Can Fibroids Go Away on Their Own? What You Need to Know

Key Points

• Fibroids rarely disappear completely on their own, but they often shrink after menopause 
• Small, symptom-free fibroids may not need treatment and can simply be monitored 
• Fibroids typically grow during reproductive years due to estrogen and progesterone 
• Pregnancy can cause temporary fibroid growth, but they often shrink after delivery 
• Treatment is recommended when fibroids cause heavy bleeding, pain, or other symptoms 
• Multiple effective treatment options exist beyond "wait and see" or hysterectomy ctomy
  

The Short Answer 

Let's get straight to it: fibroids don't usually disappear on their own during your reproductive years. However, they often shrink significantly after menopause when your hormone levels drop. The real question isn't so much whether they'll go away, but whether they need to go away at all. 

Here's the thing that surprises most women: not all fibroids need treatment. Many can be safely monitored without any intervention. But if fibroids are causing symptoms like heavy bleeding, pelvic pain, or pressure, waiting for menopause isn't always a practical solution, especially if you're in your 30s or 40s. 

At Nashville Gynecology Center, we see women with fibroids every single day. Dr. Larry D. Gurley specializes in fibroids and bleeding problems, and one of the most common questions he gets is exactly this: "Do I really need to do something about these, or will they go away?" 

Let's break down what actually happens with fibroids over time and when you might need to take action. 

What Are Fibroids, Anyway? 

Before we talk about whether they go away, let's make sure we're on the same page about what fibroids actually are. 

Uterine fibroids (also called leiomyomas or myomas) are non-cancerous growths that develop in or on the uterus. They're made of muscle and fibrous tissue, and they can range from tiny seedlings that you'd never even know are there to large masses that can actually enlarge your uterus to the size of a pregnancy. 

Key facts about fibroids: 

• They're extremely common, affecting up to 70-80% of women by age 50 
• They're almost always benign (non-cancerous) 
• Some women have just one, while others have multiple fibroids 
• They can be as small as a seed or as large as a melon 
• Location matters as much as size when it comes to symptoms 

The growth of fibroids is influenced by the hormones estrogen and progesterone, which is why they tend to grow during your reproductive years and shrink after menopause. 

What Happens to Fibroids Over Time? 

The lifecycle of a fibroid depends largely on your hormones and where you are in your reproductive journey. Here's what typically happens:

During Your Reproductive Years (Teens to Late 40s) 

This is when fibroids usually grow. Your body is producing plenty of estrogen and progesterone, which fibroids love. They have receptors for these hormones and respond by growing. 

For most women, fibroids that are present will either: 

• Slowly grow over time 
• Stay relatively the same size 
• Occasionally grow quickly during periods of hormonal change 

They very rarely shrink during this time unless you're doing something specific to make them shrink (like taking certain medications or undergoing treatment). 

During Pregnancy

Pregnancy is a wild card. The hormone surges during pregnancy can cause fibroids to grow, sometimes quite rapidly. However, many fibroids don't change much during pregnancy, and some actually shrink. 

After delivery, when hormone levels drop, fibroids often shrink back down. Many women who had fibroid growth during pregnancy find that their fibroids return to pre-pregnancy size or even smaller within a few months postpartum. 

During Perimenopause (The Years Leading to Menopause) 

Perimenopause is that transitional time when your hormones start fluctuating wildly before menopause. Fibroids can behave unpredictably during this time. Some grow due to hormone fluctuations, while others may start to shrink as overall hormone levels begin to decline. 

This is often when women notice fibroid symptoms for the first time or find that existing symptoms get worse. 

After Menopause 

This is when fibroids typically shrink. Once your ovaries stop producing significant amounts of estrogen and progesterone, fibroids lose their fuel source. Most women see their fibroids shrink by 30-50% or more after menopause. 

However, "shrink" doesn't always mean "disappear completely." Fibroids may become smaller and stop causing symptoms, but they often don't vanish entirely. The good news is that without hormones driving their growth, they usually stop being a problem. 

One important exception: If you're taking hormone replacement therapy (HRT) after menopause, fibroids may not shrink as much or could even continue growing because you're replacing some of those hormones. 

When "Wait and See" Makes Sense 

Not every fibroid needs treatment. In fact, many don't. Here's when monitoring without intervention is perfectly reasonable: 

Small fibroids with no symptoms If your fibroids were discovered incidentally (maybe during an ultrasound for something else) and you're not experiencing any problems, there's often no reason to treat them. We just keep an eye on them with periodic ultrasounds to make sure they're not growing rapidly. 

You're close to menopause If you're in your late 40s or early 50s and symptoms are manageable, it might make sense to wait it out. Once you hit menopause, those fibroids will likely shrink on their own. This is especially true if symptoms are mild and you can manage them with over-the-counter pain relievers or other conservative measures. 

Mild symptoms that don't affect quality of life Maybe your periods are a bit heavier than they used to be, but you're not anemic and it's not stopping you from doing anything you want to do. In that case, monitoring might be the right approach, at least for now. 

When Waiting Doesn't Make Sense 

On the flip side, here's when you shouldn't just wait and hope fibroids go away: 

Heavy menstrual bleeding causing anemia If you're soaking through pads or tampons every hour, passing large clots, or your blood work shows you're anemic (low iron), that's not something to ignore. Chronic anemia makes you exhausted, weak, and can lead to other health problems. For more on this, check out our guide on heavy menstrual bleeding treatment options. 

Significant pelvic pain or pressure Large fibroids can cause constant pelvic pressure, back pain, or pain during sex. Some women describe it as feeling like they're sitting on a ball or always feeling full in the lower abdomen. You shouldn't have to live with this discomfort. 

Bladder or bowel problems Fibroids can press on your bladder, making you feel like you need to pee constantly, or press on your bowel, causing constipation or difficulty with bowel movements. These symptoms can significantly affect your daily life. 

Fertility concerns If you're trying to get pregnant and fibroids are potentially interfering (especially if they're inside the uterine cavity or distorting its shape), treatment before pregnancy might be recommended. 

Rapid growth While fibroids are almost always benign, rapid growth warrants investigation. We want to make sure nothing concerning is going on. 

You're years away from menopause If you're 35 and dealing with debilitating symptoms, waiting 15 years for menopause isn't a reasonable solution. There are effective treatments that can dramatically improve your quality of life now. 

Treatment Options: You Have Choices 

If you do need treatment for fibroids, you have more options than you might think. At Nashville Gynecology Center, Dr. Gurley's philosophy is to provide a full discussion of all available options, not just jump straight to hysterectomy. 

Medications 

Hormonal birth control (pills, patch, or IUD) can help manage heavy bleeding and pain, though they don't shrink fibroids. The hormonal IUD (like Mirena) can be particularly effective for controlling bleeding. 

GnRH agonists temporarily put you into a menopause-like state, which can shrink fibroids. These are usually used short-term before surgery to make fibroids smaller and easier to remove, or to help you build up your blood count if you're anemic. 

Other medications can help manage specific symptoms like heavy bleeding (tranexamic acid) or pain (NSAIDs). 

Minimally Invasive Procedures 

Uterine artery embolization (UAE) blocks the blood supply to fibroids, causing them to shrink. This is done by an interventional radiologist and doesn't require surgery. 

MRI-guided focused ultrasound uses high-intensity ultrasound waves to destroy fibroid tissue. It's non-invasive but not widely available and works best for certain types of fibroids. 

Surgical Options 

Myomectomy removes fibroids while leaving your uterus intact. This is often the best option if you want to preserve fertility or just want to keep your uterus. Depending on the size and location of fibroids, this can be done: 

• Hysteroscopically (through the vagina, no incisions, for fibroids inside the uterine cavity) 
• Laparoscopically (minimally invasive with small incisions) 
• Through a traditional abdominal incision (for very large or numerous fibroids) 

Dr. Gurley specializes in gynecology, endoscopy, and alternatives to hysterectomy, offering advanced surgical techniques that minimize recovery time. 

Endometrial ablation might be an option if fibroids are small and your main symptom is heavy bleeding. This procedure destroys the uterine lining and can significantly reduce or stop bleeding. Learn more about endometrial ablation and whether it might be right for you. 

Hysterectomy (removal of the uterus) is the only permanent solution for fibroids. While it's sometimes the best option, it's not the only option. At our surgery center, when hysterectomy is the right choice, we focus on minimally invasive approaches when possible. 

What About Natural Remedies? 

You've probably seen claims online about supplements, herbs, or dietary changes that supposedly shrink fibroids. Let's be honest about this: while maintaining a healthy weight and eating well are always good ideas, there's no strong scientific evidence that any natural remedy or diet will make fibroids disappear. 

Some things that might help with symptoms: 

• Maintaining a healthy weight (obesity is associated with higher fibroid risk) 
  
• Regular exercise 
  
• Anti-inflammatory diet 
  
• Managing stress 

But if you have symptomatic fibroids, don't rely on supplements or dietary changes alone. Work with your doctor to find an evidence-based treatment that will actually address the problem.

How We Diagnose and Monitor Fibroids 

If you think you might have fibroids, or if you've been told you have them but aren't sure what to do next, here's what evaluation typically involves: 

Pelvic exam can often detect larger fibroids or an enlarged uterus. 

Ultrasound is the most common imaging test. We offer in-office ultrasound at Nashville Gynecology Center, which means we can often get answers the same day as your appointment. Ultrasound shows the size, number, and location of fibroids. 

Other imaging like MRI might be recommended in some cases for a more detailed view, especially if surgery is being planned. 

Blood tests to check for anemia if you're having heavy bleeding. 

If we're monitoring fibroids, we'll typically repeat ultrasounds every 6-12 months to make sure they're not growing rapidly. 

Making the Right Decision for You 

The decision about whether to treat fibroids isn't one-size-fits-all. It depends on: 

• How much your symptoms affect your quality of life 
• The size and location of your fibroids 
• Your age and how close you are to menopause 
• Whether you want to have children in the future 
• Your overall health 
• Your personal preferences 

Some women with large fibroids have minimal symptoms and choose to just monitor them. Others with smaller fibroids have significant bleeding or pain and decide treatment is the right choice. Neither approach is wrong. It's about what works for your body and your life. 

This is why having a detailed conversation with your gynecologist is so important. At Nashville Gynecology Center, we take time to understand your specific situation and help you make an informed decision. 

The Bottom Line 

Can fibroids go away on their own? In most cases during your reproductive years, no. But that doesn't automatically mean you need aggressive treatment. Many fibroids can be safely monitored, and when treatment is needed, you have multiple options to choose from. 

The key is not to suffer in silence. If fibroids are affecting your life, whether through heavy bleeding, pain, or other symptoms, effective treatments are available. You don't have to wait until menopause, and you definitely don't have to just deal with it. 

Get Expert Evaluation and Treatment 

If you're dealing with fibroids or think you might be, we're here to help. Dr. Gurley has extensive experience treating fibroids and specializes in finding the right solution for each individual patient. 

Nashville Gynecology Center

300 20th Avenue North, Suite 102

Nashville, TN 37203

Phone: (615) 284-1500

Fax: (615) 432-2007 

Call us at (615) 284-1500 to schedule your evaluation. We welcome new patients and are committed to helping you understand all your options. 

Learn more about our philosophy of patient-centered care and comprehensive treatment options, or explore our full range of gynecology services. 

Don't wait and wonder. Let's find out what's really going on and create a plan that works for you. 

FAQs About Fibroids 

At what age do fibroids stop growing?

Fibroids typically stop growing and start shrinking after menopause, usually around age 50-52 for most women. However, the exact age varies based on when you personally go through menopause. During perimenopause (the years leading up to menopause), fibroids may still grow due to hormone fluctuations before eventually shrinking.

Can fibroids shrink without surgery? 

Yes, fibroids naturally shrink after menopause when hormone levels drop. Certain medications called GnRH agonists can also temporarily shrink fibroids by creating a menopause-like state, though this is usually a short-term solution. Uterine artery embolization is a non-surgical procedure that can shrink fibroids by cutting off their blood supply. However, medication-induced shrinkage is usually temporary, and fibroids often regrow once the medication is stopped. 

How fast do fibroids grow? 

Growth rate varies widely. Some fibroids grow very slowly over years, while others can grow more rapidly, especially during pregnancy or times of hormonal change. On average, fibroids may grow about 9% in six months, but this is highly individual. Rapid growth (doubling in size in a short time) should always be evaluated by your doctor, though it's still usually benign.

Do fibroids get bigger with age? 

Generally, fibroids grow larger as you age during your reproductive years (roughly ages 20-50) because you're producing estrogen and progesterone. However, once you reach menopause, fibroids typically shrink. So they don't keep growing indefinitely with age. The highest growth period is usually during your 30s and 40s.

Can losing weight shrink fibroids? 

Weight loss alone won't typically make existing fibroids disappear, but maintaining a healthy weight may help prevent new fibroids from forming and could potentially slow growth. Obesity is associated with higher estrogen levels, which can fuel fibroid growth. While weight loss is beneficial for overall health and may help with symptoms, it shouldn't be relied upon as the sole treatment for symptomatic fibroids.

What happens if you don't remove fibroids? 

If fibroids aren't causing symptoms, nothing bad happens. Many women have fibroids their whole lives without ever needing treatment. However, if fibroids are causing heavy bleeding, you could develop anemia. Large fibroids can continue to cause pain, pressure, and urinary or bowel symptoms. In rare cases, very large fibroids can cause complications, but fibroids becoming cancerous is extremely rare (less than 1 in 1,000 cases).

Can fibroids come back after treatment? 

It depends on the treatment. After hysterectomy, fibroids cannot come back because the uterus has been removed. After myomectomy (fibroid removal), new fibroids can develop over time in about 10-25% of women within 10 years, though the original fibroids that were removed don't regrow. After uterine artery embolization, some fibroids may regrow, though many women have lasting relief.

Do birth control pills make fibroids worse? 

This is a common concern, but modern low-dose birth control pills don't typically make fibroids grow. In fact, they can help manage heavy bleeding caused by fibroids. Older, high-dose birth control pills may have contributed to fibroid growth, but today's formulations are much lower in hormones. The hormonal IUD is also often used successfully to control fibroid-related bleeding without causing growth.

FAQs About Nashville Gynecology Center 

Does Dr. Gurley specialize in fibroid treatment? 

Yes! Dr. Larry D. Gurley is an expert in the diagnosis and treatment of fibroids and bleeding problems. He has extensive experience with both surgical and non-surgical treatment options and believes strongly in providing patients with a full discussion of all available alternatives before recommending any specific treatment.

What fibroid treatment options do you offer? 

We offer comprehensive fibroid care including monitoring for asymptomatic fibroids, medications for symptom management, myomectomy (fibroid removal with minimally invasive techniques when possible), endometrial ablation for appropriate candidates, hysterectomy when it's the best option, and referrals for uterine artery embolization when indicated. We tailor treatment to each patient's specific situation and goals.

Can you tell me during my first visit if I have fibroids? 

Often, yes! We have in-office ultrasound capabilities, which means we can frequently diagnose fibroids during your initial visit. Dr. Gurley can also often feel larger fibroids during a pelvic exam. In most cases, you'll leave your first appointment with a clear understanding of whether fibroids are present and what your options are.

Do I need surgery if I have fibroids? 

Not necessarily. Many women with fibroids never need surgery. It depends entirely on whether your fibroids are causing symptoms and how much those symptoms are affecting your quality of life. We always explore conservative options first, including monitoring and medications. Surgery is only recommended when it's truly the best option for your situation.

Will removing fibroids affect my ability to have children? 

Hysterectomy (removal of the uterus) means you can't have children afterward, but myomectomy (removal of just the fibroids) preserves your uterus and fertility. In fact, removing fibroids that are interfering with the uterine cavity or distorting the uterus can actually improve fertility. If preserving fertility is important to you, make sure to discuss this with Dr. Gurley so treatment can be planned accordingly.

How long is recovery after fibroid surgery? 

It depends on the type of surgery. Hysteroscopic myomectomy (through the vagina, no incisions) typically has the shortest recovery, often just a few days. Laparoscopic surgery usually requires 1-2 weeks of recovery. Traditional abdominal surgery may require 4-6 weeks. Dr. Gurley uses minimally invasive techniques whenever possible to reduce recovery time. 

Does insurance cover fibroid treatment? 

Yes, insurance typically covers evaluation and treatment of symptomatic fibroids as they're a recognized medical condition. Coverage varies by plan for specific treatments. Our office staff can verify your coverage and help you understand your benefits before any treatment is scheduled. Call (615) 284-1500 with your insurance information.   

Have fibroids or think you might? Don't wait and wonder. Contact us today to schedule your evaluation and get expert answers about your specific situation.