Uterine fibroids: symptoms, tests, treatment and which doctor to see

What fibroids are, the symptoms they cause, how they are found, the treatment options from medicines to surgery, and which doctor to see.

Also known as: Fibroids; Uterine Leiomyomata

What uterine fibroids are

Fibroids are growths of muscle and fibrous tissue in the wall of the uterus (womb). Doctors also call them leiomyomas or myomas. They are not cancer, and having fibroids does not increase your chance of getting uterine cancer. They range from the size of a seed to large masses that enlarge the whole womb, and many women have more than one.

Fibroids are described by where they sit: inside the muscle wall (intramural), bulging into the cavity of the womb (submucosal), or on its outer surface (subserosal), sometimes on a stalk. Their position matters more than their size in deciding what symptoms they cause and how they are treated. Submucosal fibroids, even small ones, are the most likely to cause heavy bleeding and problems conceiving.

Fibroids depend on the hormones oestrogen and progesterone. They can grow during the reproductive years and in pregnancy, and they usually shrink after menopause.

Symptoms

Many women with fibroids have no symptoms, and the fibroids are found on a scan done for another reason. When symptoms occur, the common ones are:

• Heavy menstrual bleeding, sometimes with clots, flooding or needing to change pads very often
• Long periods, or bleeding between periods
• Pelvic pressure, fullness or a visible swelling of the lower abdomen
• Frequent urination, or difficulty emptying the bladder
• Constipation or bloating
• Back pain or leg pain
• Pain during sex
• Tiredness and breathlessness from anaemia caused by heavy bleeding

Many women in India put up with heavy periods for years, assuming it is normal. Bleeding that soaks through protection, lasts more than a week or leaves you exhausted is worth a check-up, whatever the cause turns out to be.

Who is at higher risk

Fibroids are very common, especially from the thirties until menopause. Their exact cause is not known, but your chance is higher if:

• Your mother or sister had fibroids
• Your periods started early
• You have never been pregnant
• You carry extra weight
• You have high blood pressure

Pregnancy and childbirth appear to lower the risk. Low vitamin D has been linked to fibroids in research, but whether treating it prevents them is not yet established.

How they are diagnosed

A gynaecologist may feel an enlarged or irregular womb during a pelvic examination. Imaging confirms the diagnosis and maps the fibroids:

• Pelvic ultrasound, through the abdomen with a full bladder, is usually the first test.
• Transvaginal ultrasound, with a slim probe placed in the vagina, gives a clearer picture of the womb and its lining.
• MRI shows the exact number, size and position of fibroids and is often used before surgery or embolisation.
• Hysteroscopy, in which a thin camera is passed through the cervix, looks directly inside the cavity and can remove some submucosal fibroids at the same time.

A complete blood count checks for anaemia caused by heavy bleeding. Depending on your age and symptoms, your doctor may also check thyroid function, do a pregnancy test, take a sample of the womb lining or do a cervical screening test, to make sure nothing else explains the bleeding.

Which doctor to see

A gynaecologist diagnoses and treats fibroids, including with medicines and surgery. Uterine artery embolisation is performed by an interventional radiologist, usually after assessment by a gynaecologist. If fibroids may be affecting your fertility, a gynaecologist with experience in fertility care can advise on whether treatment will help.

You can find gynaecologists in Bengaluru or radiologists in Bengaluru on The Doctor Index, each with a registration you can check.

Treatment

Fibroids that cause no symptoms usually need no treatment, only occasional review. When treatment is needed, the choice depends on your symptoms, the size and position of the fibroids, your age and how close you are to menopause, and whether you want to become pregnant. It is reasonable to ask about every option before agreeing to surgery.

Medicines

• Tranexamic acid, taken during periods, reduces bleeding. Pain relievers from the NSAID family can ease pain and also reduce flow.
• A hormonal IUD (levonorgestrel-releasing coil) can greatly reduce bleeding when the womb cavity is not distorted. Hormonal pills are another option.
• GnRH analogues and related medicines temporarily shrink fibroids by lowering hormone levels. They are usually used for a limited period, for example before surgery, because of menopause-like side effects and effects on bone.
• Iron treatment to correct anaemia.

Procedures and surgery

• Myomectomy removes the fibroids and keeps the womb. It can be done by hysteroscopy, laparoscopy (keyhole) or open surgery, depending on their position and size. Fibroids can come back afterwards.
• Uterine artery embolisation blocks the blood supply to fibroids through a thin tube passed into the arteries, so they shrink. It avoids major surgery; its effect on future pregnancy is less certain, so it is discussed carefully with women who want children.
• Hysterectomy, removal of the womb, is the only treatment that ensures fibroids do not return. It is an option for women who have completed their family and have significant symptoms. The ovaries can often be left in place.

Do not start or stop hormonal medicines on your own, and be cautious about products that promise to dissolve fibroids.

Living with fibroids: follow-up

• A repeat scan at intervals your doctor recommends, if you are not having treatment
• Blood counts if your periods are heavy, and iron-rich foods such as greens, pulses, jaggery and meat if you eat it
• Early booking with your obstetrician if you become pregnant, so fibroids can be monitored
• A prompt review for any bleeding after menopause, or a fibroid that grows quickly after menopause

When it is an emergency

Call 112 or 108, or go to the nearest emergency department, for:

• Very heavy bleeding — soaking a pad every hour for a few hours — or bleeding with dizziness, fainting or a racing heart
• Sudden, severe abdominal or pelvic pain, especially with fever or vomiting
• Being unable to pass urine
• Bleeding or severe pain during pregnancy

Questions to ask at your appointment

• How many fibroids do I have, and where are they?
• Are they the cause of my symptoms, or could something else be?
• Do I need treatment now, or can we watch them?
• Which options would keep my ability to have children?
• What are the risks and recovery time of the procedure you suggest?
• Is my blood count low, and do I need iron?

Common questions

All obstetrics and gynaecology conditions →

Sources

• MedlinePlus, US National Library of Medicine — Uterine Fibroids
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NIH) — Uterine Fibroids
• MedlinePlus, National Library of Medicine — Uterine Fibroids — Public-domain health-topic summary

Uterine fibroids: symptoms, tests, treatment and which doctor to see is original text by The Doctor Index; the compiled source draft was used for research. Source: MedlinePlus, National Library of Medicine. Orphadata Science: Free access data from Orphanet. © INSERM 1999; July 2026 data, CC BY 4.0. This product uses the Human Phenotype Ontology (hp/releases/2026-09-01). Only sources listed for this article apply. Source material has been selected and arranged; HPO definitions are reproduced without alteration. No source organisation endorses this compilation. Köhler S et al. The Human Phenotype Ontology project: linking molecular biology and disease through phenotype data. Nucleic Acids Research 2014;42(D1):D966–D974. doi:10.1093/nar/gkt1026.

General information, not advice about your situation. Errors can be reported through the corrections process. Reference TDI-C-2387.