How big a uterine fibroid can be without requiring treatment?

Written by Huang Shuai
Obstetrics and Gynecology
Updated on February 09, 2025
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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.

Other Voices

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Written by Wang Jing Hua
Obstetrics and Gynecology
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How to manage uterine fibroids

The occurrence and development of uterine fibroids are mainly related to congenital factors and have little to do with postnatal lifestyle conditions. Therefore, when uterine fibroids are detected, there is no need for any specific conditioning. Various traditional Chinese medicines, herbal treatments, or hormonal drugs do not have a definite curative effect on uterine fibroids, and so far, there is no specific medication for the treatment of uterine fibroids. When uterine fibroids are detected, the main considerations are whether they cause symptoms such as excessive bleeding, anemia, or whether they are increasing in size and causing compression symptoms on the surrounding tissues. Uterine fibroids without any symptoms generally only require regular physical examinations and may shrink and disappear after menopause.

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Written by Wang Kun
Surgical Oncology
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Does uterine fibroids cause high CRP?

Normal uterine fibroids do not cause an increase in CRP. CRP is an indicator of systemic inflammatory response. Only when a patient experiences infection, rupture, or acute systemic inflammatory reactions will it cause a rise in tumor markers. Uterine fibroids often do not exhibit these symptoms; therefore, most cases will not show an increase in CRP. However, in some patients, infection or rupture, and even malignancy, can lead to an increase in these indicators. Patients should undergo relevant imaging studies to assess the size and location of the uterine fibroids, as well as the presence of uterine bleeding.

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Written by Hou Jie
Obstetrics and Gynecology
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How to recuperate from uterine fibroids?

Uterine fibroids are the most common benign tumors of the female reproductive organs, composed of smooth muscle and connective tissue. Treatment varies depending on the patient's age, childbearing requirements, presence of symptoms, location and size of the fibroids, and their number. For asymptomatic fibroids, treatment is generally not necessary, especially for women nearing menopause. After menopause, fibroids often shrink or gradually disappear. In such cases, it is recommended to follow up every three to six months, or consider pharmaceutical treatment. Medication is suitable for those with mild symptoms, near menopausal age, or those who are not suitable for surgery. If there are complications such as heavy menstrual bleeding, resulting anemia, ineffective drug treatment, severe abdominal pain, or conditions like fibroid torsion or acute abdomen, surgical treatment is recommended.

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Written by Li Shun Hua
Obstetrics and Gynecology
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What are the symptoms of uterine fibroids?

If the uterine fibroids are relatively small, they generally do not show symptoms. However, submucosal uterine fibroids, regardless of their size, can cause heavy menstrual bleeding and prolonged periods. Intramural uterine fibroids, if protruding into the uterine cavity, can also lead to heavy menstrual bleeding and prolonged periods. If the uterine fibroids are large and press against the bladder in front, symptoms such as frequent urination and urinary urgency can occur. If they press against the rectum in the back, it can lead to difficulty in defecation or a feeling of downward pain. Therefore, if symptoms are present with uterine fibroids, surgical treatment is necessary.

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Written by Liu Jian Wei
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Reasons for the sudden enlargement of uterine fibroids

Uterine fibroids generally grow slowly. In clinical practice, if there is a sudden increase in the size of uterine fibroids in a short period, it is recommended that the patient immediately seek medical attention at a local hospital to ascertain the cause. Commonly observed reasons for an increase in the size of uterine fibroids include: firstly, if the uterine fibroids are tending towards malignancy, they can increase in size rapidly. Additionally, during pregnancy, under the influence of high levels of hormones in the body, pregnant women may also experience a sudden increase in the size of uterine fibroids, accompanied by red degeneration.