Uterine fibroids are noncancerous growths made of smooth muscle and fibrous tissue that develop in or on the uterus. They affect up to 80% of women by age 50 globally, with up to 1 in 5 Indian women experiencing them during their reproductive years (ICMR, 2023). Categorised by location, fibroids can cause heavy periods, pelvic pressure, or fertility challenges, though many women remain completely asymptomatic throughout life.
Key takeaways
- High prevalence: Fibroids are the most common benign pelvic tumour in women, yet most cases remain asymptomatic.
- Location dictates impact: Submucosal fibroids directly alter the uterine lining, posing the greatest barrier to successful embryo implantation.
- Hormone-driven growth: Oestrogen and progesterone fuel fibroid development during reproductive years, causing them to shrink naturally after menopause.
- Pregnancy is possible: Fibroids are the primary cause of infertility in only 2–3% of infertile women (ACOG, 2021); most women conceive naturally.
- Precision tracking: Fibroids do not stop ovulation, meaning tracking your LH surge helps identify your fertile window accurately even if cycle bleeding is irregular.
What are uterine fibroids?
Understanding the meaning of fibroids starts with their clinical definition. Uterine fibroids, formally known as leiomyomas or myomas, are noncancerous smooth muscle tumours that grow in or on the uterus. The exact reason for fibroids in uterus growth relates to hormonal shifts and genetic factors, but they are generally harmless unless they enlarge. Fibroids affect nearly 70–80% of women by age 50, making them the most common benign reproductive tract tumour (NIH, 2022).
Types of uterine fibroids
The FIGO classification system categorises fibroids based on their anatomical position in the uterine tissue.
| Fibroid type | Location | Common symptoms | Fertility impact |
| Intramural | Within the uterine muscle wall | Heavy bleeding, pelvic aching | Moderate if >5 cm |
| Subserosal | Outer surface of the uterus | Frequent urination, back pressure | Very low (rarely distorts cavity) |
| Submucosal | Inner uterine cavity lining | Heavy periods, irregular spotting | Highest (disrupts implantation) |
| Pedunculated | Attached by a narrow stem | Sharp localised pain if twisted | Very low |
| Cervical | Within the cervical tissue | Pain during intercourse, discharge | Moderate (may block sperm) |
Intramural fibroid
An intramural uterine fibroid develops within the muscular uterine wall. When an intramural fibroid expands beyond 5 cm, it increases overall uterine volume, distorts the cavity, and impairs efficient muscular contractions during menstruation.
Subserosal uterine fibroid
A subserosal fibroid grows on the outer boundary of the womb. Because a subserosal uterine fibroid expands outward into the pelvis, it presses against adjacent organs like the bladder or rectum rather than causing abnormal menstrual bleeding.
Submucosal fibroid
A submucosal fibroid protrudes directly into the inner uterine cavity. By occupying space beneath the endometrial lining, it disrupts local blood supply, causing heavy menstrual flow and creating the highest risk for embryo implantation failure.
Cervical fibroid
A cervical fibroid develops in the tissue of the cervical canal. Accounting for less than 1% of cases, it can physically block sperm entry or obstruct the birth canal during labour.
What is the main cause of uterine fibroids?
The primary cause of uterine fibroids centres on sensitivity to the female reproductive hormones oestrogen and progesterone. These hormones stimulate muscle cell proliferation during childbearing years. Genetic factors, family history, and vascular changes also cause uterine fibroids to grow over time.
Uterine fibroid symptoms
What are the signs of fibroids in a woman?
The primary uterine fibroid symptoms include heavy or prolonged menstrual cycles, dull pelvic fullness, lower back pressure, frequent urination, and pain during sexual intercourse.
Signs of fibroids breaking down (Degeneration)
When a large fibroid outgrows its blood supply, it undergoes degeneration. Signs of fibroids breaking down include sudden sharp pelvic pain, localised tenderness, low-grade fever, and mild nausea.
How to check for fibroids at home
You cannot check for or diagnose fibroids at home. However, self-awareness steps help track potential indicators for your doctor:
- Track your cycle: Log heavy bleeding, passing large clots, or periods lasting longer than 7 days.
- Palpate the lower abdomen: Press gently on your lower abdomen while lying flat to check for firm lumps or unusual fullness.
- Monitor pressure signs: Note any sudden increase in urinary frequency or unexplained bowel pressure.
Ultrasound for uterine fibroids
A pelvic ultrasound is the primary diagnostic tool. Transvaginal or abdominal ultrasounds use sound waves to map the exact size, count, and location of fibroids inside or outside the womb.
Difference between cyst and fibroid
An ovarian cyst is a fluid-filled sac that develops on or inside the ovary. In contrast, a fibroid is a solid mass composed of smooth muscle and fibrous tissue originating in the uterus.
Which size of fibroid is dangerous?
Fibroids typically become concerning when they reach 5 cm or larger (roughly the size of a plum or orange). While non-cancerous, larger growths can cause severe anaemia from heavy bleeding, intense pelvic pressure, organ compression, and pregnancy complications.
| Fibroid size | Comparison | Risk level | Typical management |
| <2 cm (Small) | Pea to grape-sized | Low / Asymptomatic | Routine annual monitoring |
| 2–5 cm (Medium) | Lime to plum-sized | Mild to moderate | Observation every 6–12 months |
| 5–10 cm (Large) | Orange to grapefruit-sized | High (symptom risk) | Medical or surgical evaluation |
| >10 cm (Very Large) | Cantaloupe-sized or larger | Very high (complications) | Surgical intervention (myomectomy) |
Is an intramural fibroid dangerous?
An intramural fibroid is rarely dangerous because it is noncancerous. However, if it grows beyond 5 cm, it can cause severe iron-deficiency anaemia from heavy blood loss or alter the shape of the uterine cavity.
Is fibroid dangerous in general?
Fibroids are benign growths and are rarely life-threatening. They become clinically concerning only when they trigger severe anaemia, unmanageable pain, or urinary retention due to organ compression.
Which size of fibroid is dangerous after menopause?
Any growing fibroid after menopause is concerning. Because fibroids naturally shrink when oestrogen levels decline, a postmenopausal fibroid that enlarges beyond 3–5 cm requires urgent evaluation to rule out rare conditions like uterine leiomyosarcoma.
Large uterine fibroid: When size becomes a concern
A large uterine fibroid exceeding 8–10 cm can cause a bulky uterus with fibroid expansion. This results in visible abdominal protrusion (commonly called “fibroid belly”), intense pelvic pressure, and potential delivery complications.
How serious are uterine fibroids?
Complications of uterine fibroids
Potential complications include severe iron-deficiency anaemia from heavy blood loss, acute pain from degeneration, urinary retention, and hydronephrosis (kidney swelling) caused by pressure on the ureters.
Can fibroids cause infertility?
Fibroids are estimated to be the sole cause of infertility in only 2–3% of infertile women (ACOG, 2021). Submucosal fibroids pose the highest risk because they alter the endometrial lining and impair embryo implantation.
Can a woman live with fibroids?
Yes, millions of women live comfortably with asymptomatic fibroids throughout their reproductive years without requiring medical treatment or surgical intervention.
Do uterine fibroids go away on their own?
Fibroids shrink naturally after menopause when oestrogen and progesterone levels drop. Before menopause, hormonal therapies (such as GnRH agonists) can temporarily shrink their volume.
Can fibroids be cured?
Fibroids are permanently cured only through a hysterectomy (removal of the uterus). A myomectomy removes existing fibroids while preserving the uterus, though new fibroids may form over time.
Uterine fibroids and pregnancy
What happens if you’re pregnant with fibroids?
Most pregnancies involving fibroids are uncomplicated, but 10%–30% of pregnant women with fibroids may experience complications during pregnancy, labor, or the postpartum period. Localized pain from fibroid degeneration is one of the more common pregnancy-related complications.
Is it safe to get pregnant if you have uterine fibroids?
Yes, it is generally safe to get pregnant with fibroids. Your obstetrician will monitor fibroid growth and fetal development using routine prenatal ultrasounds.
At what stage can fibroids cause miscarriage?
Submucosal fibroids elevate miscarriage risks primarily during the first and early second trimesters by compromising blood flow to the developing embryo.
Can having fibroids stop you from getting pregnant?
Fibroids rarely prevent pregnancy entirely, but cavity-distorting growths or large intramural fibroids can make natural conception more challenging.
Tips on getting pregnant with fibroids
- Get a pre-conception ultrasound: Confirm with your doctor whether your fibroid distorts the inner uterine cavity.
- Track your LH surge accurately: Use ovulation prediction tools to pinpoint your fertile window regardless of bleeding irregularities.
- Consult a fertility specialist early: Seek guidance if you have known submucosal fibroids or have been trying to conceive for over six months.
Can you get pregnant with fibroids inside or outside the uterus?
Yes. Subserosal fibroids (outside the uterus) rarely affect fertility. Submucosal fibroids (inside the cavity) can lower implantation success, but natural pregnancy remains possible.
Can you get pregnant if you have fibroids removed?
According to Pritts and colleagues, for women with submucosal fibroids that may affect fertility, hysteroscopic myomectomy appears to improve pregnancy outcomes, although the evidence is less clear for other fibroid types.
Fibroids during delivery and childbirth
Can a pregnant woman with fibroids have a normal delivery?
Yes, most pregnant women with fibroids achieve a normal vaginal delivery. A C-section is required only if a large fibroid obstructs the cervical canal or causes breech fetal positioning.
How to survive pregnancy with fibroids
Manage mild pregnancy discomfort by staying well-hydrated, resting on your side to relieve pelvic pressure, and using physician-approved pain management options like paracetamol.
How to deal with fibroids during pregnancy
Partner with your high-risk obstetrician to schedule regular growth scans, monitor signs of fibroid degeneration, and establish a clear delivery plan tailored to your fibroid’s location.
Uterine fibroid treatment options
Do uterus fibroids need to be removed?
Uterine fibroids require removal only if they cause unmanageable pain, severe anaemia, rapid growth, or documented reproductive issues.
How to get rid of uterine fibroids?
Surgical choices include myomectomy (removing fibroids while preserving the uterus) and hysterectomy. Non-surgical medical management can also control symptoms effectively.
Uterine fibroid embolisation
Uterine fibroid embolisation (UFE) is a minimally invasive procedure where microscopic particles block blood supply to the fibroids, causing them to shrink without open surgery.
Intramural fibroid treatment
Intramural fibroids are managed using hormonal medications, uterine artery embolisation, or laparoscopic myomectomy depending on size, symptoms, and pregnancy plans.
Homeopathy medicines for fibroid
Complementary options like homeopathy are used by some for mild symptom relief, but they lack rigorous clinical proof to physically shrink or eliminate fibroid tissue.
Diet and natural remedies for fibroids
What foods should I avoid if I have fibroids?
Limit intake of red meat, processed meats, high-fat dairy, refined sugars, and excess alcohol, as these can promote systemic inflammation and influence circulating oestrogen.
7 foods for shrinking fibroids
While dietary changes alone cannot cure fibroids, an anti-inflammatory diet supports hormonal health:
- Cruciferous vegetables: Broccoli, cabbage, and kale contain compounds that support healthy oestrogen metabolism.
- Green tea: Rich in EGCG, an antioxidant shown in preliminary studies to inhibit fibroid cell growth.
- Citrus fruits: Packed with vitamin C and bioflavonoids that protect reproductive tissue.
- Whole grains: Oats and brown rice provide fibre to aid in natural oestrogen elimination.
- Legumes: Lentils and chickpeas offer plant-based protein without saturated fats.
- Fatty fish: Salmon and mackerel supply omega-3 fatty acids to lower pelvic inflammation.
- Flaxseeds: Rich in lignans that assist in regulating circulating hormone levels.
Yoga for uterus fibroid
Practicing gentle yoga poses like Supta Baddha Konasana (Reclined Bound Angle Pose) and Bhujangasana (Cobra Pose) helps improve pelvic blood flow, relieve pressure, and manage stress.
Related conditions: Bulky uterus with fibroids & polyps
A bulky uterus occurs when multiple or large fibroids expand the overall uterine volume, causing abdominal swelling similar to early pregnancy. Additionally, women can experience both fibroids and uterine polyps together, both of which cause heavy or irregular menstrual bleeding.
Uterine fibroids ICD-10 code reference
For medical documentation and insurance coding, uterine fibroids fall under the ICD-10 code D25:
- D25.0: Submucosal leiomyoma of uterus
- D25.1: Intramural leiomyoma of uterus
- D25.2: Subserosal leiomyoma of uterus
- D25.9: Leiomyoma of uterus, unspecified
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Key terms explained
- Uterine fibroid: A noncancerous smooth muscle growth (leiomyoma) located within or on the walls of the uterus.
- Intramural fibroid: A fibroid embedded entirely within the thick muscular wall of the uterus.
- Subserosal fibroid: A fibroid located on the outer surface wall of the uterus.
- Submucosal fibroid: A fibroid growing beneath the inner lining that bulges directly into the uterine cavity.
- FIGO classification: A standardised 0–8 staging system that categorises fibroids according to their precise anatomical location.
Disclaimer
This content is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified gynaecologist or healthcare provider regarding any medical condition, symptoms, or fertility plans.
