Do Fibroids Go Away On Their Own After Menopause? What to Know

Uterine fibroids (leiomyomas) are common, benign growths of the uterus. If you’re approaching menopause or are already postmenopausal, you may wonder whether fibroids will shrink or disappear on their own—and what to do if they don’t. Here’s an evidence-based look at how fibroids behave around menopause, when to seek care, and the options available.

Quick refresher: What are fibroids and who gets them?

Fibroids are noncancerous tumors made of smooth muscle and connective tissue that develop in or on the uterus. Many people have no symptoms; others may experience heavy or prolonged periods, pelvic pressure, anemia, urinary frequency, constipation, or pain.

Fibroids are very common: by age 50, a large proportion of women and people assigned female at birth will have them. Prevalence is higher among Black women and those with a family history, and risk increases with reproductive years. Trusted public health sources estimate that between 20% and 80% of women develop fibroids by age 50, with higher rates in Black women. Fibroids are hormone-sensitive, particularly to estrogen and progesterone, which helps explain their behavior around menopause.

Do fibroids go away after menopause?

Often, yes—fibroids tend to shrink after menopause. Menopause is defined as 12 consecutive months without a menstrual period. With menopause, ovarian production of estrogen and progesterone declines substantially, removing the key hormonal drivers that support fibroid growth. As a result, many fibroids decrease in size and symptoms like heavy menstrual bleeding resolve.

That said, not all fibroids completely disappear. Some remain stable in size, and a minority can continue to cause pressure symptoms (for example, urinary frequency or pelvic fullness) even without bleeding. Shrinkage typically occurs gradually over months to a few years after the final menstrual period.

Why might fibroids persist—or grow—after menopause?

Several factors can influence fibroid behavior postmenopause:

• Body fat and estrogen production: Adipose tissue converts androgens to estrogen. Higher body fat can maintain low levels of estrogen that may slow or blunt fibroid shrinkage.
• Hormone therapy (HT/HRT): Some people taking estrogen-containing therapy for menopausal symptoms may notice fibroid-related bleeding or slight growth. This doesn’t happen to everyone, but it’s something to monitor with your clinician.
• Other hormone exposures: Certain medications or supplements with estrogenic activity may affect fibroids.

Important: Fibroids are benign and do not “turn into” cancer. However, any new or enlarging uterine mass, or new bleeding after menopause, warrants prompt medical evaluation to exclude other causes, including rare uterine sarcomas.

Symptoms after menopause: when to worry

Call your clinician if you have:

• Any vaginal bleeding after menopause
• Rapidly enlarging pelvic or abdominal mass
• Persistent pelvic pain, pressure, or new urinary or bowel symptoms
• Unexplained anemia, fatigue, or weight loss

These signs don’t mean cancer, but they do merit evaluation.

How are fibroids evaluated around and after menopause?

Your clinician will take a history, perform a pelvic exam, and may order imaging. First-line imaging is pelvic ultrasound (transvaginal and/or transabdominal). If findings are unclear or surgical planning is needed, MRI offers detailed mapping of fibroid size, number, and location. If there’s any postmenopausal bleeding, your clinician will evaluate the uterine lining (endometrium) with ultrasound measurement, and possibly an endometrial biopsy, to rule out other conditions.

Management options: watchful waiting to definitive treatment

The best approach depends on your symptoms, fibroid size and location, overall health, and personal preferences.

1) Watchful waiting

If you’re close to or past menopause and symptoms are mild, observation is often reasonable. Many fibroids shrink enough to relieve symptoms without intervention. Your clinician may monitor with periodic exams or imaging if there are concerns about growth.

2) Medications (primarily before menopause)

Medical therapies are most useful for heavy menstrual bleeding in premenopausal or perimenopausal patients. Options include:

• Tranexamic acid during menses to reduce bleeding
• NSAIDs for pain and modest bleeding reduction
• Levonorgestrel-releasing IUD to control bleeding (uterine anatomy must allow placement)
• GnRH agonists or antagonists to temporarily shrink fibroids and reduce bleeding; typically short-term due to side effects like bone loss, and generally used prior to menopause or as preoperative therapy

After menopause, these medicines are rarely needed, since bleeding typically stops. If you’re using menopausal hormone therapy and develop bleeding or pressure symptoms, discuss dose, formulation, or alternatives with your clinician.

3) Uterus-sparing procedures

• Uterine artery embolization (UAE): Interventional radiology procedure that blocks blood flow to fibroids, shrinking them and relieving bulk symptoms. It’s effective for many and preserves the uterus, though not typically used to address postmenopausal bleeding (which needs evaluation first).
• Focused ultrasound (MRgFUS): Noninvasive thermal ablation for select candidates with accessible fibroids.

4) Surgery

• Myomectomy: Removes fibroids while preserving the uterus. Less common after menopause unless there’s a specific reason to avoid hysterectomy.
• Hysterectomy: Definitive cure for fibroids and an option for persistent, significant symptoms or when there’s concern for malignancy. Route (vaginal, laparoscopic, abdominal) depends on size, anatomy, and surgeon expertise.

Note: The U.S. Food and Drug Administration (FDA) advises against the use of uncontained power morcellation for hysterectomy or myomectomy in postmenopausal patients because of the risk of spreading an unsuspected cancer. Discuss surgical techniques and safety measures with your surgeon.

Hormone therapy for menopause: can you use it if you have fibroids?

Many people safely use menopausal hormone therapy to manage hot flashes, night sweats, and other symptoms. If you have a history of fibroids:

• Inform your clinician; they may recommend the lowest effective dose and careful follow-up.
• If you have a uterus and take estrogen, you also need a progestin to protect the uterine lining. A levonorgestrel IUD can sometimes provide that endometrial protection.
• Report any bleeding after menopause promptly; it requires evaluation regardless of HT use.

Lifestyle and self-care

Lifestyle cannot eliminate fibroids, but it can support overall health and may help symptoms:

• Maintain a healthy weight; excess body fat can maintain estrogen levels and may influence fibroid behavior.
• Exercise regularly for cardiovascular health, bone density, and mood.
• Manage blood pressure and iron status (especially if you had prior anemia).
• Discuss supplements with your clinician before starting them; evidence is limited for most over-the-counter products marketed for fibroids.

Key takeaways

• Most fibroids shrink after menopause as hormone levels fall; many symptoms improve or resolve.
• Not all fibroids disappear. Persistent pressure symptoms can be treated, and any postmenopausal bleeding or new/enlarging mass should be evaluated.
• Observation is reasonable for mild symptoms; effective procedural and surgical options exist if needed.
• If you use menopausal hormone therapy, monitor for bleeding or symptom changes and stay in touch with your clinician.

When to see a clinician

Seek care if you notice bleeding after menopause, new or worsening pelvic pressure, pain, or a growing mass. A tailored evaluation can differentiate typical postmenopausal fibroid changes from other conditions and align treatment with your goals—whether that’s doing nothing, managing symptoms conservatively, or choosing a definitive procedure.

Trusted resources

• U.S. Office on Women’s Health (OASH): Uterine Fibroids – https://www.womenshealth.gov/a-z-topics/uterine-fibroids
• NIH, Eunice Kennedy Shriver NICHD: Uterine Fibroids – https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
• MedlinePlus (NIH): Uterine Fibroids – https://medlineplus.gov/uterinefibroids.html
• American College of Obstetricians and Gynecologists (ACOG): Uterine Fibroids FAQ – https://www.acog.org/womens-health/faqs/uterine-fibroids
• U.S. FDA: Power Morcellation Safety Communication – https://www.fda.gov/medical-devices/safety-communications
• National Cancer Institute: Uterine Sarcoma – https://www.cancer.gov/types/uterine/patient/uterine-sarcoma-treatment-pdq