Pelvic pain, a sense of pressure or fullness, and heavy menstrual bleeding are common symptoms that may point to uterine fibroids. These noncancerous growths develop in or around the uterus, most often during a woman’s reproductive years. While fibroids are generally harmless, they can grow large or numerous enough to interfere with daily life and, in some cases, fertility.
Understanding what fibroids are, why they develop, and how they can be treated can help you make informed decisions about your health.
What Are Uterine Fibroids?
Uterine fibroids are benign tumors composed of muscle and connective tissue that form within the uterus. They are not cancerous, but their size and location can lead to discomfort, pain, or heavy menstrual bleeding.
Fibroids typically do not appear before puberty and often shrink after menopause, suggesting a strong connection to estrogen and progesterone levels. Although very common, affecting up to one in three women, not all fibroids cause symptoms.
Symptoms of Uterine Fibroids
Many women with fibroids never experience symptoms. However, when fibroids become large or numerous, they may cause noticeable and sometimes disruptive effects. Symptoms can include:
- Menstrual periods that become heavier or last longer over time
- Signs of anemia such as fatigue or dizziness
- Pelvic heaviness, pressure, or bloating
- Lower back or leg pain
- Abdominal enlargement or constipation
- Frequent urination due to pressure on the bladder
- Pain during sexual intercourse
Depending on their size and position, fibroids may also interfere with fertility by affecting implantation or blocking the fallopian tubes.
Fibroids can be categorized based on where they develop within the uterus:
- Subserosal fibroids grow on the outer surface of the uterus
- Intramural fibroids form within the muscular wall of the uterus
- Submucosal fibroids develop inside the uterine cavity
As hormone levels decline during menopause, fibroid-related symptoms often stabilize or resolve.
What Causes Fibroids to Develop?
The exact cause of uterine fibroids remains unclear, but hormonal and genetic factors play a significant role. Fibroids tend to grow during pregnancy and may shrink after menopause, reinforcing the influence of reproductive hormones.
Certain factors are associated with a higher likelihood of developing fibroids, including:
- A family history of fibroids
- Age between 30 and 40
- Pregnancy or hormonal contraceptive use
- Obesity or elevated body mass index
- Early onset of menstruation
- Dietary factors and nutritional deficiencies
- African American ancestry
Research shows that fibroids occur more frequently and often more severely in African American women. While not all risk factors can be controlled, maintaining a healthy lifestyle may help reduce overall risk.
How Are Uterine Fibroids Treated?
Treatment depends on symptom severity, fibroid size and location, and individual health goals. One effective, minimally invasive option is uterine fibroid embolization (UFE).
UFE treats fibroids by cutting off their blood supply, causing them to shrink and gradually die. This approach offers an alternative to major surgery, such as hysterectomy or myomectomy, while significantly improving symptoms.
How Uterine Fibroid Embolization Works
During UFE, a thin catheter is inserted through a tiny puncture in an artery, usually in the wrist or hip. Using real-time X-ray guidance, the catheter is directed to the uterine arteries. Small embolic particles are then released, blocking blood flow to the fibroids.
Without a steady blood supply, fibroids shrink over time, leading to reduced bleeding, pain, and pressure. The procedure is performed in an outpatient setting, typically without general anesthesia, allowing most patients to return home the same day.
Benefits of Uterine Fibroid Embolization
UFE offers several advantages compared to more invasive surgical treatments:
- Minimally invasive with no large incisions
- Performed on an outpatient basis
- Preserves the uterus
- Treats multiple fibroids simultaneously
- Lower risk than open surgery
- No visible scarring
- Shorter recovery time
- Symptom improvement often within three months
- Potential to maintain fertility
What to Expect After the Procedure
After UFE, fibroids begin to lose their blood supply and shrink. This process can cause temporary symptoms such as pelvic cramping, abdominal pain, low-grade fever, or nausea. These symptoms are most noticeable in the first few days and may persist for one to two weeks.
Medications are typically prescribed to manage pain, inflammation, and nausea during recovery. While fibroids start shrinking soon after treatment, noticeable size reduction can take several weeks. Many women report significant symptom improvement within three months.
Fibroids may shrink by more than 50 percent over time, although the full effect can take six months or longer. Outcomes vary, and very large fibroids may occasionally require additional treatment.
Frequently Asked Questions About UFE
Is uterine fibroid embolization safe?
UFE has been performed worldwide for more than two decades and is considered a safe and well-established procedure. Complications are uncommon but may include infection, bruising, or bleeding. Some women experience temporary changes in their menstrual cycle, and a small percentage may enter menopause earlier than expected.
Can I have UFE if I want to become pregnant in the future?
Many women are able to conceive after UFE, but fertility outcomes can vary. Some studies suggest a slight reduction in fertility compared to surgical options. If future pregnancy is a priority, this should be discussed carefully with a specialist before treatment.
How effective is uterine fibroid embolization?
UFE has a success rate of approximately 85 to 90 percent. Most women experience significant symptom relief and a noticeable reduction in fibroid size.
How long do the results last?
Symptom relief typically begins within weeks to months and is long-lasting for most patients. Studies show sustained improvement for many years, although fibroid regrowth can occur in a small number of cases.