What Is a Myoma?

A myoma (also known as a uterine fibroid or a leiomyoma) is a common noncancerous tumor that grows in or around the uterus. Myomas vary in size, causing symptoms like abdominal pain and heavy menstrual bleeding though some people remain symptom-free.

The cause of myomas is not clear, but risk factors include a family history of myoma, obesity, and age. More than half of all people with a uterus will experience a myoma by age 50.

This article offers an overview of myomas, including the most common symptoms, risk factors, and treatment options. It will help you to know more about whether to see a healthcare provider.

Types of Myoma

Myomas are categorized by where they are located, how big they are, and the symptoms that they may cause.

Each person's experience with myomas will look and feel different. It's possible to have just one myoma or several. They can range in size from as small as a pea to as large as a melon. Myomas can be located inside the uterus or on its outer surface. They may grow quickly or slowly.

The different types of myomas include:

• Intramural myomas are the most common type. They are located within the wall of the uterus.
• Subserosal myomas grow on the outside of the uterine wall and may put pressure on nearby organs (like the bladder) or distort the shape of the uterus if they grow large enough.
• Pedunculated myomas develop a stalk or a stem that attaches them to the uterus. The stem may become twisted as the tumors grow away, causing severe pain.
• Submucosal myomas are found just under the lining of the uterus and can push into the uterine cavity. They are not as common as the other types and can cause heavy bleeding.

In general, a large myoma is considered to be 10 centimeters (cm) or more in diameter. For size reference:

• Small myomas: Up to 5 cm across (about the size of a seed to a cherry)
• Medium myomas: Up to 10 cm (roughly the size of a plum or an orange)
• Large myomas: 10 cm or larger (about as big as a large grapefruit or a small melon)
  

Myoma Symptoms

The symptoms of myomas depend on how big the tumors are and where they are located. People with myomas may have symptoms that come and go. The symptoms may get worse during their menstrual cycle.

For some people, myoma symptoms are severe and cause constant pain. Others do not experience any symptoms.

Possible symptoms of a myoma include:

• Heavy, painful, or prolonged periods
• Bleeding between periods
• Pelvic pain and abdominal pressure
• A feeling of fullness in the lower abdomen
• Swelling or enlargement of the lower abdomen
• Constipation or diarrhea
• A frequent need to urinate or trouble urinating
• Pain during sex
• Lower back pain
• Reproductive issues (such as trouble getting pregnant)
• Fatigue and weakness

In most cases, a myoma is not life-threatening. A myoma can cause death in rare cases, such as those involving heavy blood loss or that lead to obstruction in other organs. It's also a top cause of hysterectomy surgeries, which may lead to their own risks and complications.

Causes of Myoma

Myomas are likely associated with hormone activity but experts aren't exactly sure what causes them. High levels of estrogen and progesterone (hormones produced by the ovaries) may stimulate the growth of myomas, which tend to shrink when hormone levels go down after menopause.

There are certain things that make a person more likely to get a myoma in their lifetime. These risk factors for myomas include:

• Family history: You're more likely to get a myoma if you have a family member who has them.
• Obesity: People who are overweight or who have high blood pressure might be at a higher risk of developing myomas.
• Age: Myomas become more common as people age, appearing most often in people in their 30s, 40s, and 50s. After menopause, myomas tend to get smaller.
• Diet: Eating a diet high in red meat might be linked with developing myomas, as is having a vitamin D deficiency.

Myoma Diagnosis

If your healthcare provider thinks you have a myoma, there are a few steps needed to confirm the diagnosis. They will start by asking you about your health, including your family's health history.

They will also want to know what your menstrual cycles have been like, and will have you describe any symptoms you experience.

Medical tests that your healthcare provider might use to diagnose fibroids include:

• Pelvic examination to feel for any abnormal growths
• Ultrasound or transvaginal ultrasound to get a clear view of the uterus
• Magnetic resonance imaging (MRI) to look at images of the uterus and other pelvic organs

Treating a Myoma

A myoma that's not causing any pain or other symptoms doesn't necessarily need to be treated. However, if your symptoms are severe or if the myoma is large and has the potential to cause damage to surrounding organs, your healthcare provider will help you to decide on the best treatment.

There are several choices for treating myomas, including medications, noninvasive procedures, surgery, or a combination of therapies.

You and your healthcare provider will choose a treatment based on several factors, including:

• How severe your symptoms are
• The size and location of the myoma(s)
• Whether you may want to become pregnant in the future
• Your age and how close you are to menopause

Medication

There are several over-the-counter (OTC) and prescription medications that can be used to treat myomas. Some options only treat the symptoms of a myoma while others affect the growth itself.

Medications that your healthcare provider might suggest include:

• Over-the-counter pain medications, such as Advil (ibuprofen) or Tylenol (acetaminophen), if you have mild pain and discomfort from fibroids.
• Iron supplements if you have depleted iron levels from heavy bleeding.
• Birth control methods such as contraceptive pills, intrauterine devices, and Depo-Provera can help control heavy menstrual bleeding.
• GnRH agonists (hormone-stimulating medications) to temporarily shrink myomas. If surgery to remove the fibroids is planned, your healthcare provider might want you to take them to reduce the size of the tumors so they are easier to take out.
• MyFembree, which is a recently approved combination medication of GnRH, a synthetic estrogen, and a type of progestin to help stop heavy menstrual bleeding.

Surgical Procedures

Depending on the size, location, and number of myomas you have, your healthcare provider might suggest that you have surgery to remove the fibroids.

Less invasive surgical options include:

• Laparoscopic myomectomy, a surgical procedure that uses small incisions and an instrument with a tiny camera to remove myomas that are easily accessible
• Uterine fibroid embolization (UFE), a radiology procedure that uses injections to block blood flow to the myomas, causing them to shrink and sometimes die
• MRI-guided ultrasound surgery, a technique that uses ultrasound waves to shrink myomas

In more severe cases, you might need to consider a more invasive type of surgery. These options include:

• Hysterectomy is a surgery to completely remove the uterus. While this will get rid of the fibroids, it also means that you will no longer have the option of getting pregnant in the future.
• Abdominal myomectomy is a surgical procedure that requires a large incision in the abdomen to remove the fibroids without removing the uterus. While a person still has their uterus and might be able to get pregnant in the future, there is also a risk that the fibroids will come back.

Home Remedies

While there are no home remedies that directly treat fibroids, you might find that some of them help you to cope with fibroid symptoms. Talk to your healthcare provider about any complementary therapies they would approve for you to try.

Types of alternative therapies you might want to discuss with your healthcare provider include:

• Acupuncture
• Yoga
• Massage
• Traditional Chinese medicine
• Heating pads

There are also some lifestyle changes that might help you cope more effectively with fibroid symptoms and can improve your overall health and wellness, including:

• Dietary changes
• Exercising
• Managing your stress levels
• Losing weight if you are overweight/obese

Prognosis

Myomas are common, but each person's experience with them will be different. Some people are able to effectively manage the condition with treatment that reduces their symptoms and improves their quality of life.

Myomas that are not treated can cause complications—even if you do not have symptoms.The potential complications of myomas mostly pertain to fertility, pregnancy, and childbirth and include:

• Fertility issues
• Pregnancy complications (such as miscarriage or early labor)
• The need for cesarean delivery (or C-section)

A Word From Verywell

If you've been diagnosed with a myoma, be sure to tell your healthcare provider about symptoms that affect your life. They'll help you to determine which treatments are the best choice.