Uterine Fibroids
Uterine fibroids are noncancerous growths of the uterus that can cause heavy bleeding, pelvic pressure, pain, or fertility challenges. Fibroids may be discovered during a routine exam or after symptoms begin to interfere with daily life.
At The Medical Group of New Jersey, our Ob/Gyn team offers comprehensive evaluation and a full range of treatment options, from medication to minimally invasive surgery, based on your symptoms, fertility goals, and overall health.
Symptom Onset & Initial Evaluation
Fibroid symptoms can appear gradually or progress over time. Some patients have no symptoms at all, while others experience significant changes in bleeding patterns, pelvic comfort, or bladder function.
During your initial visit at The Medical Group of New Jersey, your clinician will carefully explore your symptoms and how they affect your quality of life.
Common Symptoms
- Heavy or prolonged menstrual bleeding
- Pelvic pressure or fullness
- Increased urinary frequency or constipation
- Lower back pain
- Pain during intercourse
- Difficulty becoming pregnant or carrying a pregnancy
Evaluation
Your initial evaluation may include:
- Detailed menstrual and reproductive history
- Review of prior imaging or treatments
- Discussion of fertility plans or pregnancy history
- Pelvic examination to assess uterine size and tenderness
These steps help determine whether fibroids are the likely source of your symptoms.
Diagnosis & Risk Assessment
Diagnosis focuses on identifying the location, size, and number of fibroids, as well as ruling out other causes of abnormal bleeding or pelvic pain. Tests used to diagnose fibroids include:
Pelvic Ultrasound
A pelvic ultrasound is often the first-line imaging test. It is used to:
- Visualize fibroid size and shape
- Determine whether fibroids are submucosal, intramural, or subserosal
- Assess ovarian health and surrounding structures
Saline Infusion Sonogram (SIS)
A SIS provides a more detailed view of the uterine cavity to identify fibroids or polyps that affect bleeding and fertility.
MRI (when indicated)
An MRI is often used for:
- Evaluating complex cases
- Surgical planning
- Very large uteri
- Suspected adenomyosis
Laboratory Evaluation
Blood tests may be performed to evaluate:
- Blood count for anemia
- Thyroid function
- Pregnancy testing if needed
Treatment & Management
Your treatment plan will depend on your symptoms, fibroid size and location, and whether you want a future pregnancy. Many patients benefit from a combination of lifestyle strategies, medications, and procedures tailored to their goals.
Lifestyle & Symptom Support
To ease symptoms while planning treatment, your clinician may recommend:
- Iron supplementation for anemia
- Heat therapy and exercise for pelvic discomfort
- Cycle tracking to monitor bleeding patterns
Medication Options
Medications can reduce bleeding or temporarily control growth:
Hormonal Options
- Combined hormonal contraception (pill, patch, ring)
- Progestin-only methods (IUD, injection, implant)
- Oral progestins to stabilize bleeding
Non-Hormonal Options
- Tranexamic acid for heavy menstrual bleeding
- NSAIDs for pain
Advanced Medical Therapy
- Gonadotropin-releasing hormone (GnRH) agonists or antagonists to shrink fibroids temporarily (often used before surgery)
Minimally Invasive Procedures
If medications are not enough, minimally invasive procedures may be recommended:
- Hysteroscopic Myomectomy: Removes submucosal fibroids inside the uterine cavity. It is performed through the vagina without incisions. It often helps improve bleeding and fertility.
- Laparoscopic or Robotic Myomectomy: Removes fibroids while preserving the uterus. It is ideal for patients planning a pregnancy.
- Uterine Fibroid Embolization (UFE): Performed by interventional radiology to reduce fibroid blood supply, shrink growths, and relieve symptoms.
Definitive Surgical Options
For those who do not desire future pregnancy or have severe symptoms, a hysterectomy may be an option. A hysterectomy involves the complete removal of the uterus and eliminates bleeding and fibroid recurrence.
Monitoring & Follow-Up
Fibroid management often requires periodic follow-up to assess symptoms and monitor fibroid size. Your follow-up plan may include:
- Repeat ultrasound to evaluate growth or change
- Monitoring hemoglobin levels if anemia was present
- Reviewing response to medications
- Adjusting treatment based on fertility goals
- Post-procedure or post-surgical visits
Even after successful treatment, many patients benefit from ongoing gynecologic care to support long-term health.
Fibroids are benign, and with individualized care, most patients experience significant relief. Depending on the chosen treatment, symptoms can resolve quickly, and fertility outcomes may improve. Some patients may develop new fibroids over time, which is why consistent follow-up is helpful.