Large Fibroma and Fibroids: What to Know

Hearing that you have a “large fibroma” or large fibroids can be unsettling. The good news: these growths are usually benign (noncancerous), and there are effective ways to monitor and treat them. This guide explains what “large” means in practical terms, how symptoms and risks change with size, and the latest, evidence-based options for diagnosis and treatment.

Fibroma vs. Fibroid—What’s the Difference?

Although the terms sound similar, they refer to different types of benign tumors:

• Fibroma: A tumor made up of fibrous or connective tissue. Fibromas can occur in many places (skin, mouth, ovaries). An ovarian fibroma is a solid, usually benign ovarian tumor.
• Fibroid (uterine leiomyoma): A benign tumor of smooth muscle and connective tissue that grows in or on the uterus. Uterine fibroids are extremely common during the reproductive years and are the most frequent pelvic tumors in women.

Because most people asking about “fibroids” are referring to uterine fibroids, this article focuses mainly on large uterine fibroids while noting key points for ovarian fibromas.

How Large Is “Large”?

There’s no single cutoff, but clinicians often describe uterine size as if it were a pregnancy (for example, “12-week size”) or measure fibroids in centimeters. As fibroids grow beyond about 5–7 cm—or when the uterus enlarges to the size expected at 12–14 weeks of pregnancy—pressure symptoms and heavy bleeding tend to become more likely. For ovarian fibromas, tumors larger than about 5 cm increase the risk of ovarian torsion (twisting), which can cause sudden severe pain and requires urgent care.

Symptoms and Red Flags

Uterine fibroids

• Heavy menstrual bleeding (soaking pads/tampons in an hour, clots, prolonged periods)
• Anemia (fatigue, shortness of breath, dizziness)
• Bulk/pressure symptoms (pelvic fullness, urinary frequency/urgency, constipation, low back pain)
• Pain (cramps, pelvic pain, pain during sex)
• Fertility and pregnancy issues (depending on location and size): difficulty conceiving, miscarriage, preterm birth, breech position

Ovarian fibroma

• Pelvic pain or pressure
• Acute, severe pain from torsion (twisted ovary)
• Rarely, Meigs syndrome (benign tumor with fluid around the lung and in the abdomen), which resolves after tumor removal

Seek urgent care if you have:

• Heavy bleeding soaking more than one pad or tampon per hour for two or more consecutive hours
• Fainting, chest pain, or shortness of breath (possible severe anemia)
• Sudden, severe pelvic pain, with or without nausea/vomiting (possible torsion or degeneration)
• Fever with pelvic pain (possible infection)

Who Is at Higher Risk?

Uterine fibroids can affect anyone with a uterus, but risk is higher with:

• Age 30–50 (though they can occur earlier or later)
• Black race/ethnicity (fibroids tend to occur earlier, be larger, and cause more symptoms)
• Family history of fibroids
• Early first period, obesity, hypertension

Some studies also suggest a link with low vitamin D, though evidence is evolving.

How Are Large Fibromas and Fibroids Diagnosed?

• History and pelvic exam: To assess size, tenderness, and symptoms.
• Ultrasound (transvaginal/abdominal): First-line imaging to map fibroids or evaluate a suspected ovarian mass.
• MRI: Helpful for large or numerous fibroids to plan treatment (e.g., surgery, embolization) and differentiate locations.
• Blood tests: Complete blood count (CBC) for anemia; pregnancy test when relevant.

Uterine fibroids are benign, but rarely a cancer (leiomyosarcoma) can mimic fibroids. No imaging test reliably rules this out preoperatively; your clinician considers growth rate, symptoms, and imaging features, and discusses risks. Ovarian fibromas are typically benign; ultrasound and, if needed, MRI help guide management.

Treatment Options—From Watchful Waiting to Surgery

The best approach depends on your symptoms, the size and location of the tumor(s), your age, and whether you want future pregnancies.

Uterine fibroids

Watchful waiting

• Reasonable if symptoms are mild and you are nearing menopause (fibroids often shrink when estrogen falls).

Medications (often used to reduce bleeding, pain, or shrink fibroids temporarily):

• Hormonal contraceptives (pills, patch, ring) and the levonorgestrel intrauterine device (LNG-IUD) can reduce bleeding and cramps.
• Tranexamic acid (non-hormonal) reduces heavy menstrual bleeding during periods.
• GnRH agonists (e.g., leuprolide acetate) can temporarily shrink fibroids and correct anemia before surgery; typically used short-term due to menopausal-type side effects and bone loss.
• Oral GnRH antagonists with add-back therapy (to protect bones and reduce side effects) are FDA-approved to treat heavy menstrual bleeding associated with fibroids: elagolix + estradiol + norethindrone acetate and relugolix + estradiol + norethindrone acetate. These can reduce bleeding and shrink fibroids while on therapy.
• NSAIDs (e.g., ibuprofen) can help pain, though they don’t reduce bleeding as effectively as options above.
• Iron supplementation treats iron-deficiency anemia from heavy bleeding.

Minimally invasive procedures

• Uterine fibroid embolization (UFE): An interventional radiology procedure that blocks blood flow to fibroids, causing them to shrink. Can improve bleeding and bulk symptoms; not ideal if you’re planning pregnancy soon.
• Radiofrequency ablation (RFA) (laparoscopic or transcervical): Uses heat to shrink fibroids while preserving the uterus. Recovery is usually quick; data on future pregnancy are evolving.
• MRI-guided focused ultrasound: Noninvasive ultrasound energy to ablate fibroid tissue in selected cases.
• Hysteroscopic myomectomy: For fibroids inside the uterine cavity (submucosal), removed via the cervix; helpful for heavy bleeding and fertility.

Surgery

• Myomectomy (removal of fibroids only): Preserves the uterus and fertility; may be abdominal, laparoscopic, or hysteroscopic depending on size/location. Fibroids can recur over time.
• Hysterectomy (removal of the uterus): Definitive cure for uterine fibroids and bleeding; not for those desiring future pregnancy. Approach (vaginal, laparoscopic, abdominal) depends on size and anatomy.

For very large uteri, surgeons may recommend preoperative medical therapy to reduce size and anemia. Your team will discuss benefits, risks, and recovery for each option.

Ovarian fibroma

• Observation: If small and asymptomatic with reassuring imaging.
• Surgery: Recommended if large, symptomatic, growing, or with suspected torsion. Surgeons often aim for fertility-sparing removal of the mass (cystectomy) or, if necessary, oophorectomy (removal of the ovary) depending on age, goals, and surgical findings.

Living With Large Fibroids: Practical Tips

• Track symptoms: Note bleeding days, pad/tampon use, pain scores, and bulk symptoms. Bring this to appointments.
• Optimize iron: Ask about ferritin and hemoglobin testing. Combine iron-rich foods with vitamin C to enhance absorption; consider oral iron if prescribed.
• Pain plan: NSAIDs at the start of menses may help; discuss safe dosing, especially if you have kidney, heart, or GI issues.
• Health maintenance: Manage blood pressure, maintain a healthy weight, and discuss vitamin D status with your clinician.
• Don’t delay care: Rapidly enlarging abdomen, worsening bleeding, or new severe pain warrant prompt evaluation.

Questions to Ask Your Clinician

• What type, size, and location of fibroids/fibroma do I have?
• How do my symptoms and goals (including fertility) influence treatment choices?
• Which medications or procedures fit my situation, and what are the side effects, recovery time, and impact on future pregnancy?
• How will we monitor for recurrence or regrowth?
• What can I do now to reduce bleeding and anemia while we plan?

Bottom Line

Large fibromas and fibroids are usually benign but can significantly affect quality of life. With modern imaging, medications, and minimally invasive procedures, most people can find a plan that controls bleeding and pain, reduces bulk symptoms, and aligns with their reproductive goals. Partner with a clinician experienced in fibroid care to tailor the approach to your needs.

Sources

• National Institutes of Health (NIH), MedlinePlus: Uterine Fibroids
• Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD): Uterine Fibroids
• U.S. Department of Health and Human Services, Office on Women’s Health: Uterine Fibroids
• American College of Obstetricians and Gynecologists (ACOG): Uterine Fibroids FAQ
• U.S. Food and Drug Administration (FDA): Elagolix combination (Oriahnn) for heavy menstrual bleeding due to fibroids
• U.S. Food and Drug Administration (FDA): Relugolix combination (Myfembree) for heavy menstrual bleeding due to fibroids
• U.S. Food and Drug Administration (FDA): Tranexamic acid (Lysteda) labeling
• American College of Obstetricians and Gynecologists (ACOG) Practice Bulletin/Guidance on Management of Symptomatic Uterine Leiomyomas

This article is for educational purposes and is not a substitute for professional medical advice. Always consult a qualified clinician for diagnosis and treatment decisions.