What Happens If Fibroids Go Untreated?

Your fertility issues could be tied to the presence of undiagnosed fibroids.

Fibroids are tumors made of smooth muscle that can grow in the walls of a woman’s uterus. It’s estimated that about one in five women will develop fibroids while they are in the childbearing age range. By age 50, almost half of all women find themselves dealing with fibroids. Occurrences of fibroid tumors are rare in women younger than 20. 

Some fibroids may be small enough that they can only be viewed by a microscope. Others can grow large enough to fill your uterus. Fibroids of varying sizes in different places around the uterus may develop at the same time. The types of uterine fibroids are:

Intramural fibroids 

These fibroids grow in the myometrial wall, or muscle wall, of the uterus. 

Submucosal fibroids 

These fibroids grow in the submucosal area, found under the uterus lining. 

Subserosal fibroids  

These fibroids occur outside the uterus lining.

Pedunculated fibroids 

These fibroids grow on a long stalk in or outside of the uterus.

Fibroids typically grow at different rates, even when you have more than one. It’s rare for fibroids to become cancerous, though they can cause symptoms that can be disruptive to your daily life. Some of the most common signs women experience when they have fibroids include:

• Disruptions in their menstrual cycle
• Vaginal period outside of the menstrual cycle
• Frequent urination
• Anemia
• Have a feeling of fullness or heaviness in the lower abdomen
• Feeling pain during intercourse
• Lower back pain
• Abdominal cramps
• Swollen uterus and abdomen
• Reproductive issues like miscarriages, early labor, or infertility

Some women do not know that they have fibroids until they receive a pelvic exam during a routine well-woman visit. Doctors often uncover fibroids during checkups for other medical problems. 

Fibroids are the most common in women between the ages of 30 and 40. Women of African ancestry are also more likely to develop fibroids than white women, and to experience them at a younger age. Other factors that can influence whether you are at risk for developing fibroids include:

• Having a family history of fibroids
• Carrying extra weight on your frame
• Eating foods like red meat and pork

You should see a doctor if you find yourself experiencing the more severe fibroid symptoms, like pain or heavy bleeding. Women can end up with complications including the growth of large fibroids. These are tumors that have twisted or started to break down. Your fertility issues could be tied to the presence of undiagnosed fibroids. 

Gynecologists often discover the presence of fibroids while conducting a pelvic exam. Your doctor may also decide that you should undergo one of these diagnostic tests to better understand what type of fibroids you have:

Ultrasound  

Ultrasounds emit soundwaves that form a picture of your uterus and other organs in the pelvis.

Hysteroscopy  

Doctors insert a hysteroscope through your vagina and cervix to obtain a clear view of any fibroids in your uterus. 

Hysterosalpingography 

Doctors rely on this x-ray test to detect any unusual changes in the size and shape of your fallopian tubes and uterus.

Sonohysterography 

After inserting fluids into your uterus, the doctor uses an ultrasound to get a clearer view of your uterine lining.

Laparoscopy 

Your doctor makes a small cut around your naval. They then insert a laparoscopy device inside to view fibroids on the outside of your uterus.

Doctors occasionally rely on imaging tests like magnetic resonance imaging (MRI) when tracking the growth of fibroids. 

You may not require treatment for your fibroids if: 

• Your fibroids are small
• Are causing no issues
• Appear when you are close to menopause

Some fibroids may be treatable through medications. These medications typically control the heavy bleeding and reduce the pain that you might experience during your period: 

• Birth control or other hormonal medication for heaving bleeding and pain during periods
• Progestin IUD for women whose tumors do not distort the uterus.
• Gonadotropin-releasing hormone (GnRH) agonists to stop your menstrual cycle and potentially reduce the size of your fibroids. They are usually prescribed before surgery.

Your doctor may recommend that you have surgery to remove your fibroids for the permanent relief of your symptoms. Surgery options to remove fibroids include:

Myomectomy 

Your surgeon removes any existing fibroids without removing your uterus. This makes it possible for you to carry a child. New fibroids could still grow in your uterus, making it necessary for you to have surgery in the future.

Hysterectomy 

Your surgeon removes the entire uterus and sometimes your ovaries, depending on your condition's severity. A hysterectomy is typically the last resort, used when your fibroids fail to respond to other treatment methods.