The short version.

Fibroids are very common, they are almost never cancer, and many never need treatment. When they do cause problems, there are more options than there used to be, including treatments that keep the uterus.

The hard part is often getting taken seriously. Heavy periods get brushed off as “just bad periods” for years. Knowing what to look for, and what to ask, helps.

What fibroids are.

Fibroids (also called leiomyomas or myomas) are growths made of muscle and fibrous tissue in or on the wall of the uterus. They can be as small as a seed or as large as a grapefruit, and you can have one or many.

They are hormone-dependent. Estrogen and progesterone promote their growth, which is why they usually appear after puberty and tend to shrink after menopause unless hormone therapy is used.

Symptoms to know.

Symptoms depend on the size, number and location of the fibroids. Many people have none.

Depending on their size and location, fibroids can sometimes affect fertility or pregnancy, so tell your provider if you hope to conceive.

These symptoms overlap with other conditions, including adenomyosis and endometriosis. A clinical evaluation is the only reliable way to tell them apart.

Getting diagnosed.

1. A conversation about your symptoms. Your period history, bleeding pattern, pain and any plans for pregnancy.
2. A pelvic exam. It may reveal an enlarged or uneven uterus, but imaging confirms the diagnosis.
3. Imaging. A transvaginal ultrasound is the usual first test. An MRI can show more detail when needed.
4. Hysteroscopy, if needed. A thin camera looks inside the uterus and can detect fibroids growing into the cavity.
5. Blood work. A complete blood count checks for anemia caused by heavy bleeding.

Before your appointment

• Track your cycle for a few months: start and end dates, how heavy the flow is, and any clots.
• Note pain, pressure and any changes in urination.
• Write down your family history of fibroids.
• Be ready to say whether you want to have children, now or later.

Questions worth asking

• Where are my fibroids, and how big are they?
• Do I need treatment now, or can we monitor them?
• Should I be checked for anemia?
• What are my options if I want to become pregnant?
• Which treatments keep my uterus?
• Can fibroids be prevented?

Managing fibroids.

There is no single best option. The right plan depends on your symptoms, the size, number and location of your fibroids, your age and whether you want children. Treatment choices are best made together with a gynecologist.

Everyday support

• Eat plenty of fruits and vegetables. Higher intake is linked with lower fibroid risk.
• Ask about a vitamin D test before taking supplements. Low levels are linked with fibroids, but vitamin D is not a proven treatment, and more is not better.
• Move regularly. Walking and other exercise support mood, pain and a healthy weight.
• Limit alcohol. Regular drinking is linked with higher risk.
• Track your symptoms so you can show your provider whether things are changing.

Fabric, chemicals and fibroids.

Fibroid growth is driven by hormones, so researchers have studied whether chemicals that interfere with hormones, known as endocrine disruptors, might play a role. A 2022 PNAS study led by Northwestern researchers found that chemicals found in everyday products can activate fibroid growth in human cell models.

That is early, laboratory-stage evidence, and it doesn’t show that any garment causes fibroids. Many everyday exposures add up, including food packaging, personal care products and household items, and what you wear against your skin is one of the easiest to choose.

Where it’s easy, keep unnecessary exposure low:

• Choose certified organic cotton, such as GOTS and OEKO-TEX, for what you wear closest to your skin.
• Wash new underwear before wearing it.
• Use a fragrance-free detergent and skip fabric softener.

To learn more, read Fabric School and the chemical guide.

When to get care.

Sources.

1. Stewart et al. (2017). Epidemiology of uterine fibroids: a systematic review. BJOG.
2. Keizer et al. (2024). Modifiable prognostic factors in uterine fibroid development: a systematic review. Journal of Obstetrics and Gynaecology.
3. Mayo Clinic. Q&A: Risk factors for uterine fibroids.
4. Mount Sinai. What are uterine fibroids and what are the treatment options?
5. ISUOG patient information series. Uterine fibroids (2023).
6. Cleveland Clinic. Foods to reduce uterine fibroids.
7. Science Feedback. Vitamin D and fibroids: more research needed.
8. PNAS (2022). Everyday-product chemicals and fibroid growth.
9. Northwestern University research summary (2022).

This guide is for educational purposes only and is not medical advice, diagnosis or treatment. Talk to a qualified healthcare provider about your symptoms and options.