Fibroids Found on Ultrasound: What Does It Mean for Me?

Fibroids found on ultrasound are usually non-cancerous growths made of muscle and other tissue in or around the womb (uterus). They are very common, many people never notice them, and the NHS says they do not need treatment if they cause no symptoms. The report describes what the scan saw; deciding whether anything needs to be done depends on your symptoms and plans.

Fibroids are often found by chance, for example on a pregnancy scan or a scan done for another reason. MedlinePlus states that about half of women have fibroids by age 50. This guide helps you read the report and prepare questions. It cannot diagnose you or tell you which treatment, if any, is right for you.

Most fibroids are not an emergency. Seek urgent or emergency care through local services if you have sudden, severe pelvic or abdominal pain, or bleeding so heavy that you feel faint, dizzy, breathless or unwell. MedlinePlus notes that a fibroid on a stalk can twist and cut off its own blood supply, and that severe pain or very heavy bleeding can need emergency treatment.

Contact a clinician promptly, rather than waiting for a routine review, if you notice:

• periods that are much heavier than usual, or new bleeding between periods or after sex
• pain that is not controlled by your usual painkillers, or cramping that is getting worse
• tiredness or breathlessness that could suggest low iron (anaemia) from heavy bleeding
• new swelling, fullness or pressure in the lower belly, or new problems passing urine
• any bleeding or pain if you might be pregnant

Ultrasound reports usually name fibroids by where they sit in the wall of the womb. The same person can have more than one type.

Location matters because it helps explain symptoms. Cleveland Clinic notes that intramural fibroids are the most common type. Fibroids pressing on the lining are more closely linked with bleeding, while larger fibroids on the outside may press on nearby organs such as the bladder or bowel.

• Intramural (sometimes called myometrial): within the muscle wall of the womb.
• Submucosal: just under the inner lining, bulging into the cavity of the womb.
• Subserosal (or subserous): under the outer surface, growing outwards into the pelvis.
• Pedunculated: attached to the womb by a stalk, either inside the cavity or on the outside.

Reports usually give each fibroid's size in millimetres (mm) or centimetres (cm), often as two or three measurements taken in different directions. They may also state the number of fibroids, their position, and the overall size of the womb. Fibroids can range from a few millimetres to more than 20 cm, according to Cleveland Clinic.

Size on its own does not decide what happens next. Cleveland Clinic states that there is no fixed size at which a fibroid must be removed, and that a small fibroid can still cause heavy bleeding depending on where it is. Measurements can also vary slightly between scans and machines, so ask your clinician how any change should be read. Wording such as a 'bulky uterus' is covered in our guide to that phrase.

Yes. MedlinePlus, the NHS and the US Office on Women's Health all state that many people with fibroids have no symptoms. Cleveland Clinic says most small fibroids cause no symptoms.

When symptoms do occur, they depend on the fibroids' size, number and location. They can include:

• heavy or long periods, sometimes with clots, or bleeding between periods
• period pain, pelvic or lower back pain
• a feeling of fullness or pressure in the lower belly, or bloating
• needing to pass urine more often, or constipation
• pain or discomfort during sex
• in some cases, difficulty getting pregnant or problems during pregnancy

The NHS says treatment is not needed if fibroids cause no symptoms. Fibroids that cause no symptoms may simply be checked at future examinations or scans. Fibroids often shrink after menopause.

Treatment is usually considered when symptoms such as heavy bleeding, pain or pressure affect daily life, or when complications such as anaemia occur. Options range from medicines that reduce bleeding or pain, to hormonal treatments, to procedures such as uterine artery embolisation, myomectomy (removing the fibroids) or hysterectomy (removing the womb). The choice depends on symptoms, fibroid type, size and number, age and whether you want a future pregnancy. Some treatments affect fertility, so raise pregnancy plans early.

It can help to keep a simple record before your appointment: how many days you bleed, whether you pass clots or flood through protection, how strong any pain or pressure is, and what it stops you doing. Healthdirect suggests seeing another doctor if you feel your concerns are not being heard.

If heavy periods continue but the scan looks normal or does not seem to explain them, our guide on heavy periods with a normal ultrasound covers that situation.

Bring the full scan report, not just a portal summary, and a short note of your symptoms and periods. These questions can help you leave with a clear plan.

• How many fibroids were seen, where are they, and what size is each one?
• Could these fibroids explain my symptoms, or might something else be contributing?
• Was the scan through the abdomen, internal (transvaginal), or both, and did it show the lining clearly?
• Do I need a blood test for anaemia, a repeat scan, or another type of imaging?
• If no treatment is needed now, what changes should make me get back in touch?
• How would each treatment option affect my bleeding, pain and any plans for pregnancy?

On SameCase, patients and verified doctors share de-identified cases. Reading how others with fibroids in a similar location described their symptoms, scans and discussions with clinicians can help you notice questions you had not thought to ask.

Other people's cases cannot tell you what your scan means or what you should do. Use what you read to prepare for your appointment, and rely on your own clinician for diagnosis and treatment decisions.