Fibroid Growth & Progression
Everyone’s fibroids behave differently—and even within one body, multiple fibroids can behave differently from each other. Learning more about how fibroids typically grow and progress, and how the phases of our lives affect fibroid development will help you make informed choices about your care and treatment options.
Keep reading to learn:
Where do uterine fibroids grow?
Image source: https://www.ncbi.nlm.nih.gov/books/NBK279535/
Uterine fibroids can grow in different locations in or around the uterus. Where they’re located will often affect what kind of symptoms they result in.
There are four main types of fibroids¹, and they’re named after the location or form they take:
Intramural fibroids: Grow within the muscular wall of the uterus. These are the most common type of uterine fibroid. Intramural fibroids can cause heavy periods, pelvic pain, and bloating as they enlarge. Since they’re literally growing within the walls of your uterus, they make your uterus larger as they grow. The larger your uterus is, the more it presses on nearby organs like your bladder and colon. And if your uterus is larger that means there’s more surface area for menstrual lining to build up, which is what leads to having heavier periods.
Subserosal fibroids: Develop on the outer surface of the uterus and can grow outward, sometimes pressing against nearby organs like the bladder or intestines. If your bladder, intestines, and colon are being pressed on, this can lead to frequent urination or constipation.
Submucosal fibroids: Grow just underneath the lining of the uterine cavity. Submucosal fibroids can cause heavy or prolonged menstrual bleeding and fertility problems since their presence can interfere with implantation or growing embryos.
Pedunculated fibroids – Grow on a stalk called a peduncle that’s attached to the uterus. These can be subserosal (outside lining of the uterus) or submucosal (inside lining of the uterus) and they may cause additional pain if the stalk twists.
The location and size of fibroids determine whether they cause symptoms or remain unnoticed.
1) https://www.ncbi.nlm.nih.gov/books/NBK279535/ - National Library of Medicine - Overview: Uterine fibroids
Do fibroids grow over time?
Unfortunately, yes. But their growth rate varies from person to person, and even within the same person. In general, fibroids grow slowly, averaging 1-2 cm¹ every couple of years.
Some fibroids stay the same size for years, while others increase in size rapidly. Rapid growth is more likely to happen during reproductive years when estrogen and progesterone levels are high.
Some fibroids may grow slowly over decades, while others expand quickly within months. That’s why it’s important to monitor fibroids, keeping an eye on them and understanding how quickly they’re growing over time.
Lots of factors can influence fibroid growth², such as:
Pregnancy (more on this in the question down below)
What type of birth control you’re using e.g. hormonal methods
Hormone therapy
Overall health and lifestyle: You want a healthier diet, a good amount of exercise, and low stress.
Fibroids tend to grow the fastest during pregnancy³ due to increased hormone levels but may shrink after childbirth. (More on this below)
Fibroids usually stop growing or shrink after menopause⁴ when hormone levels decline. (More on this below)
If a fibroid is growing rapidly, causing severe symptoms, or significantly enlarging the uterus, doctors may recommend treatment options like medications, non-surgical procedures, or surgery to manage symptoms and prevent complications.
1) https://www.pacificfertilitycenter.com/blog/fibroids-and-their-impact-conception - Fibroids and their impact on conception
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC9277653/ - Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC11330289/ - Navigating Pregnancy With Uterine Fibroids: A Case Study
4) https://pmc.ncbi.nlm.nih.gov/articles/PMC6994343/ - Uterine Fibroids in Menopause and Perimenopause
What factors influence fibroid growth?
Are you wondering why fibroids grow? Fibroid growth is primarily influenced by hormones, but several other factors can contribute.
Estrogen & Progesterone: These hormones fuel fibroid growth, making them more likely to grow during pregnancy and to shrink after menopause when hormone levels drop.
Genetics¹: If you have a family history of fibroids, you’re more likely to get them.
Obesity¹: Higher body fat levels can lead to increased estrogen production, which may promote fibroid growth.
Diet³: Diets high in red meat, processed foods, and alcohol are linked to larger fibroids, while vegetables, fruits, and whole grains may help slow their growth. In addition, a meta-analysis found that consuming large amounts of soy products was linked to a 92% increase in the risk of having uterine fibroids.³ There is also conflicting data on the impact of consuming soy baby formula—one meta-analysis found that infants fed soy baby formula had a 35% increase in the risk of developing fibroids³, while another study found that infant consumption of soy formula didn’t increase the prevalence of fibroids, only the fibroids’ diameter.³
Stress³: Chronic stress can disrupt your hormone balance, potentially affecting fibroid growth.
Environmental factors: Exposure to endocrine-disrupting chemicals (found in plastics, cosmetics, and pesticides) and frequent use of chemical hair straighteners³
High blood pressure² has been found to be a factor in fibroid growth
Vitamin D deficiency² has been found to be a factor in fibroid growth
Never been pregnant²: If you’ve never been pregnant, you have a higher likelihood of having and growing fibroids. This is because of an interesting fluke with pregnancy, where even if fibroids were present before conception, the uterus’ postpartum shrinking coupled with the drop in estrogen after giving birth, can lead to the shrinking of fibroids.
Because multiple factors influence fibroid growth, your lifestyle, diet, and hormone management may help slow or reduce fibroid development, growth, progression, and size.
1) https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/people-affected - What are the risk factors for uterine fibroids?
2) https://www.nichd.nih.gov/health/topics/factsheets/uterine - Uterine Fibroids
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC10708302/ - The Role of Nutrition in Pathogenesis of Uterine Fibroids
Can fibroids shrink or disappear on their own?
Yes, but it might take a while and require other huge life changes—like having a baby or going through menopause. While fibroids can shrink or disappear on their own, it depends on factors like hormone levels, age, and overall health.
After menopause¹, fibroids often shrink naturally due to the drop in estrogen and progesterone levels. Many people see a reduction in symptoms as fibroids shrink. However, taking hormone therapy to treat menopause’s symptoms can stop fibroids from shrinking¹.
During pregnancy, some fibroids grow due to increased hormones, but other fibroids may shrink in the postpartum phase as hormone levels normalize and as the uterus shrinks back down.²
Lifestyle changes³ like diet, weight loss, and stress reduction may help slow fibroid growth or even reduce their size over time.
Medications such as GnRH agonists can temporarily shrink fibroids, but the fibroids usually return or start growing again once you stop taking the medication.
While fibroids don’t always disappear completely, many people find that symptoms improve naturally especially after hormones drop during menopause.
But if your symptoms are getting worse, read the room—get help, sis. If your fibroid symptoms are progressively getting more severe and lifestyle changes aren’t making a difference, it might be time to seek medical intervention.
1) https://www.ncbi.nlm.nih.gov/books/NBK279535/ - Overview: Uterine fibroids
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC3608270/ - The Impact and Management of Fibroids for Fertility: an evidence-based approach
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC10708302/ - The Role of Nutrition in Pathogenesis of Uterine Fibroids
How does pregnancy affect fibroids?
Are you ready to go on a roller coaster with unpredictable twists and turns? 🎢 Sorry. Here it is.
Pregnancy can cause fibroids to grow, shrink, or remain the same size due to fluctuating hormone levels. It’s really hard to predict because everyone’s body and hormones are different.
According to a study published by the National Institutes of Health (NIH), 71.4% of fibroids increase in size during the first and second trimesters, and 66.6% of fibroids increase in size during the third trimester.¹ Additionally, getting pregnant after 30 years of age can mean a higher likelihood of developing fibroids during pregnancy.¹
We know for sure that estrogen and progesterone are implicated as reasons for fibroid growth.² Estrogen and progesterone increase during pregnancy. But the relationship between hormone level and fibroid growth during pregnancy is not always linear.³
Physically, pregnancy’s effect on fibroids can include:
Increased pain or pressure as fibroids expand.
More frequent urination if fibroids press against the bladder. (And pregnancy already leads to increased urination due to the uterus pressing against the bladder.)
Higher risk of miscarriage⁴ or preterm labor⁴
Labor complications⁴, depending on fibroid size and location.
Postpartum hemorrhage⁴, which is excessive bleeding after childbirth, can also occur.
But there’s a possible upside. Sometimes fibroids shrink after childbirth⁴ as hormone levels return to normal. As the uterus shrinks back down after having a baby, it often shrinks the fibroids back down too. In a 2010 study, researchers discovered that up to 79% of fibroids present before pregnancy shrank after the baby’s delivery.
1) https://pmc.ncbi.nlm.nih.gov/articles/PMC11330289/ - Navigating Pregnancy With Uterine Fibroids: A Case Study
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC4701845/ - Circulating Sex Hormones and Risk of Uterine Fibroids: Study of Women's Health Across the Nation (SWAN)
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC3896432/ - The Rapid Growth of Fibroids during Early Pregnancy
4) https://pmc.ncbi.nlm.nih.gov/articles/PMC3608270/ - The Impact and Management of Fibroids for Fertility: an evidence-based approach
How do fibroids affect pregnancy?
Fibroids can affect pregnancy in different ways, depending on their size, number, and location in the uterus. While many people with fibroids have healthy pregnancies, some may experience complications.
Most of the time, fibroids don’t cause any symptoms during pregnancy and they don’t interfere with the pregnancy or baby¹, but sometimes fibroids can cause trouble.
Here’s how fibroids can impact a pregnancy:
Implantation Issues²: If an embryo tries to implant directly onto a fibroid or onto endometrium directly above a submucosal fibroid, this can interfere with the embryo’s ability to properly implant and develop the healthy vascular system that would support a healthy placenta. This can lead to failure to implant or even a miscarriage.
Increased Pain and Discomfort²: As the uterus expands, fibroids may grow due to increased estrogen levels, leading to pelvic pain, pressure, or cramping.
Higher Risk of Miscarriage²: If fibroids are inside the uterine cavity (submucosal fibroids), they can interfere with embryo implantation or proper fetal growth, increasing miscarriage risk.
Preterm Labor²: Large fibroids can make the uterus less flexible, increasing the chances of early contractions and preterm birth.
Placental Problems²: Fibroids may affect blood flow to the placenta, leading to issues like placental abruption, where the placenta detaches too early, posing risks to both mother and baby.
Labor and Delivery Complications²: Fibroids may block the birth canal, making vaginal delivery difficult. In such cases, a C-section may be required.¹
If you have fibroids and you also are trying to conceive a baby, consider getting those fibroids treated first to give your baby the best case scenario.
In many cases, fibroids do not prevent pregnancy, but if the fibroids are large, located inside the uterine cavity, or located right where an embryo is trying to implant and grow, it might be necessary to treat your fibroids before conception to improve fertility outcomes.
1) https://pmc.ncbi.nlm.nih.gov/articles/PMC11330289/ - Navigating Pregnancy With Uterine Fibroids: A Case Study
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC3608270/ - The Impact and Management of Fibroids for Fertility: an evidence-based approach
Do fibroids stop growing after menopause?
Finally, some good news! 🎉 Menopause is already a welcome relief for many, since it literally means no more periods. Hallelujah. So let’s talk about what that means for your fibroids.
Yes, in most cases, fibroids stop growing after menopause due to the decline in estrogen and progesterone levels.¹ Since estrogen and progesterone hormones fuel fibroid growth, their natural decrease after menopause causes fibroids to shrink. This can mean that symptoms like heavy bleeding and pelvic pain improve.
But fibroid behavior can vary according to race.
“African American and white women have similar growth rates until the age of 35. However, after age 35 growth rates decline in white but not in African American women.”¹ Research also shows that fibroids are more likely to stop growing in postmenopausal white women than in postmenopausal Black women.¹
This is more unfortunate news for Black women, since we’re already more likely to develop fibroids at a younger age, grow larger fibroids, and experience more severe fibroid symptoms.²
If your fibroids keep growing after you’ve completed menopause, it would be a good idea to get further medical evaluation to rule out other conditions.
For people who experience lingering fibroid-related issues after menopause, non-surgical treatments or procedures like radiofrequency ablation (RFA) or uterine artery embolization (UAE) can be considered to relieve symptoms.
1) https://pmc.ncbi.nlm.nih.gov/articles/PMC6994343/ - Uterine Fibroids in Menopause and Perimenopause
2) https://www.nichd.nih.gov/health/topics/factsheets/uterine - Uterine Fibroids
Can diet and lifestyle changes slow fibroid growth?
Yes, diet and lifestyle changes can help slow fibroid growth and reduce symptoms. While these changes won’t make your fibroids go away, they could influence your hormone levels and lower your body’s inflammation.
Since hormones and inflammation² play a role in fibroid development, it’s a good idea to put your body in as healthy a situation as you reasonably can.
Here are some helpful lifestyle changes to try:
Eat more fruits, leafy green vegetables, dairy, whole grains, and lean meats¹,³: These foods provide fiber, bolster your immune system, and increase the antioxidants that help balance your hormones.
Reduce red meat, soy, and processed foods³: These have been linked to increased estrogen levels and fibroid growth.
Drink green tea³: The compounds in green tea can reduce the symptoms and size of fibroids.
Increase omega-3s: Found in fish, flaxseeds, and walnuts, omega-3s have anti-inflammatory properties.
Get more Vitamin D: Vitamin D can limit the proliferation of fibroid cells. It’s found in cheese, egg yolks, beef liver. Our bodies also produce Vitamin D when we get sunlight, even while wearing sunscreen.
Limit alcohol and caffeine: Excess consumption may raise estrogen levels. Multiple studies show that drinking a lot of alcohol can increase the risk of developing uterine fibroids. Try to limit yourself to no more than one alcoholic drink per day.
Maintain a healthy weight¹: Excess body fat produces more estrogen, fueling fibroid growth.
Exercise regularly: Exercise helps regulate hormones and it reduces inflammation. Studies show that being less sedentary and getting at least four hours of vigorous physical activity per week can reduce your risk of developing uterine fibroids.¹
Reduce stress¹: Chronic stress can contribute to hormonal imbalances. Wellbeing activities like yoga, meditation, and deep breathing can help you cut back on stress.
While lifestyle changes alone won’t shrink fibroids significantly, they can help manage symptoms and slow their growth over time. Learn more about living with fibroids and the lifestyle changes that can make your fibroids easier to deal with.
1) https://pmc.ncbi.nlm.nih.gov/articles/PMC10975324/ - Empowering Strategies for Lifestyle Interventions, Diet Modifications, and Environmental Practices for Uterine Fibroid Prevention; Unveiling the LIFE UP Awareness
2) https://pmc.ncbi.nlm.nih.gov/articles/PMC9277653/ - Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment
3) https://pmc.ncbi.nlm.nih.gov/articles/PMC10708302/ - The Role of Nutrition in Pathogenesis of Uterine Fibroids