How often should uterine fibroids be checked?

Written by Wang Jing Hua
Obstetrics and Gynecology
Updated on January 06, 2025
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The follow-up timing after uterine fibroids depends on the current size of the fibroids and the symptoms. If the fibroids are particularly small and there are no symptoms, a follow-up after one year is generally acceptable. However, if during the follow-up the fibroids are found to have grown quickly, or if there are symptoms such as increased menstrual flow or a shortened cycle, a follow-up every six months may be warranted. Most uterine fibroids do not cause any symptoms and simply exist; they tend to grow gradually with age and generally shrink and disappear after menopause.

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Written by Jia Rui
Obstetrics and Gynecology
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How to check for uterine fibroids?

Uterine fibroids are a type of benign tumor of the female reproductive organs. Uterine fibroids are a common gynecological disease and are frequently occurring; they can be clearly seen via abdominal ultrasound. Uterine fibroids mainly form due to the proliferation of uterine smooth muscle cells, with a small amount of fibrous connective tissue existing as a supportive tissue. If the fibroids do not exceed five centimeters and do not affect menstruation or present any clinical symptoms, conservative treatment can be considered, with attention to regular follow-up examinations.

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Written by Jia Rui
Obstetrics and Gynecology
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What is uterine fibroids?

In clinical practice, uterine fibroids are common benign tumors found in female reproductive organs. Clinically, they present with symptoms such as heavy menstrual bleeding, anemia, and pressure on the rectum, causing difficulty in defecation, as well as pressure on the bladder, leading to urgency in urination. Uterine fibroids, also known as fibromyomas or uterine leiomyomas, are the most common tumors in the human body. They mainly consist of proliferating smooth muscle cells of the uterus, with a small amount of fibrous connective tissue acting as support. Uterine fibroids can affect the function of the reproductive cycle. It is advisable to visit a gynecologist for examination and actively seek treatment.

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Written by Sun Shan Shan
Obstetrics and Gynecology
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Uterine fibroids are classified into several types.

Uterine fibroids are classified by location into two types: myometrial fibroids and cervical fibroids. Based on the relationship between the uterine fibroids and the muscular wall, there are three kinds of uterine fibroids: intramural fibroids, subserosal fibroids, and submucosal fibroids. Intramural fibroids, primarily located within the uterine wall and enclosed by a muscular layer, are recommended for surgical treatment once the fibroid's diameter exceeds four centimeters, as they tend to grow rapidly. Similarly, subserosal fibroids grow towards the peritoneal surface of the uterus and are on the exterior of the uterus. If subserosal fibroids also exceed four centimeters in diameter and are accompanied by menstrual changes, surgical treatment is advised. Furthermore, submucosal fibroids, regardless of their size, require timely surgical intervention due to their association with heavy bleeding and a high risk of anemia.

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Written by Fan Li Ping
Obstetrics and Gynecology
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Do uterine fibroids require surgery?

Whether or not surgery is needed for uterine fibroids primarily depends on clinical symptoms, with clinical symptoms as the criterion. If the fibroids are small but affect menstruation, such as heavy periods or noticeable prolongation and increase in menstrual flow, surgery might be necessary. Another consideration for surgery is if the fibroid noticeably enlarges in a short period, and there's a suspicion of malignant transformation. Additionally, if there are significant symptomatic compressions clinically, surgery might also be considered. Therefore, if someone has uterine fibroids, it's important to consult with a gynecologist who can assess the situation based on ultrasound and physical examination to determine whether surgery is required.

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Written by Huang Shuai
Obstetrics and Gynecology
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How big a uterine fibroid can be without requiring treatment?

The size of uterine fibroids is one of the indicators we consider for whether treatment and surgery are necessary. It is generally believed that surgery is indicated when the diameter of a fibroid exceeds 6cm, or when the entire uterus is larger than the size it would be at ten weeks of pregnancy. However, in reality, the size of a uterine fibroid is not an absolute indicator for surgery. This means that even if the fibroid exceeds 6cm, or the entire uterus reaches around ten weeks in size, it doesn’t necessarily require surgery. At this point, other factors are usually also considered, such as whether there are symptoms, whether the large fibroids cause heavy menstruation and anemia, whether there are compression symptoms, the radiological appearance of the fibroids, whether they resemble malignant conditions, whether the fibroids are rapidly growing, and whether the fibroids are located in special areas like the cervix, the hip ligament, or submucosal. Thus, the size of the uterine fibroids is just one aspect we consider for treatment or surgery; the presence of symptoms and whether the fibroids are malignant, among others, are actually more important.