What Happens If Fibroids Go Untreated?

For the up to 80 percent of women who develop fibroids by the time they’re 50, a major question arises: What happens if these noncancerous growths in the uterus go untreated? But there’s no one-size-fits-all answer, with treatment decisions hinging on each woman’s experience with the gynecological condition.

Some women have only one fibroid, while others have many scattered throughout the uterus. Similarly, fibroids (also called myomas or leiomyomas) can be as small as a pinhead or as large as a grapefruit. This variability in the number and size of fibroids—along with the array of symptoms they can produce—guides gynecologists to either leave the growths alone or take steps to shrink or eradicate them.

“Often, nothing happens if fibroids go untreated,” says Jocelyn Carlo, M.D., a minimally invasive gynecologic surgeon at Jersey Shore University Medical Center. “It really depends on your symptoms and reproductive plans.”

Fibroid Risk Factors

Since the hormones estrogen and progesterone fuel fibroid growth, the fibroids will often shrink on their own as a woman approaches menopause and hormone levels diminish. As with any condition, however, leaving fibroids untreated can sometimes be risky. According to Dr. Carlo, these risks depend on:

• Fibroid size: “If we let fibroids get too big, they’re harder to treat,” she says. “And rapidly growing fibroids can be a sign that they’re cancerous.”
• Location in the uterus: Most grow in the wall of the uterus, but some fibroids develop inside and others on the outside of the organ. Some areas of growth can prove more problematic than others.
• Symptoms: Not all fibroids produce symptoms, but others wreak havoc on women’s day-to-day lives.

“The biggest risk is that symptoms will worsen,” says Erin Conway, M.D., an obstetrician/gynecologist at Riverview Medical Center. “It’s very rare for fibroids to be cancerous. But by leaving them untreated, you risk decreasing your quality of life due to the symptoms they produce.”

Symptoms to Watch For 

Indeed, fibroid symptoms can be mild or extreme. Which ones should women watch for?

• Heavy periods
• Excessive pain during periods
• Bleeding between periods
• Nausea or vomiting
• Abdominal swelling
• Pain in the back or belly
• Pelvic pressure
• Pain during sex
• Frequent urination
• Constipation

“Bladder and bowel symptoms aren’t something that many women would immediately connect to fibroids,” Dr. Conway says. “Painful sex is another one. A worsening of any symptoms, however, suggests their fibroids are growing and need to be evaluated.”

Fibroid Treatment Approaches 

Doctors use a variety of imaging tests to diagnose fibroids and their severity, including ultrasound and MRI. Treatment options rely on a woman’s age and childbearing plans and can include:

• Hormone-regulating medications such as birth control pills
• Ablation techniques that use laser, freezing or electric current to destroy the lining of the uterus
• Uterine artery embolization, which blocks the fibroids’ blood supply
• Surgical removal of the fibroid or uterus

“The first step is seeing a gynecologist and undergoing a pelvic exam to assess fibroid size and location,” Dr. Conway says. “Next, a pelvic ultrasound can tell us how many fibroids there are and how big they are. The ultrasound also gives us a method to track growth going forward.”

Next Steps & Resources:

• Meet our sources: Erin Conway, M.D.;Jocelyn Carlo, M.D.
• To make an appointment with a gynecologist near you, call 800-822-8905 or visit our website.
• Learn more about women’s health at Hackensack Meridian Health.

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.