Myths vs. Facts: What the Medical Industry Doesn’t Always Tell You About Fibroids

Myths vs. Facts: What the Medical Industry Doesn’t Always Tell You About Fibroids

Uterine fibroids are common, often confusing, and surrounded by persistent myths. As many as 70% of people with a uterus may develop fibroids by age 50, yet not everyone receives clear, balanced information about risks, symptoms, and treatment choices. Below, we separate myth from fact using evidence from trusted sources like the National Institutes of Health (NIH), the U.S. Food and Drug Administration (FDA), and the American College of Obstetricians and Gynecologists (ACOG).

Myth 1: “Fibroids always cause symptoms.”

Fact: Many fibroids are silent. Fibroids are benign growths of the uterine muscle that vary in size and location. Some cause heavy bleeding, pelvic pressure, pain, frequent urination, or fertility challenges—while others cause no symptoms at all. The NIH notes that fibroids are highly prevalent but often go undetected because they can be asymptomatic (NIH/NICHD).

Myth 2: “Fibroids are cancerous or will turn into cancer.”

Fact: Fibroids are benign. A rare cancer called uterine leiomyosarcoma can occur in the uterus, but it is not believed to arise from benign fibroids. ACOG emphasizes that malignant transformation of a fibroid is extremely uncommon (ACOG). If you have rapid growth after menopause or concerning symptoms, your clinician may recommend further evaluation to rule out other conditions.

Myth 3: “Hysterectomy is the only cure.”

Fact: There are multiple evidence-based options—surgical and nonsurgical. The “best” choice depends on your symptoms, fibroid size and location, age, overall health, and whether you want to preserve fertility.

  • Watchful waiting: Appropriate if symptoms are mild or absent. Fibroids often shrink after menopause (ACOG).
  • Medications: Options may include hormonal birth control to reduce bleeding, tranexamic acid for heavy periods, NSAIDs for pain, and short-term use of GnRH agonists or antagonists (often with “add-back” therapy) to shrink fibroids and improve anemia (ACOG).
  • Myomectomy: Surgical removal of fibroids (hysteroscopic, laparoscopic, or open). This preserves the uterus and is often preferred when future pregnancy is desired (ACOG).
  • Uterine fibroid embolization (UFE): A minimally invasive radiology procedure that shrinks fibroids by blocking their blood supply. It can relieve bleeding and pressure in many patients but may not be the first choice for those planning pregnancy soon (ACOG).
  • Focused ultrasound and radiofrequency ablation: Select centers offer MRI-guided focused ultrasound (MRgFUS) and radiofrequency ablation devices to target fibroids while sparing surrounding tissue. These technologies have FDA clearance for specific indications; ask your specialist whether you are a candidate (FDA).
  • Hysterectomy: Definitive, but removes the uterus and ends fertility. It may be appropriate for severe symptoms, very large fibroids, or when other treatments have failed (ACOG).

Myth 4: “You caused your fibroids.”

Fact: No one causes their fibroids. The exact cause is unknown. Hormones, genetics, and environmental factors appear to play roles. Fibroids are more common with increasing reproductive age until menopause and can run in families. Black women are disproportionately affected, often developing fibroids earlier and experiencing more severe symptoms. Lifestyle factors like obesity are associated with higher risk, but there is no proven way to prevent fibroids entirely (HHS Office on Women’s Health; NIH/NICHD).

Myth 5: “If you have fibroids, you must treat them right away.”

Fact: Treatment is based on your goals and symptoms. If you are not bothered by symptoms, a watch-and-wait approach with periodic follow-up is reasonable. When heavy bleeding, anemia, pain, or fertility issues occur, evidence-based treatments can help. Shared decision-making with your clinician is essential (ACOG).

Myth 6: “Procedures are risk-free.”

Fact: Every intervention has potential risks and trade-offs. For example, when fibroids are removed via minimally invasive surgery, surgeons may consider fragmenting tissue to remove it through small incisions. The FDA warns that using certain power morcellators in the uterus can spread an unsuspected cancer and is contraindicated in some patients. If morcellation is considered, FDA recommends specific risk mitigation (e.g., appropriate patient selection, containment systems) (FDA Safety Communication). Ask how your surgeon minimizes risks and what alternatives exist.

Myth 7: “Fibroids always come back after treatment.”

Fact: Outcomes vary by treatment, age, and number of fibroids. After myomectomy, new fibroids can develop over time, and some patients eventually need additional treatment. After UFE, many patients have lasting relief, though a portion may require reintervention in subsequent years. Hysterectomy eliminates fibroid recurrence because the uterus is removed—but it is permanent and not appropriate for those wishing to conceive (ACOG).

Myth 8: “You can’t get pregnant if you have fibroids—or after treatment.”

Fact: Many people with fibroids conceive and have healthy pregnancies. Fertility impact depends on fibroid size and location—submucosal fibroids that protrude into the uterine cavity are more likely to affect implantation or cause miscarriage. Myomectomy can improve fertility in select cases. The data on pregnancy after UFE are evolving; when future pregnancy is a priority, ACOG generally favors myomectomy over UFE. Discuss your reproductive plans with your clinician before any procedure (ACOG).

Myth 9: “Supplements and detoxes can shrink fibroids.”

Fact: There is no high-quality evidence that over-the-counter supplements, detoxes, or cleanses shrink fibroids. Some products may interact with medications or cause side effects. In the United States, dietary supplements are not approved by the FDA to diagnose, treat, cure, or prevent fibroids. Focus instead on proven strategies: managing anemia, addressing heavy bleeding, and considering medical or procedural therapies when appropriate (FDA on Supplements).

What the industry doesn’t always emphasize—but you should know

  • Symptom burden matters: Treatment decisions should reflect how much fibroids affect your life—bleeding, pain, fatigue from anemia, fertility goals, and work or caregiving responsibilities.
  • Equity and access: Black women face higher rates of fibroids and may encounter delays in diagnosis or limited access to minimally invasive options. Advocate for a full discussion of choices and second opinions when needed.
  • Informed consent: Ask about benefits, risks, alternatives, and recovery time for each option—including device-related advisories like the FDA’s guidance on morcellation.
  • Comprehensive care: Iron studies for anemia, management of pain and heavy bleeding, and mental health support can significantly improve quality of life while you evaluate long-term options.

Smart questions to ask your clinician

  • Which fibroids (size and location) are most likely causing my symptoms?
  • What are my choices if I want to preserve fertility or avoid surgery?
  • What are the expected outcomes, recovery time, and risks of each option for someone like me?
  • If surgery is recommended, will morcellation be used? If so, how are FDA recommendations followed?
  • How will we monitor my fibroids if I choose watchful waiting?

Bottom line

Fibroids are common and typically benign. Most importantly, you have options. An individualized, evidence-based plan—aligned with your symptoms and life goals—often delivers the best results. Use reputable sources and shared decision-making to choose confidently.

Trusted sources and further reading

This article is for general education and is not a substitute for personalized medical advice. Always consult a qualified healthcare professional about your symptoms, diagnosis, and treatment options.

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