Fibroids

Fibroids can grow in different parts of the uterus:

  • Pedunculated fibroids are attached to the uterine wall by stalks.
  • Subserosal fibroids extend outward from the uterine wall.
  • Submucosal fibroids expand from the uterine wall into the uterine cavity.
  • Intramural fibroids develop within the uterine wall.

Different types of fibroids are associated with different symptoms. For example, submucosal fibroids typically cause heavy periods. In contrast, subserosal fibroids are more likely to push against the bladder, causing frequent urination.

Causes of Fibroids

Doctors and medical researchers do not know what causes fibroids to develop. There is evidence that the female hormones, estrogen and progesterone, can make them grow. During pregnancy, when the hormone levels are high, fibroids tend to increase in size. After menopause, when the hormone levels are low, fibroids stop growing and may become smaller.

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Symptoms of fibroids may include:

  • Heavy Vaginal Bleeding — Excessively heavy or prolonged menstrual bleeding is a common symptom. Women describe soaking through sanitary protection in less than an hour, passing blood clots and being unable to leave the house during the heaviest day of flow. As a result, some women develop anemia, also known as a low blood count. Anemia can cause fatigue, headaches and lightheadedness.

    If heavy bleeding interferes with your everyday activities or if you develop anemia, you should see your doctor to discuss fibroid treatment options.
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Usually, fibroids are found during a routine gynecologic visit with a pelvic examination. A pelvic exam allows the doctor to feel the size and shape of the uterus; if it is enlarged or irregularly shaped, fibroids may be present. Or, you may notice new symptoms and inform your doctor.

If your doctor thinks you may have fibroids after performing the exam, there are several tests that can confirm the diagnosis. The first is usually an ultrasound. The other tests are more specialized and are only performed if needed to guide treatment options. Below is a brief description of each type of exam.

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Treatment for fibroids can range from no treatment at all to surgery. Unless fibroids are causing excessive bleeding, discomfort or bladder problems, treatment usually isn't necessary.

If you have fibroids, you should be evaluated periodically to review symptoms, and to monitor the fibroid and uterus size with abdominal and pelvic examinations. If you don't have symptoms, routine pelvic ultrasounds have very little benefit. Fibroids are likely to grow each year until menopause, but this isn't an indication that you need treatment, unless the change is accompanied by disabling symptoms.

The following are treatment options for fibroids:

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Reviewed by health care specialists at UCSF Medical Center.

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UCSF Clinics & Centers

Women's Health Center

Comprehensive Fibroid Center
2356 Sutter St., Sixth Floor
San Francisco, CA 94143-1648
Phone: (415) 885-7788
Fax: (415) 353-9550
Appointment information