Fibroids Quiz and Fibroids: What to Know

Fibroids Quiz and Fibroids: What to Know

Uterine fibroids are common, benign (noncancerous) growths in or on the uterus. Many people have them without realizing it, while others experience heavy bleeding, pain, or fertility challenges. Use the quick quiz below to assess whether your symptoms and risk factors suggest a conversation with a clinician, then read on for clear, evidence-based guidance on diagnosis and treatment options.

Quick Fibroids Quiz

Answer yes or no to each question. This quiz is not a diagnosis, but it can help you decide whether to seek medical advice.

  1. Do you frequently have very heavy periods (for example, soaking through a pad or tampon every 1–2 hours or passing clots)?
  2. Have your periods lasted longer than 7 days in recent months?
  3. Have you been told you have iron-deficiency anemia, or do you feel unusually tired, short of breath, or dizzy during your period?
  4. Do you feel pelvic pressure, fullness, or pain that is not explained by another condition?
  5. Do you urinate more often than usual or wake at night to urinate, without a urinary tract infection?
  6. Do you have pain during sex or lower back pain that seems related to your cycle?
  7. Are you having trouble getting pregnant, or have you had recurrent pregnancy loss?
  8. Have you been told your uterus is enlarged or irregular during a pelvic exam?
  9. Do you have a family history of fibroids, or are you of African descent (groups with higher risk)?
  10. Are you between ages 30–50 (prime years for fibroid growth)?

How to use your results: If you answered yes to 2 or more questions, especially the first three about bleeding and anemia, consider scheduling a visit with your primary care clinician or gynecologist. If you are soaking through a pad or tampon every hour for more than 2 hours, have severe pain, or feel faint, seek urgent care.

What are uterine fibroids?

Fibroids (also called leiomyomas or myomas) are growths made of muscle and fibrous tissue that develop in the uterine wall. They are very common: the Office on Women’s Health reports that between 20% and 80% of women develop fibroids by age 50, and they occur more often and at younger ages in Black women. Most fibroids are harmless and do not become cancerous.

Common symptoms

Many people with fibroids have no symptoms. When symptoms occur, they may include:

  • Heavy or prolonged menstrual bleeding
  • Pelvic pressure or pain, including bloating or a feeling of fullness
  • Frequent urination or difficulty emptying the bladder
  • Constipation
  • Pain during sex
  • Back or leg pain
  • Anemia-related fatigue from heavy bleeding

Symptoms depend on the number, size, and location of fibroids. For example, fibroids inside the uterine cavity (submucosal) are more likely to cause heavy bleeding, while those on the outer surface may cause pressure symptoms.

How fibroids are diagnosed

Your clinician will review your medical history and perform a pelvic exam. Imaging confirms the diagnosis:

  • Pelvic ultrasound (often transvaginal) is the first-line test.
  • MRI can help plan treatment, especially if there are many or large fibroids, or if surgery is being considered.
  • Hysteroscopy (a small camera in the uterus) may be used for abnormal bleeding or to treat certain fibroids inside the cavity.

Other conditions can mimic fibroid symptoms, such as adenomyosis, endometrial polyps, or thyroid abnormalities. Blood tests may check for anemia or other causes of heavy bleeding.

Treatment options: from watchful waiting to procedures

Management depends on your symptoms, fibroid size and location, age, fertility goals, and personal preferences. Many fibroids do not require treatment.

Watchful waiting

If symptoms are mild, monitoring with periodic exams and ultrasound may be all that is needed. Fibroids often shrink after menopause.

Medications

  • NSAIDs (such as ibuprofen) can ease cramps but do not reduce bleeding substantially.
  • Hormonal birth control (pills, patch, ring) can regulate or reduce bleeding.
  • Levonorgestrel intrauterine device (IUD) can significantly reduce heavy bleeding for many patients.
  • Tranexamic acid, taken only during menses, reduces heavy menstrual bleeding.
  • GnRH agonists or antagonists reduce estrogen to shrink fibroids and bleeding; oral combination therapies (adding low-dose estrogen/progestin) are FDA-approved to manage heavy menstrual bleeding due to fibroids in premenopausal women. These are usually short- to medium-term options because of potential side effects like bone density loss.

Uterine-sparing procedures

  • Myomectomy: Surgical removal of fibroids while preserving the uterus. It can be hysteroscopic (through the cervix for cavity fibroids), laparoscopic/robotic, or open (abdominal). It is preferred when future fertility is a priority. Fibroids can recur.
  • Uterine fibroid embolization (UFE): A minimally invasive radiology procedure that blocks blood flow to fibroids, shrinking them and improving bleeding and bulk symptoms. Not typically recommended for those actively pursuing pregnancy.
  • Radiofrequency ablation (laparoscopic or transcervical): Uses targeted heat to shrink fibroids and relieve symptoms; recovery is usually quick. Fertility data are evolving.

Definitive treatment

  • Hysterectomy: Surgical removal of the uterus. This is the only definitive cure and eliminates bleeding and bulk symptoms. It is not appropriate for those who wish to carry a pregnancy.

Technical note: The U.S. Food and Drug Administration advises caution with laparoscopic power morcellation (a technique to fragment tissue for removal) because of the rare risk of spreading an unsuspected uterine cancer. When morcellation is considered, the FDA recommends using containment systems and avoiding use in certain patients. Discuss the approach and risks with your surgeon.

Fibroids, fertility, and pregnancy

Fibroids can sometimes affect fertility or pregnancy depending on their size and location, especially when they distort the uterine cavity. Submucosal fibroids are most likely to interfere with implantation or cause heavy bleeding. During pregnancy, most fibroids remain stable, but some can grow in the first trimester and increase risks such as pain, breech position, preterm birth, or cesarean delivery. Treatment decisions should be individualized; myomectomy may improve fertility in certain cases, particularly for cavity-distorting fibroids. UFE is generally not recommended for those trying to conceive immediately.

Myths vs facts

  • Myth: Fibroids always cause cancer. Fact: Fibroids are benign; transformation to cancer is very rare.
  • Myth: Hysterectomy is the only treatment. Fact: Many effective medical and uterus-sparing options exist.
  • Myth: You must treat fibroids if you have them. Fact: If you have no symptoms, watchful waiting is often appropriate.
  • Myth: All heavy periods mean fibroids. Fact: Thyroid disorders, bleeding conditions, and other uterine issues can also cause heavy bleeding.

Preparing for your appointment

  • Track your periods (dates, flow, clots, number of pads/tampons, pain level).
  • List your symptoms, how long they have lasted, and how they affect work, exercise, and sleep.
  • Bring your medication list and any prior imaging results.
  • Clarify your goals (symptom relief, avoiding surgery, preserving fertility).

Bottom line

Fibroids are common and often manageable. If you have heavy bleeding, pelvic pressure, or fertility concerns, speak with a clinician. Together, you can choose a plan that aligns with your symptoms, values, and goals. This article is for education and does not replace personalized medical advice.

Sources and further reading

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