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What Happens to Untreated Fibroids?

Uterine fibroids do not always require treatment, especially if they are small, do not cause any symptoms, or affect fertility. Sometimes untreated fibroids can go away on their own when estrogen levels decrease, such as during menopause or from taking certain medications.
Uterine fibroids do not always require treatment, especially if they are small, do not cause any symptoms, or affect fertility. Sometimes untreated fibroids can go away on their own when estrogen levels decrease, such as during menopause or from taking certain medications.

Uterine fibroids, also called uterine leiomyomas or myomas, are benign (noncancerous) tumors that form in the muscle of the uterus. Fibroids can form inside or outside of the uterus. 

In some cases, uterine fibroids may not need treatment. Fibroids that are small, do not cause symptoms, and are not expected to impact fertility may not need to be treated.

Untreated fibroids may go away on their own if estrogen levels in the body decrease. This usually happens during menopause, but some medications, such as gonadotropin-releasing hormone (GnRH) agonists or antagonists, may also lower estrogen levels. 

Uterine fibroids that cause problematic symptoms are usually treated with medications or surgery. 

Medications used to treat uterine fibroids include: 

  • Iron and vitamins for women who are anemic due to heavy periods
  • Nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn) for menstrual cramps
  • Hormonal birth control to reduce bleeding, cramps, and pain during menstrual periods and to correct anemia 
  • Antifibrinolytic medicines such as tranexamic acid (Lysteda) to slow menstrual bleeding quickly 
  • Progesterone receptor modulators to stop heavy menstrual bleeding and cause some fibroid shrinkage
  • Gonadotropin-releasing hormone analogues that cause the ovaries to temporarily stop producing estrogen and progesterone and reduce heavy menstrual bleeding

Surgery used to treat uterine fibroids include: 

What Are Symptoms of Fibroids?

Uterine fibroids may not cause any symptoms. When symptoms occur, they may include:

  • Heavy menstrual bleeding
  • Painful menstrual cramps
  • Pain, pressure, or a feeling of fullness in the abdomen
  • Abdominal swelling
  • Urinary frequency
  • Lower back pain
  • Fatigue from heavy periods
  • Painful sexual intercourse 
  • Constipation
  • Infertility

What Causes Fibroids?

The cause of uterine fibroids is unknown. The female hormones estrogen and progesterone may be associated with the development of fibroids. When estrogen levels are elevated, fibroids tend to grow, and when estrogen levels are low, fibroids may shrink. 

Other factors that may impact the development of uterine fibroids include: 

  • Genetics: fibroids tend to run in families
  • Being overweight or obese
  • Consumption of red meat, alcohol, and caffeine is associated with an increased risk of fibroids

How Are Fibroids Diagnosed?

Uterine fibroids are diagnosed with a patient history and a pelvic examination. Tests used to confirm uterine fibroids or to rule out other conditions include:

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References
https://www.uptodate.com/contents/uterine-fibroids-the-basics?search=fibroids&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1

https://www.uptodate.com/contents/uterine-fibroids-beyond-the-basics?search=fibroids&topicRef=15421&source=see_link#H7