Awareness

Millions of women silently suffer from a treatable condition that is often overlooked, misdiagnosed, or dismissed until it causes life-altering consequences.

Who Gets Fibroids

Fibroids are extremely common, with estimates suggesting that up to 70 to 80 percent of women will develop them by age 50, often without noticeable symptoms. They are most commonly diagnosed between the ages of 30 and 49, although they can occur at any time during the reproductive years.

Several factors are associated with a higher likelihood of developing fibroids, including:

• Family history and genetic predisposition

• Higher body weight and obesity

• Early onset of menstruation

• Vitamin D deficiency

• African-American race, with an earlier onset and often more severe disease

Pregnancy is associated with a reduced risk of developing fibroids. Women who have given birth are less likely to develop them, and this protective effect appears to increase with each additional pregnancy.

Impact

• Fibroids are the leading cause of hysterectomy worldwide.

• They affect millions of women’s daily lives, causing chronic pain, missed work, emotional strain, and fertility challenges.

• About 26 million women in the U.S. have fibroids

• 24% report fibroids affect career potential; 28% reported missing work due to symptoms.

• Despite prevalence, fibroids remain under-discussed, under-researched, and under-funded.

1. Intramural Fibroids

• Location: Develop within the muscular wall of the uterus
  Key point: Most common type of fibroid
  Symptoms: Heavy menstrual bleeding, pelvic pain, and pressure, especially as they enlarge

2. Submucosal Fibroids

• Location: Form just beneath the uterine lining (endometrium) and may extend into the uterine cavity
  Key point: Even small fibroids can cause significant symptoms
  Symptoms: Heavy or prolonged menstrual bleeding, fertility challenges, and increased risk of miscarriage

3. Subserosal Fibroids

• Location: Grow on the outer surface of the uterus and expand outward
  Key point: Less likely to affect menstrual bleeding
  Symptoms: Pressure on nearby organs, leading to frequent urination, constipation, or lower back pain

4. Pedunculated Fibroids

• Location: Attached to the uterus by a thin stalk, either inside or outside the uterus
  Key point: Risk of torsion (twisting), which can cause acute pain
  Symptoms: Sudden or localized pain, as well as pressure symptoms depending on size and position

5. Cervical Fibroids

• Location: Develop in the cervix, the lower portion of the uterus that connects to the vagina
  Key point: Relatively rare
  Symptoms: Urinary symptoms, pain during intercourse, or complications with labor and delivery

6. Calcified Fibroids

• Definition: Fibroids that have undergone degeneration and developed calcium deposits
  Key point: Typically represent a later stage of fibroid life cycle and are no longer actively growing
  Symptoms: Often asymptomatic, but may cause discomfort or pressure if large or poorly positioned

1. Watchful Waiting (Monitoring)

• For women with no or mild symptoms.

• Fibroids may shrink after menopause.

• Regular ultrasounds and check-ups.
  
  

2. Medications

Hormonal treatments help control symptoms, but they do not cure fibroids.

• GnRH agonists (e.g., Lupron) → can shrink fibroids temporarily and are often used before surgery.

• GnRH antagonists (newer oral medications):

  • Relugolix combination therapy (e.g., Myfembree, Ryeqo) → oral GnRH antagonist combined with estrogen and progestin; helps reduce heavy menstrual bleeding and other fibroid-related symptoms.

  • Linzagolix (e.g., Yselty) → oral GnRH antagonist used for moderate to severe fibroid symptoms; reduces heavy bleeding and can be used with or without add-back hormone therapy.

  • Elagolix combination therapy (e.g., Oriahnn) → helps reduce heavy menstrual bleeding associated with fibroids.

• Progestin-releasing IUD → reduces heavy bleeding but does not shrink fibroids.

• Oral contraceptives → help control bleeding but do not reduce fibroid size.

• Tranexamic acid (e.g., Lysteda) → non-hormonal medication taken during menstruation that helps reduce heavy bleeding.

• Iron supplements → used to treat or prevent anemia caused by heavy menstrual bleeding.

3. Minimally Invasive Procedures

• Uterine artery embolization, UAE or UFE → blocks blood flow to fibroids, causing them to shrink.

• MRI-guided focused ultrasound surgery, FUS → noninvasive treatment that uses high-intensity ultrasound to destroy fibroid tissue without an incision.

• Radiofrequency ablation → uses heat energy to destroy fibroid tissue and shrink fibroids over time. This includes laparoscopic radiofrequency ablation, such as Acessa, and transcervical radiofrequency ablation, TCRF, such as Sonata, which is performed through the cervix without abdominal incisions.
  
  

4. Surgical Options

1. Myomectomy (removal of fibroids, uterus preserved):

• Hysteroscopic → through the vagina and cervix, for submucosal fibroids.

• Laparoscopic or robotic → through small abdominal incisions, for selected fibroids depending on size, number, and location.

• Abdominal → open surgery for large, multiple, or complex fibroids.

Important: Fibroids can recur after myomectomy.

2. Hysterectomy (removal of uterus):

• Definitive treatment for fibroids, with no recurrence.

• Ends the ability to carry a pregnancy.

• Can be performed vaginally, laparoscopically, robotically, or abdominally, depending on the case.
  
  

Alternative / Complementary Approaches
Not cures, but may help with symptoms, inflammation, or overall health. Effectiveness varies, and evidence is limited or mixed.

1. Lifestyle & Natural Supports

• Dietary changes → higher intake of fruits, vegetables, and whole grains is associated with lower fibroid risk; high intake of red meat and processed foods is associated with higher risk.

• Exercise and weight management → may help regulate estrogen levels and reduce overall risk, though direct impact on existing fibroids is not clearly established.

• Stress reduction → yoga, meditation, and breathing practices may improve overall well-being and symptom perception, but do not directly treat fibroids.
  
  

2. Supplements & Herbal Supports (consult a doctor before use)

• Green tea extract (EGCG) → some clinical evidence suggests a reduction in fibroid volume and improvement in symptoms, but data is still limited, and dosing is not standardized.

• Vitamin D → deficiency is associated with higher fibroid risk; supplementation may have a protective role, though evidence for shrinking existing fibroids is not conclusive.

• Turmeric or curcumin → anti-inflammatory properties; evidence is mostly preclinical and not sufficient to confirm clinical benefit for fibroids.

• Milk thistle → supports liver function; no strong clinical evidence for fibroid treatment.

• Omega-3 fatty acids → anti-inflammatory effects; may support overall health, but no direct evidence for fibroid reduction.
  
  

3. Traditional / Integrative Medicine

• Acupuncture → may help reduce pelvic pain and improve quality of life; does not shrink fibroids.

• Chinese herbal medicine → used for symptom management and menstrual regulation; evidence varies, and formulations are not standardized.

• Ayurveda → includes herbal therapies and lifestyle approaches aimed at balance; no strong clinical evidence for fibroid reduction.