Dr. Eric DePopas, MD
PainTheory Chief Medical Officer
Vascular & Interventional Radiologist
The size of a fibroid can worsen symptoms and cause medical issues for many women. Although any size fibroid can cause symptoms, large fibroids are more likely to compress structures within the abdomen and pelvis, consequently causing pain, cramping, bloating, constipation, and issues with urination. While the natural assumption is “bigger fibroids=greater symptoms”, that isn’t always the case. Here’s everything you need to know about the correlation between fibroid size and symptoms.
DID YOU KNOW
Not all fibroids are symptomatic. In fact, only around 50% of women with fibroids experience symptoms as a result of the growth.
Table of Contents
What size fibroid is considered large?
Any fibroid bigger than five centimeters which is about the size of a lemon is considered to be larger than average.
Small fibroids
Small fibroids can range anywhere from smaller than a centimeter up to 5 cm. For perspective this is about the size of a grain of rice to the size of a berry or cherry.
Medium fibroids
Medium fibroids fall within the 5-10 cm range. These mid-sized fibroids range in size between a plum and an orange.
Large fibroids
Anything that exceeds 10 cm. Picture a grapefruit or a small watermelon. These large fibroids cause stomachs to distort to the point where a woman may say she looks pregnant.
Are large fibroids more dangerous to your health?
Put simply: no. Remember, fibroids are rarely cancerous and therefore rarely life-threatening, meaning bigger fibroids are not automatically more dangerous for your health.
The fibroid’s location is more influential upon symptoms than the size or number of fibroids. For example, the uterus is where the majority of fibroids grow, but if one develops near the endometrial canal (the inner lining of the uterus), it is more likely to stimulate symptoms like bleeding. That means how you feel, and the symptoms you experience, are more important than the physical mass of the fibroid itself.
Large Fibroid Symptoms
Relating the size of a fibroid to certain symptoms is not an exact science. However, a large fibroid can cause symptoms which a small fibroid could not, like:
- Abdominal enlargement
- Bloating
- Weight gain
- Urinary issues; either feelings of urgency or inability to empty bladder
- Constipation
A “fibroid belly” is a perfect example. Fibroids can reach a size where they can distort a woman’s stomach. A smaller fibroid cannot do that.
Larger fibroids are also more likely to cause constipation and urinary issues as their size and location on the uterus can impede both the bladder and colon.
PHYSICIAN INSIGHT
At our clinic, we have treated fibroids that have weighed 5 to 10 pounds. It is no wonder some women liken the look of stomach distortions caused by fibroids to being pregnant. This range is the same as the size of a newborn.
Treatment for Large Fibroids
When fibroids become very large, usually the only surgical option for treatment is hysterectomy or complete removal of the uterus. However, non-invasive or minimally invasive treatments like uterine fibroid embolization can provide just as effective results without having to undergo a major surgery.
The most prevalent non-invasive treatment option for fibroids is uterine fibroid embolization. Because this is a non-surgical procedure, it results in an easier recovery period. Take our assessment to find out if you’re a candidate for uterine fibroid embolization.
Fibroids can also be treated with medication; however, medications usually do not cure the underlying fibroid, so, when medications are stopped, fibroid symptoms usually return.
Can small fibroids cause pain?
Patient symptoms manifest on a case-by-case basis, but smaller fibroids are less likely to cause intense discomfort and strong symptoms. However, small fibroids can still cause symptoms that would be deemed disruptive to a patient’s daily life.
The decision whether to treat fibroids is often based on the severity of symptoms, not the exact size of fibroids. For example, a patient with a small fibroid experiencing blood loss will be considered a more serious case than a patient with a larger fibroid who has no major symptoms.
Does the number of fibroids make a difference?
People with fibroids typically don’t have just one fibroid, they have a cluster of them. It is possible to have only one fibroid, although that is less common
Some women have numerous fibroids and are asymptomatic. While others may have one fibroid and display symptoms, there is no definitive causation between the number of fibroids and the impact on your health.
Fibroid Symptom Types
A more accurate way to determine if fibroids are dangerous is by splitting the major types of symptoms into two categories: bulk symptoms and bleeding symptoms.
Bulk symptoms
Bulk symptoms are related to the size of the fibroid and involve mostly pain or discomfort in the pelvic region. Fibroids that are particularly large in size can also press on your bladder and give you the sensation of having to urinate regularly.
Alternatively, large fibroids that push heavily on the bladder can also add pressure to the bowel behind it and make you feel constipated. It’s worth noting that in both these instances, the fibroid has to be considerably large.
Bleeding symptoms
Bleeding symptoms are not related to the size of the fibroid. Even fibroids that are two or three centimeters (or smaller) can cause bleeding symptoms. This is when women have heavy bleeding during menstruation or continued bleeding between periods. Such bleeding can lead to anemia, a condition in which you don’t have sufficient healthy red blood cells to carry enough oxygen to your body’s tissues. Anemia can be treated with iron supplements and dietary changes, but in some cases, it may require prescribed medication.
In very rare circumstances, anemia can cause chest pains, palpitations, and heart attacks. A small percentage of women may require a blood transfusion because of severe anemia brought on by fibroids.
In most cases, your doctor will recommend a more aggressive treatment plan when bleeding symptoms are present.
What fibroid symptoms are most severe?
Medical professionals generally consider bleeding symptoms more dangerous than bulk symptoms. While bulk symptoms can be uncomfortable and unsettling, many women find bleeding symptoms more disruptive to their daily lives.
PainTheory’s Final Thoughts on Fibroid Size
Size is not the only factor that plays a role in the severity of fibroid symptoms. Fibroid location is equally as important to consider. Evaluating symptoms and their impact on a patient’s life is a more complete way to analyze fibroids and choose the appropriate course of treatment for you.
If you have concerns regarding your symptoms or general fibroid care, speak with your doctor or reach out to PainTheory’s medical professionals for more information.
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