Uterine fibroids are growths in or on the uterus. They are not cancer. Fibroids can grow on the inside of the uterus, within the muscle wall of the uterus, or on the outer surface of the uterus. They can change the shape of the uterus as they grow.

Over time, the size, shape, location, and symptoms of fibroids may change.

Your risk for uterine fibroids increases as you age, especially from your 30s and 40s through menopause. Most have mild or no symptoms. But fibroids can cause bad pain, bleeding, and other problems.

The cause of fibroids is not known. But the hormones estrogen and progesterone can make them grow. Your body makes the highest levels of these hormones during the years you have periods. After menopause, when hormone levels decrease, fibroids often shrink or disappear.

Uterine fibroids usually need treatment when they cause:

• Anemia from heavy fibroid bleeding.
• Ongoing low back pain or a feeling of pressure in the lower belly.
• Trouble getting pregnant.
• Problems during pregnancy, such as miscarriage or preterm labor.
• Problems with the urinary tract or bowels.

Depending on the reasons you need treatment, one type of treatment may work better for you than another.

Myomectomy, which is surgery to take out just the fibroids, can decrease pain and other symptoms. It allows the uterus to be left in place.

Surgery can be done:

• Through the vagina and into the uterus using a lighted scope.
• Through a large cut in the belly.
• Through several small cuts in the belly using a lighted scope. This is called a laparoscopy.

How well myomectomy works

Taking out fibroids decreases menstrual bleeding and pelvic pain from fibroids. It may improve your chances of getting pregnant.

Chance that fibroids can come back

Fibroids tend to grow back, unless you have your uterus taken out. New fibroids also can grow. Fibroids can return when surgery is done to take out just the fibroids. They are more likely to come back if you had many fibroids. Talk to your doctor about if your fibroids may be more likely to grow back.

Risks of myomectomy

Cutting into the uterine wall during this surgery may cause problems in a future pregnancy. During labor, the uterus might not work like it should. This could mean that you would need a cesarean delivery.

Hysterectomy, which is surgery to take out the uterus, cures fibroids. But it's usually the last choice for treatment, because it's major surgery and it makes you unable to get pregnant. Having this surgery means that you will no longer have menstrual periods. The ovaries and fallopian tubes also may be taken out at the same time.

This surgery gives most people relief from their symptoms.

Talk to your doctor if you are not close to menopause (about age 50) and you're thinking about having your uterus and ovaries taken out. Having your ovaries removed may raise your risk for some long-term health problems, such as heart disease. These risks may be higher for people who are younger. The benefits of keeping your ovaries reduce as you age.

How well hysterectomy works

This surgery:

• Relieves pain from fibroids.
• Stops anemia from heavy and irregular vaginal bleeding.
• May fix leakage of urine if it was caused by fibroids.

Chance that fibroids can come back

Fibroids do not grow back after your uterus is taken out.

Risks of hysterectomy

Most people don't have problems from this surgery. But possible long-term problems include:

• Scar tissue that can cause pelvic pain.
• Early menopause caused by a slow, early decline of the ovaries.
• Weakness of the pelvic muscles and ligaments that support the vagina, bladder, and rectum. This can cause bladder or bowel problems.
• Trouble urinating.
• Pelvic pain. If you had pain before surgery, taking out your uterus may not relieve your pain.

Most people do not have problems after either surgery to treat fibroids. But problems can include:

• Rare problems, such as:
  • Infection.
  • Blood clots in the legs or lungs.
  • Scar tissue (also called adhesions).
  • Injury to other organs, such as the bladder or bowel.
  • A collection of blood at the surgical site.
  • Continued heavy bleeding.
  • Problems from the medicine used to make you sleep during surgery.
  • Severe blood loss that causes you to need more blood (transfusion).

Your doctor might suggest that you have surgery to take out just your fibroids if:

• You want to treat your fibroids in a way that may make it possible for you to get pregnant later.

Your doctor might suggest that you have surgery to remove your uterus if:

• You have bad symptoms and:
  • Other treatments have not helped.
  • You're not near menopause.
  • You don't plan to get pregnant.
  • There is a risk of cancer.