The cause of myomas is not clear, but risk factors include a family history of myoma, obesity, and age. More than half of all people with a uterus will experience a myoma by age 50.
This article offers an overview of myomas, including the most common symptoms, risk factors, and treatment options. It will help you to know more about whether to see a healthcare provider.
Types of Myoma
Myomas are categorized by where they are located, how big they are, and the symptoms that they may cause.
Each person’s experience with myomas will look and feel different. It’s possible to have just one myoma or several. They can range in size from as small as a pea to as large as a melon. Myomas can be located inside the uterus or on its outer surface. They may grow quickly or slowly.
The different types of myomas include:
Intramural myomas are the most common type. They are located within the wall of the uterus. Subserosal myomas grow on the outside of the uterine wall and may put pressure on nearby organs (like the bladder) or distort the shape of the uterus if they grow large enough. Pedunculated myomas develop a stalk or a stem that attaches them to the uterus. The stem may become twisted as the tumors grow away, causing severe pain. Submucosal myomas are found just under the lining of the uterus and can push into the uterine cavity. They are not as common as the other types and can cause heavy bleeding.
In general, a large myoma is considered to be 10 centimeters (cm) or more in diameter. For size reference:
Small myomas: Up to 5 cm across (about the size of a seed to a cherry)Medium myomas: Up to 10 cm (roughly the size of a plum or an orange)Large myomas: 10 cm or larger (about as big as a large grapefruit or a small melon)
Myoma Symptoms
The symptoms of myomas depend on how big the tumors are and where they are located. People with myomas may have symptoms that come and go. The symptoms may get worse during their menstrual cycle.
For some people, myoma symptoms are severe and cause constant pain. Others do not experience any symptoms.
Possible symptoms of a myoma include:
Heavy, painful, or prolonged periods Bleeding between periods Pelvic pain and abdominal pressure A feeling of fullness in the lower abdomen Swelling or enlargement of the lower abdomen Constipation or diarrhea A frequent need to urinate or trouble urinating Pain during sex Lower back pain Reproductive issues (such as trouble getting pregnant) Fatigue and weakness
In most cases, a myoma is not life-threatening. A myoma can cause death in rare cases, such as those involving heavy blood loss or that lead to obstruction in other organs. It’s also a top cause of hysterectomy surgeries, which may lead to their own risks and complications.
Causes of Myoma
Myomas are likely associated with hormone activity but experts aren’t exactly sure what causes them. High levels of estrogen and progesterone (hormones produced by the ovaries) may stimulate the growth of myomas, which tend to shrink when hormone levels go down after menopause.
There are certain things that make a person more likely to get a myoma in their lifetime. These risk factors for myomas include:
Family history: You’re more likely to get a myoma if you have a family member who has them. Obesity: People who are overweight or who have high blood pressure might be at a higher risk of developing myomas. Age: Myomas become more common as people age, appearing most often in people in their 30s, 40s, and 50s. After menopause, myomas tend to get smaller. Diet: Eating a diet high in red meat might be linked with developing myomas, as is having a vitamin D deficiency.
Myoma Diagnosis
If your healthcare provider thinks you have a myoma, there are a few steps needed to confirm the diagnosis. They will start by asking you about your health, including your family’s health history.
They will also want to know what your menstrual cycles have been like, and will have you describe any symptoms you experience.
Medical tests that your healthcare provider might use to diagnose fibroids include:
Pelvic examination to feel for any abnormal growths Ultrasound or transvaginal ultrasound to get a clear view of the uterus Magnetic resonance imaging (MRI) to look at images of the uterus and other pelvic organs
Treating a Myoma
A myoma that’s not causing any pain or other symptoms doesn’t necessarily need to be treated. However, if your symptoms are severe or if the myoma is large and has the potential to cause damage to surrounding organs, your healthcare provider will help you to decide on the best treatment.
There are several choices for treating myomas, including medications, noninvasive procedures, surgery, or a combination of therapies.
You and your healthcare provider will choose a treatment based on several factors, including:
How severe your symptoms areThe size and location of the myoma(s)Whether you may want to become pregnant in the futureYour age and how close you are to menopause
Medication
There are several over-the-counter (OTC) and prescription medications that can be used to treat myomas. Some options only treat the symptoms of a myoma while others affect the growth itself.
Medications that your healthcare provider might suggest include:
Over-the-counter pain medications, such as Advil (ibuprofen) or Tylenol (acetaminophen), if you have mild pain and discomfort from fibroids. Iron supplements if you have depleted iron levels from heavy bleeding. Birth control methods such as contraceptive pills, intrauterine devices, and Depo-Provera can help control heavy menstrual bleeding. GnRH agonists (hormone-stimulating medications) to temporarily shrink myomas. If surgery to remove the fibroids is planned, your healthcare provider might want you to take them to reduce the size of the tumors so they are easier to take out. MyFembree, which is a recently approved combination medication of GnRH, a synthetic estrogen, and a type of progestin to help stop heavy menstrual bleeding.
Surgical Procedures
Depending on the size, location, and number of myomas you have, your healthcare provider might suggest that you have surgery to remove the fibroids.
Less invasive surgical options include:
Laparoscopy, a surgical procedure that uses small incisions and an instrument with a tiny camera to remove myomas that are easily accessible Uterine fibroid embolization (UFE), a radiology procedure that uses injections to cause myomas to shrink and sometimes die MRI-guided ultrasound surgery, a technique that uses ultrasound waves to shrink or remove myomas
In more severe cases, you might need to consider a more invasive type of surgery. These options include:
Hysterectomy is a surgery to completely remove the uterus. While this will get rid of the fibroids, it also means that you will no longer have the option of getting pregnant in the future. Myomectomy is a surgical procedure that requires a large incision in the abdomen to remove the fibroids without removing the uterus. While a person still has their uterus and might be able to get pregnant in the future, there is also a risk that the fibroids will come back.
Home Remedies
While there are no home remedies that directly treat fibroids, you might find that some of them help you to cope with fibroid symptoms. Talk to your healthcare provider about any complementary therapies they would approve for you to try.
Types of alternative therapies you might want to discuss with your healthcare provider include:
Acupuncture Yoga Massage Traditional Chinese medicine Heating pads
There are also some lifestyle changes that might help you cope more effectively with fibroid symptoms and can improve your overall health and wellness, including:
Dietary changesExercisingManaging your stress levelsLosing weight if you are overweight/obese
Prognosis
Myomas are common, but each person’s experience with them will be different. Some people are able to effectively manage the condition with treatment that reduces their symptoms and improves their quality of life.
Myomas that are not treated can cause complications—even if you do not have symptoms.The potential complications of myomas mostly pertain to fertility, pregnancy, and childbirth and include:
Fertility issuesPregnancy complications (such as miscarriage or early labor)The need for cesarean delivery (or C-section)
A Word From Verywell
If you’ve been diagnosed with a myoma, be sure to tell your healthcare provider about symptoms that affect your life. They’ll help you to determine which treatments are the best choice.
