Understanding Fibroids Symptoms and Treatment Options 

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Fibroids are a common yet often misunderstood condition affecting many women. In a recent episode of the “Healthful Woman” podcast, guest Dr. Michael Silverstein discusses fibroids with host Dr. Nathan Fox, shedding light on what they are, the symptoms they may cause, and, only when needed, the various treatment options available. At Carnegie Women’s Health, we aim to provide comprehensive care and understanding for women dealing with fibroids.

What are Fibroids?

Fibroids are benign muscle masses, described by Dr. Silverstein as “swirls of muscle” that form in the uterus. These growths are extremely common, with autopsy studies indicating that between a quarter and a third of women have fibroids, often without knowing it. Fibroids can vary in size, from as small as marbles to as large as watermelons. The vast majority are on the smaller end of the spectrum. Firbroids are frequently discovered incidentally during imaging tests, such as CT scans, when conducted for other health issues.

Symptoms of Fibroids

Fibroids can develop anywhere on the uterus, and their location and size largely determine whether they cause symptoms. Most fibroids are asymptomatic and go unnoticed. However, when symptoms do occur, they can significantly impact a woman’s quality of life. Common symptoms include:

Painful Periods

Particularly when fibroids are located inside the uterus.

Frequent Urination

If fibroids press against the bladder.

Constipation or Difficulty with Bowel Movements

If fibroids press against the rectum.

Dr. Fox explains that fibroids need to be large enough as well as strategically located in the uterus to cause noticeable problems. Smaller fibroids generally do not cause symptoms unless in more sensitive areas like the endometrium (lining of the uterus).

Despite the absence of symptoms, gynecologists should monitor fibroids regularly, as they can grow over time. This is important prior to and during pregnancy, as fibroids thrive tend to grow more rapidly when exposed to the increased estrogen and blood flow that are associated with pregnancy.

Treating Fibroids

Treatment for fibroids is usually reserved for those experiencing severe symptoms. Dr. Silverstein highlights two primary concerns that necessitate treatment: severe heavy bleeding leading to anemia and debilitating menstrual pain. While other causes of these symptoms should be ruled out first, treating fibroids can be necessary.

The first line of treatment typically involves stabilizing hormones using hormonal contraceptives. These medications help thin the uterine lining and stabilize estrogen levels, frequently slowing fibroid growth and alleviating symptoms.

For women planning conception, the pregnancy itself most often provides temporary relief from menstrual pain, provided the fibroids are not too large or in a disruptive location. Dr. Silverstein states, “Surgery remains the ultimate cure.”

Surgical Options

Surgery remains the definitive treatment for fibroids, particularly for those who do not wish to have children in the future. Options include:


Complete removal of the uterus, effectively curing fibroids. This surgery has no impact on hormones, and is not associated with menopause.


Removal of fibroids while preserving the uterus. This procedure (myomectomy) is frequently associated with a greater blood loss than hysterectomy, since it cuts into the muscle of the uterus. These surgeries may result in scar tissue formation, potentially causing pelvic pain.


When fibroids grow into the cavity of the uterus (submucosal myomas), a less intrusive option is hysteroscopic resection. In the operating room, a camera is inserted through the cervix and instruments passed through the camera port can be used to shave or carve out fibroids. This modality frequently results in improvements in bleeding and fertility issues.

Learn More

At Carnegie Women’s Health, we are committed to providing personalized and effective care for women with fibroids. Understanding the nature of fibroids and the available treatment options empowers our patients to make informed decisions about their health. Contact us today through our online contact form to schedule an appointment.

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Carnegie Women's Health

At Carnegie Women’s Health, we’re more than just a gynecological practice. We’re partnered with some of the most experienced and award-winning obstetricians and maternal fetal medicine specialists in the field of women’s health.

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