Fibroid Specialist Toronto and Fibroids: What to Know

Uterine fibroids are common, benign (noncancerous) growths of the uterus that can cause heavy bleeding, pelvic pressure, pain, and fertility challenges. If you live in Toronto or the GTA, you have access to a range of specialists and minimally invasive treatments—most of which are available in hospital-based programs. This guide explains what fibroids are, how they are diagnosed and treated, and how to navigate care locally and confidently.

What are fibroids?

Fibroids (leiomyomas) are muscle-and-fibrous-tissue growths that form in or on the uterus. They vary in size and location and are classified by where they grow:

• Submucosal: Just beneath the uterine lining; often linked to heavy bleeding and fertility issues.
• Intramural: Within the uterine wall; can enlarge the uterus and cause bleeding and pressure.
• Subserosal: On the outside of the uterus; often cause pressure symptoms.
• Pedunculated: Attached by a stalk; may cause localized pain if twisted.

Fibroids are very common—by age 50, an estimated 20–80% of women have them. They are most often diagnosed in the 30s and 40s and are more prevalent and often more severe among Black women. Family history, earlier onset of menstruation, obesity, and hypertension are associated risk factors.

Symptoms: when to see a specialist

Many fibroids cause no symptoms and are found incidentally. See your primary care clinician or seek a referral to a gynecologist if you have:

• Heavy menstrual bleeding (soaking pads/tampons hourly, clots, or periods longer than seven days)
• Iron-deficiency anemia (fatigue, shortness of breath, dizziness)
• Pelvic pressure, bloating, urinary frequency, constipation, or low back pain
• Pain with intercourse
• Infertility, recurrent miscarriage, or pregnancy complications

Go to urgent care if you have severe pain with fever, fainting, or signs of severe anemia.

How care works in Toronto

In Ontario, a referral from a family physician or nurse practitioner is typically needed to see a gynecologist under OHIP. Gynecologists often collaborate with interventional radiologists for uterine fibroid embolization (UFE) and, in select centers, with teams offering MRI-guided focused ultrasound or radiofrequency ablation. Most medically necessary consultations, imaging done in hospital, and surgical procedures are covered by OHIP. Medications and certain devices (for example, some intrauterine systems) may require private insurance or out-of-pocket payment; coverage varies.

Diagnosis: what to expect

• History and exam: Focus on bleeding pattern, pain, fertility goals, and anemia symptoms.
• Imaging: Transvaginal ultrasound is first-line. Saline-infusion sonohysterography helps define submucosal fibroids. MRI is used for complex cases or pre-procedure planning (e.g., myomectomy, UFE, or focused ultrasound).
• Endometrial assessment: Hysteroscopy or biopsy may be recommended, especially for abnormal bleeding after age 40 or with risk factors.
• Labs: Complete blood count and iron studies to assess anemia; pregnancy test when appropriate.

Treatment options

The best approach depends on symptoms, fibroid size/number/location, your desire for future pregnancy, other health conditions, and personal preference. Shared decision-making with a specialist is key.

Watchful waiting

If fibroids are small and symptoms are mild, monitoring with periodic exams and imaging may be appropriate. Fibroids often shrink after menopause.

Medications (symptom control or temporary shrinkage)

• NSAIDs: Help menstrual pain; modest effect on bleeding.
• Tranexamic acid: Non-hormonal option taken during menses to reduce heavy bleeding.
• Hormonal contraceptives: Pills, patch, ring, or progestin-only methods can reduce bleeding and cramps.
• Levonorgestrel-releasing intrauterine system (LNG-IUS): Often very effective for heavy bleeding; suitability depends on uterine cavity shape and fibroid location.
• Gonadotropin-releasing hormone (GnRH) analogs: Agonists and antagonists can shrink fibroids and reduce bleeding short-term (commonly used before surgery). Side effects can include hot flashes and bone density loss; add-back therapy may be used to mitigate this. These are typically time-limited therapies.

Note: Some selective progesterone receptor modulators have been restricted due to rare but serious liver safety concerns in certain jurisdictions. Your specialist will review what’s currently available and appropriate in Ontario.

Procedures and surgeries

• Hysteroscopic myomectomy: Removes submucosal fibroids via the cervix; outpatient, preserves the uterus, and can improve bleeding and fertility.
• Myomectomy (laparoscopic/robotic or open): Removes fibroids while preserving the uterus. Best for those who wish to maintain fertility or avoid hysterectomy. Recovery time varies by approach; fibroids can recur.
• Uterine fibroid embolization (UFE): A minimally invasive radiology procedure that blocks the blood supply to fibroids, shrinking them and reducing symptoms. Typically an overnight or same-day hospital stay; cramping is common post-procedure. UFE is generally not the first choice for people actively pursuing pregnancy, though some conceive afterward—discuss risks and benefits with your care team.
• Radiofrequency ablation (RFA): Uses targeted heat to shrink fibroids via laparoscopic or transcervical methods. Available in select centers; data on fertility are evolving.
• MRI-guided focused ultrasound (MRgFUS): Noninvasive treatment using focused ultrasound to thermally ablate fibroid tissue under MRI guidance. Suitable only for certain fibroid types and locations; availability is limited to select hospitals.
• Hysterectomy: Definitive cure by removing the uterus. Recommended for severe symptoms when childbearing is complete or when other treatments are unsuitable. Approaches include vaginal, laparoscopic/robotic, or abdominal. Your surgeon will discuss safety considerations, including techniques for tissue removal.

Important safety note: For certain patients, particularly those nearing or after menopause who are undergoing hysterectomy or myomectomy, the use of laparoscopic power morcellation to remove tissue has specific safety warnings due to the risk of spreading an unsuspected uterine cancer. Your surgeon will review risks and alternatives.

Choosing the right option

Consider:

• Your goals: Symptom relief only, uterine preservation, or future pregnancy.
• Fibroid profile: Size, number, and location strongly influence which treatments are feasible.
• Recovery time: Time away from work or caregiving may differ by approach.
• Durability: Myomectomy and UFE reduce symptoms for many, but fibroids may recur; hysterectomy is definitive.
• Risks and side effects: Ask about bleeding, infection, scarring/adhesions, impact on ovarian reserve, and need for future procedures.

Preparing for your Toronto appointment

• Track your cycles, bleeding volume (pads/tampons per day), pain scores, and any clots.
• List all medications and supplements, including iron.
• Bring prior imaging and reports.
• Clarify your goals (e.g., avoid surgery, preserve fertility, fastest recovery).
• Ask about wait times, hospital location, and which treatments your specialist offers directly versus via referral.

Frequently asked questions

Are fibroids cancer? No—fibroids are benign. A rare cancer called leiomyosarcoma can occur in the uterus but is uncommon. Imaging and clinical evaluation help guide safe treatment choices.

Can fibroids affect pregnancy? They can, depending on size and location. Submucosal fibroids are most linked to fertility and miscarriage risk. Many people with fibroids have healthy pregnancies; preconception counseling is valuable.

Will they grow back? After myomectomy, new or smaller fibroids can grow over time. After UFE, most patients have lasting symptom relief, though some need repeat treatment. Hysterectomy is definitive.

Is everything covered? Specialist consultations and hospital-based procedures are generally covered by OHIP. Medication and device coverage varies by plan; ask your clinician and pharmacist.

The bottom line

With experienced fibroid specialists and multidisciplinary care available in Toronto, most people can find a personalized plan that relieves symptoms and fits their goals. Start with a referral to a gynecologist, discuss all options—including medical, minimally invasive, and surgical—and make a decision with full information about benefits, risks, and recovery.

References and trusted resources

• National Institutes of Health, Office on Women’s Health. Uterine fibroids: symptoms, diagnosis, and treatment. https://www.womenshealth.gov/a-z-topics/uterine-fibroids
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD). What are fibroids? https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
• American College of Obstetricians and Gynecologists (ACOG). Uterine Fibroids FAQ and Practice Bulletin. https://www.acog.org/womens-health/faqs/uterine-fibroids
• U.S. Food and Drug Administration (FDA). Laparoscopic power morcellators—safety communication. https://www.fda.gov/medical-devices/surgery-devices/laparoscopic-power-morcellators

This article is informational and does not replace medical advice. Consult your healthcare provider for care tailored to you.