Uterine fibroids (leiomyomas) are non-cancerous growths of the uterus that often appear during childbearing years. They are remarkably common, affecting up to 70–80% of women by age 50. While they aren’t associated with an increased risk of uterine cancer, they can cause significant physical discomfort and reproductive challenges.
Types of Fibroids
Fibroids are classified by their location in the uterus, which largely determines the symptoms they cause:
Intramural: Grow within the muscular uterine wall. These are the most common and can make the uterus feel enlarged or “heavy.”
Submucosal: Push into the uterine cavity. Even small ones can cause severe, heavy bleeding and fertility issues.
Subserosal: Grow on the outside of the uterus. They can put pressure on the bladder (causing frequent urination) or the rectum (causing constipation).
Pedunculated: Grow on a slender stalk inside or outside the uterus; they can cause sudden, sharp pain if the stalk twists (torsion).
Common Symptoms
Many women have “silent” fibroids with no symptoms. When symptoms do occur, they include:
Heavy Menstrual Bleeding: Periods lasting more than a week or involving large blood clots.
Pelvic Pressure: A feeling of “fullness” or a visible bulge in the lower abdomen.
Pain: Dull aching in the pelvis, lower back, or legs, and pain during intercourse.
Urinary/Bowel Issues: Frequent urge to urinate or difficulty emptying the bladder; constipation.
2025 Treatment Options
In 2025, treatment is highly personalized based on whether you want to preserve fertility or avoid major surgery.
| Category | Option | Best For |
| Medication | GnRH Antagonists (e.g., Elagolix) | Rapidly reducing heavy bleeding and shrinking fibroids temporarily. |
| Non-Surgical | Uterine Artery Embolization (UAE) | Cutting off blood supply to fibroids so they shrink; no incisions. |
| Minimally Invasive | Acessa / Sonata (RFA) | Using heat (radiofrequency) to “melt” fibroids via a tiny needle or through the cervix. |
| Fertility-Sparing | Laparoscopic Myomectomy | Removing only the fibroids while keeping the uterus intact. |
| Definitive | Hysterectomy | Permanent removal of the uterus; the only “cure” for recurring fibroids. |
Emerging 2025 Technology
MRgFUS (MRI-guided Focused Ultrasound): A completely non-invasive procedure that uses high-intensity ultrasound waves to destroy fibroid tissue while you lie inside an MRI scanner.
Robotic-Assisted Myomectomy: Provides surgeons with 3D views to remove complex, deep-seated fibroids with much higher precision than traditional surgery.
When to See a Doctor
You should schedule an evaluation if you experience:
Pelvic pain that doesn’t go away.
Overly heavy, prolonged, or painful periods.
Spotting or bleeding between periods.
Difficulty emptying your bladder.
Unexplained low red blood cell count (anemia), which can cause fatigue and dizziness.