Fibroids
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Discover evidence-based insights on how uterine fibroids intersect with endometriosis and adenomyosis—key differences, symptoms, diagnosis, fertility impact, and treatment options—to support informed decisions and care for optimal outcomes.
Overview
Fibroids (uterine leiomyomas) are benign muscle tumors that can cause heavy or prolonged periods, clots, pelvic pressure, urinary frequency, constipation, and pain with sex. These symptoms often overlap with Endometriosis and Adenomyosis, and all three can coexist, which is why accurate mapping and planning matters. Understanding whether bleeding, pressure, or cyclical inflammatory pain is driving symptoms helps tailor care and protect fertility and quality of life.
Evaluation typically begins with a pelvic exam and targeted imaging. Ultrasound can identify size, number, and location; MRI refines mapping and helps distinguish fibroids from diffuse changes seen in Adenomyosis. Treatment depends on goals and fibroid type or location (submucosal, intramural, subserosal): options range from watchful waiting and medical therapies to uterus‑sparing procedures and hysterectomy. Readers learn which fibroids impact conception and pregnancy, how medicines affect bleeding and pain, and when to consider myomectomy versus alternatives like uterine artery embolization or focused ultrasound. Guidance also points to related topics such as Diagnostics & Imaging for test choices and Fertility & Reproductive Health for planning around conception or IVF.
How can I tell fibroids from endometriosis or adenomyosis?
Fibroids more often cause heavy bleeding, clots, and pressure or bulk symptoms, whereas endometriosis tends to cause cyclical inflammatory pain, pain with bowel/bladder, and deep pain with sex; adenomyosis commonly combines heavy bleeding with intense cramping and a diffusely tender, enlarged uterus. Imaging helps: Ultrasound shows well‑circumscribed fibroid nodules, while MRI can highlight junctional zone thickening typical of Adenomyosis and map endometriosis-related findings. See Diagnostics & Imaging for how results guide next steps.
Can fibroids and endometriosis occur together, and does that change treatment?
Yes—coexistence is not uncommon and can amplify pain and bleeding. Care planning should map both conditions so surgical or medical treatments address each; for example, myomectomy can relieve bleeding and pressure, while endometriosis may need separate pain-focused strategies or excision depending on severity.
Which fibroids affect fertility and when is myomectomy recommended?
Submucosal fibroids and intramural fibroids that distort the uterine cavity are most associated with reduced implantation, miscarriage, and pregnancy complications. Myomectomy is often considered for cavity‑distorting lesions or symptomatic intramural fibroids, particularly before conception or IVF & ART; subserosal or pedunculated (on a thin stalk) fibroids rarely affect fertility. See Fertility & Reproductive Health for individualized planning.
What non‑surgical treatments help, and how do they interact with endometriosis care?
Levonorgestrel IUDs, combined pills, and tranexamic acid reduce bleeding; GnRH agonists or oral antagonists can temporarily shrink fibroids and may also calm endometriosis symptoms. However, that is at the expense of menopausal symptoms in most cases. Uterine artery embolization and focused ultrasound reduce bulk but are less favored when future pregnancy is a priority and do not treat endometriosis itself; combining approaches may be needed. For pain strategies related to endometriosis, see Medical Management and Pain Relief.
Do fibroids turn into cancer and what are red flags?
Leiomyosarcoma is rare, and benign fibroids do not “become” cancer. Concerning signs include rapid growth after menopause, atypical features on imaging, or unexplained bleeding; advanced MRI assessment and specialist review help assess risk, and definitive diagnosis is by pathology after removal.
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