Fibroid (Uterine Tumor)

Fibroids are benign growths of the uterus and are commonly known as uterine growths. Smaller fibroids are harmless and rarely require medical attention. If there are symptoms, however, a doctor’s visit is essential to keep fibroids under control and, if necessary, to remove them.

Fibroid (Uterine Tumor)

What is a fibroid?

A fibroid is a benign growth that slowly grows in the muscular wall of the uterus. Fibroids do not metastasize and can grow or bulge in the wall of the uterus. See sciencedict for Introduction to Kleine-Levin Syndrome.

A smaller fibroid is about the size of a pea. The size of an orange is also not uncommon. In extreme cases, the size of a fibroid can mimic pregnancy. A fibroid develops from muscle fibers and enlarges under the influence of hormones.

Fibroids affect more than 20% of all women. It most commonly affects women between the ages of 35 and 55. In less than one percent of all cases, a fibroid can be malignant.


Why a fibroid develops cannot be clearly defined. It has been proven that fibroids can be partially inherited. It is also considered certain that the sex hormone estradiol plays a role in the development of fibroids.

Fibroids do not appear in girls before puberty. They only grow when the body has increased estrogen levels. This is the case, for example, with pregnancy or when taking hormone preparations.

During menopause, estrogen levels drop and the fibroids shrink. Fibroids no longer appear in women after menopause.

Symptoms, Ailments & Signs

Fibroids cause different symptoms depending on their size and location. If they are still small, they often do not cause any problems and are therefore only discovered by chance. The most common symptom is pain, which can increase to extremely strong, labor-like cramps, usually during the menstrual phase.

Depending on their location, fibroids can put pressure on nerves, which can cause pain that radiates down the legs or back. During physical exertion or during sexual intercourse, an unpleasant painful pressure can be felt. Large fibroids can constrict the bladder or bowel and cause increased urination or constipation.

It rarely happens that the urethra is completely squeezed and urination is no longer possible. This would require immediate medical attention. Extremely large fibroids can increase abdominal girth. Bleeding disorders also occur. The period can be unusually heavy because the bleeding vessels are prevented from closing up quickly enough by the tumors.

Menstruation often lasts longer than usual. The amount of blood excreted is significantly increased, sometimes it comes off like a gush. Due to the increased blood loss, the blood iron level drops and iron deficiency develops. Typical signs of this are tiredness, listlessness, tachycardia, pale skin, brittle nails and hair loss.

Diagnosis & History

A smaller fibroid often goes unnoticed and is only discovered by chance during routine examinations. If you experience menstrual cramps or spotting or continuous bleeding, you should see a doctor.

This will first carry out a gynecological examination. A fibroid can often be felt by touch. Ultrasound or a cell examination, in which a smear is taken, will bring certainty. If a hysteroscopy is performed, a special endoscope is inserted through the vagina into the uterus. The uterus is filled with gas and illuminated.

A smaller fibroid causes no symptoms. If the fibroid is larger, it can cause pain or complications with menstrual bleeding. Larger fibroids change the shape of the uterus. In pregnant women, the fetus is pushed into unusual positions. It can lead to miscarriage. A fibroid can also put pressure on the rectum and bladder.


A uterine tumor can cause a variety of symptoms. First and foremost, women suffer from menstrual disorders and thus also from relatively severe menstrual pain. These can also lead to mood swings and thus significantly reduce the quality of life of those affected. Dizziness and pallor also occur.

Those affected appear exhausted and weak and also suffer from circulatory problems. It is not uncommon for a loss of consciousness to occur. In pregnant women in particular, a uterine tumor can be a serious complication and, in the worst case, lead to a miscarriage. In most cases, no specific treatment is necessary for a uterine tumor. However, those affected are dependent on regular visits and checks by a gynecologist.

In some cases, the uterine tumor must also be surgically removed. However, there are no complications and the patient’s life expectancy is not reduced. Even after the treatment, a uterine tumor can reoccur. In many cases, the fibroid can also be treated with medication.

When should you go to the doctor?

Disorders and irregularities in menstrual bleeding in a sexually mature woman should be clarified by a doctor. If bleeding or spotting occurs outside of the normal menstrual period, you should see a doctor for a check-up. If there is discomfort during intercourse, there is cause for concern. Pain, a feeling of pressure or a pulling sensation in the abdomen must be examined and treated. Disorders of the digestive tract, diarrhea or constipation are signs of health problems. A doctor’s visit is necessary as soon as the symptoms persist for a long time or if they increase in scope and intensity.

In the case of swelling in the abdomen, palpable lumps or changes in the appearance of the skin, the symptoms should be presented to a doctor. If there is a decrease in general performance, fatigue or inner weakness, a doctor is needed. Heart palpitations or irregular heart rhythms should be discussed with a doctor. Feelings of anxiety, inner insecurity, sleep disorders or changes in urination are indications that should be monitored further.

If they occur constantly, it is advisable to consult a doctor. A pale appearance, sudden hair loss or irregularities in the fingernails or toenails should be checked by a doctor. The cause is determined in various tests so that treatment can be initiated to alleviate the symptoms.

Treatment & Therapy

A small fibroid does not necessarily have to be treated. Regular check-ups by the gynecologist are sufficient. A smaller fibroid can be removed during a hysteroscopy. For this rather unpleasant procedure, the patient receives local anesthesia or anesthesia.

Larger fibroids require surgical removal through an incision in the abdomen. If several fibroids have formed, the entire uterus often has to be removed. A larger fibroid can be made to shrink by administering hormones. After that, surgical removal is possible, whereby the uterus can be preserved.

A new method is causing a sensation in special clinics. This involves shrinking the fibroid by blocking the surrounding blood vessels. This is done by injection. The type of therapy can depend on various factors. These include the size and location of the growth, the symptoms caused or the age of the patient and the associated status of family planning.

Therapy usually aims to preserve the uterus. However, if the myoma is proliferating and causing a lot of pain, a hysterectomy is often unavoidable.

New drug treatment options

The hormone treatment with GnRH analogues, which has been tried and tested for many years, is now being supplemented by the new therapy against symptomatic uterine fibroids with the active ingredient ulipristal acetate. It is taken in tablet form. The indication is the pre-operative treatment of moderate and severe symptoms – such as lower abdominal pain, exhaustion or pain – as well as long-term treatment. One tablet is taken daily for a period of up to twelve weeks. If necessary, the treatment can be repeated, there is no time limit for this.

The active ingredient ulipristal acetate reduces the volume of the fibroids and at the same time the associated symptoms. This means that surgery can often be avoided. The long-term therapy mentioned is ideal for women who are still approaching the menopause and who want to get through the menopause without surgery. Once the menopause is over, the risk of fibroids also disappears. These stop growing due to the reduction in the hormones progesterone and estrogen. Long-term therapy is also suitable for women who complain of severe symptoms, who want to control them effectively and permanently and who have not yet completed their family planning.

The mode of action of the tablet

Ulipristal acetate is one of the selective progesterone receptor modulators, so the active ingredient is used for causal drug therapy. This has a direct influence on the cause of the disease. Not only are the symptoms alleviated, it is also about bringing about healing. The activity of progesterone, a hormone that occurs naturally in the body, is inhibited by ulipristal acetate. However, the preparation itself is not a hormone, which means that it is well tolerated and leads to permanent and rapid relief of symptoms. The bleeding is reduced or stopped completely, the fibroids become smaller and the pain subsides.

Outlook & Forecast

The course of the disease depends on the size and location of the tumor. Affected patients should go to the gynecologist for regular check-ups in order to avoid complications. This also applies if fibroids show no symptoms. Urinary tract infections and pain during urination can occur if the tumor presses on the bladder.

Functional disorders of the bladder, intestines and kidneys can also occur if the tumor presses on the organs. Heavy or prolonged menstrual bleeding often leads to anemia as a result of iron deficiency. There are also problems with fertility and during pregnancy. In principle, however, the myoma does not represent an obstacle to pregnancy. Infertility only occurs in a few cases, for example if the tumor is in front of a fallopian tube.

During pregnancy, the fibroid can cause various problems. As an estrogen-dependent tumor, a fibroid grows faster during pregnancy because the body then produces more sex hormones. Due to the increasing size and position, the fibroid can cause pain. Anomalies in the position of the unborn child can also occur or even block the birth canal. Preterm labor can also occur. A fibroid has been shown to increase premature birth and miscarriage rates. If the tumor grows in the uterine cavity or under the lining of the uterus, miscarriage and ectopic pregnancy can occur.


There are no known preventive measures against a fibroid. Women between the ages of 35 and 55 should have check-ups with their gynecologist every six months. A fibroid can be detected at an early stage by palpation and ultrasound.

In this way, complications can be eliminated that can arise if the fibroid is detected too late. If a fibroid has been removed, the patient is not immune to this growth. A fibroid can recur at any time. Women who have already had problems with a fibroid and consider their family planning to be over should consider having the uterus removed. A fibroid only grows in the muscles of the uterus and can therefore no longer occur in patients who have undergone surgery.


A fibroid is usually not treated because it is small and does not cause any acute symptoms. Instead, doctors choose to monitor the benign tumor as part of follow-up care. This happens for two reasons: On the one hand, the fibroid can grow and thereby disrupt the function of other organs. On the other hand, scientists assume that the myoma degenerates in a fraction of the cases and then tends to form metastases.

Follow-up care therefore serves to avoid complications. Doctor and patient agree on a quarterly or semi-annual rhythm. In addition to a palpation examination, an ultrasound examination is also carried out. Doctors believe that diagnosing a change early has the best chance of a cure. Therefore, the scheduled examinations must be followed conscientiously.

If the doctor and patient decide to remove a fibroid, follow-up care is also indicated afterwards. This aims to eliminate any symptoms that may follow from the procedure and to prevent the tumor from recurring. Because the uterine tumor can form again under certain circumstances.

The extent of the progress control corresponds to the descriptions above. Participation in a rehabilitation measure immediately after an operation may be necessary. In addition, patients should of course see their doctor immediately if acute problems arise.

You can do that yourself

Since fibroids usually do not pose a health risk, symptoms can be alleviated by self-treatment. Depending on the severity and duration of the symptoms, a prompt medical consultation is advisable. In the case of existing fibroids, a regular gynecological examination should be carried out.

Fibroids usually cause more severe symptoms around the time of menstrual bleeding and a few days before. In order to counteract spasmodic pain, it is recommended to avoid alcohol and salty foods – as they remove water from the body – and to compensate for increased fluid intake beforehand. This also counteracts frequently occurring circulatory problems. Coffee and dairy products also put a strain on the body and should be reduced. Some women are iron deficient due to fibroids. Eating green leafy vegetables (chard, kale, nettle, herbs) or taking a ready-made preparation like the ones available in pharmacies can help hereis available. It was also possible to determine that the symptoms were alleviated by taking magnesium. Nuts, avocados, algae and legumes provide important vitamin B, which also works against muscle cramps.

In order to support the body in the healing process, stress avoidance and light exercise are the top priorities. Alternative healing methods such as acupuncture, acupressure or aromatherapy can also help. The local application of heat with heating pads or warm compresses relaxes the musculature of the uterus and ensures holistic relaxation. St. John’s wort oil can be added to a bath.