11 Mm Fibroid and Fibroids: What to Know
An 11 mm fibroid is a very small uterine fibroid—about the size of a pea. While the word “tumor” can sound alarming, uterine fibroids (also called leiomyomas) are benign growths of the muscle layer of the uterus and are extremely common. What matters most is not only size, but also location and symptoms. This guide explains what an 11 mm fibroid means, how fibroids are diagnosed and managed, and when treatment makes sense—using guidance aligned with trusted sources such as the National Institutes of Health (NIH), the American College of Obstetricians and Gynecologists (ACOG), and the U.S. Food and Drug Administration (FDA).
What exactly is an 11 mm fibroid?
Fibroids are noncancerous growths arising from the smooth muscle of the uterus. An 11 mm fibroid equals 1.1 cm. By size, this is considered small. However, impact varies by location:
- Submucosal (projecting into the uterine cavity): Even small fibroids can cause heavy bleeding or fertility issues because they distort the cavity.
- Intramural (within the uterine wall): Small ones are often asymptomatic. Larger intramural fibroids can cause bulk symptoms and heavy periods.
- Subserosal (on the outer surface): More likely to cause pressure or pain when larger; small subserosal fibroids rarely cause symptoms.
Most fibroids are benign and do not become cancerous. Leiomyosarcoma, a rare uterine cancer, typically arises de novo rather than from a benign fibroid. Suspicion is raised by atypical imaging features or rapid growth post-menopause; your clinician will guide evaluation if there are concerns (ACOG).
How common are fibroids and who is at risk?
Fibroids are very common—by age 50, the majority of women will have them. Prevalence and symptom burden are higher among Black women. Other risk factors include family history, earlier age at first period, and higher body mass index (NIH/ NICHD).
Symptoms to watch for
Many 11 mm fibroids cause no symptoms and are found incidentally on ultrasound. When symptoms do occur, they typically relate to location rather than size:
- Heavier or longer periods; passing clots
- Pelvic pressure or cramping
- Pain during intercourse
- Spotting between periods (especially with submucosal fibroids)
- Infertility or recurrent miscarriage due to cavity distortion (usually with submucosal types)
Seek urgent care for very heavy bleeding soaking a pad hourly for several hours, severe pain with fever, or symptoms of anemia (fatigue, shortness of breath, dizziness).
How are fibroids diagnosed?
- Pelvic exam: May suggest an enlarged or irregular uterus.
- Ultrasound: Transvaginal ultrasound is the first-line test to confirm and map fibroids.
- Saline infusion sonohysterography (SIS) or hysteroscopy: Helpful to define small submucosal fibroids that protrude into the cavity.
- MRI: Used when imaging is unclear or for surgical/procedural planning.
- Bloodwork: If heavy bleeding is present, a complete blood count can check for anemia.
Does an 11 mm fibroid need treatment?
Often, no. For small, asymptomatic fibroids, ACOG supports watchful waiting. Your clinician may recommend periodic follow-up, for example repeat ultrasound in 6–12 months, especially if you develop symptoms or plan pregnancy. Fibroids often grow during reproductive years and typically shrink after menopause as estrogen and progesterone levels fall (NIH/ACOG).
Treatment is generally considered when you have any of the following:
- Heavy menstrual bleeding causing anemia or quality-of-life impact
- Significant pain or pressure symptoms
- Fertility problems linked to a submucosal fibroid
- Recurrent pregnancy loss attributed to cavity distortion
Fertility and pregnancy considerations
A single 11 mm fibroid usually does not impair fertility or pregnancy. The exception is a submucosal fibroid that indents the uterine cavity; even small lesions can affect implantation or increase risk of miscarriage. Hysteroscopic removal of a symptomatic submucosal fibroid can improve bleeding and may improve fertility outcomes in selected patients (ACOG).
During pregnancy, most small fibroids require only monitoring. Rarely, fibroids can cause pain due to degeneration, or contribute to malpresentation if larger and strategically located. Discuss your individual risk with your obstetric provider.
Evidence-based treatment options
The right approach depends on your symptoms, fibroid location, plans for pregnancy, and personal preferences. Options include:
Medications
- NSAIDs (e.g., ibuprofen): Help with pain and may modestly reduce bleeding.
- Hormonal contraception: Combined pills, patches, rings, or progestin-only methods can reduce bleeding and cramps. The levonorgestrel intrauterine system (LNG-IUS) often markedly decreases menstrual blood loss (ACOG).
- Tranexamic acid: A non-hormonal antifibrinolytic taken only on heavy flow days to reduce bleeding (ACOG).
-
GnRH analogs/antagonists: Short-term options that lower estrogen and progesterone to reduce bleeding and shrink fibroids while used. FDA-approved oral combination therapies include:
- Elagolix + estradiol + norethindrone acetate (brand: Oriahnn) for heavy menstrual bleeding due to fibroids in premenopausal women.
- Relugolix + estradiol + norethindrone acetate (brand: Myfembree) for heavy menstrual bleeding associated with uterine fibroids.
Procedures
- Hysteroscopic myomectomy: Removes submucosal fibroids via the cervix; ideal for small fibroids that distort the cavity and for patients seeking fertility.
- Laparoscopic or open myomectomy: Removes fibroids while preserving the uterus; preferred for women desiring future pregnancy when fibroids are intramural or subserosal and symptomatic.
- Uterine fibroid embolization (UFE): A minimally invasive radiology procedure that reduces fibroid blood supply, shrinking fibroids and improving bleeding/pressure. UFE is uterus-sparing but may not be first-line for those planning pregnancy (ACOG).
- Radiofrequency ablation (RFA): Laparoscopic or transcervical techniques use heat to ablate fibroids; uterus-sparing, with growing evidence for symptom relief.
- Hysterectomy: Definitive treatment for those who do not desire future fertility.
For a small, asymptomatic 11 mm fibroid, surgery is rarely indicated unless it is submucosal and clearly linked to heavy bleeding or fertility issues.
Practical self-care and monitoring tips
- Track cycles and bleeding (use a period app or calendar). Note clots, pad/tampon changes, and pain levels.
- Address anemia: Ask about iron studies if you have heavy bleeding; incorporate iron-rich foods and supplements if advised.
- Use heat, NSAIDs, and gentle exercise for cramp relief as appropriate.
- Keep follow-up appointments if your clinician recommends surveillance imaging.
When to call a clinician
- Soaking through a pad/tampon every hour for more than two consecutive hours
- Severe or worsening pelvic pain, fever, or fainting
- Signs of anemia: extreme fatigue, shortness of breath, dizziness, palpitations
- New difficulty getting pregnant or recurrent miscarriage
The bottom line
An 11 mm fibroid is small and often harmless, especially if not distorting the uterine cavity. The decision to treat hinges on symptoms, location, and your reproductive goals. If you’re asymptomatic, watchful waiting with periodic check-ins is common. If you have heavy bleeding, pain, or fertility concerns, effective medical and procedural options exist—many of which are uterus-sparing. A gynecologist can help you tailor a plan that fits your life and priorities.
Trusted resources
- NIH/NICHD: Uterine Fibroids – Overview and treatment: https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
- ACOG Patient FAQ: Uterine Fibroids: https://www.acog.org/womens-health/faqs/uterine-fibroids
- FDA: Oriahnn (elagolix, estradiol, norethindrone acetate) – approval information: FDA press announcement
- FDA: Myfembree (relugolix, estradiol, norethindrone acetate) – approval information: FDA approval
This article is for educational purposes and does not replace personalized medical advice. Always consult your clinician for diagnosis and treatment decisions.
