Do uterine fibroids cause bleeding?

Written by Wang Kun
Surgical Oncology
Updated on May 27, 2025
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When uterine fibroids are large or located under the endometrium, they can lead to bleeding, resulting in increased menstrual flow and even anemia in patients. At this point, patients can consider undergoing a gynecological color Doppler ultrasound to determine the number, size, and location of the fibroids to guide the choice of clinical treatment options. The best surgical option for treating uterine fibroids is a total hysterectomy, which will prevent the recurrence of the disease. However, for young patients who wish to preserve their fertility, myomectomy should be considered, as it can effectively treat the disease while preserving uterine function.

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How to check for uterine fibroids?

Uterine fibroids can primarily be diagnosed through ultrasound and gynecological examinations. Uterine fibroids are relatively easy to diagnose; an ultrasound can reveal irregular masses on the uterus or solid echoes, with a fairly intact capsule, which could be either solitary or multiple, confirming the presence of uterine fibroids. During a gynecological examination, an irregular uterine shape with localized protrusions can be felt, which are fairly mobile and typically not associated with significant pain, further confirming the presence of uterine fibroids.

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What department should I visit for uterine fibroids?

Uterine fibroids are a common gynecological condition. Once uterine fibroids occur, it is necessary to register for a gynecological examination. Further gynecological ultrasound examinations are required to determine the location of the uterine fibroids. There are several types of uterine fibroids, including subserosal, intramural, and submucosal fibroids. In particular, if submucosal fibroids are present, regardless of their size, timely surgery is needed due to the high risk of severe bleeding and anemia they pose. If the submucosal fibroid is small, hysteroscopic submucosal fibroid electrosurgery can be performed. If the fibroid is large, an open surgery may be necessary. Additionally, in the case of intramural and subserosal uterine fibroids, if the fibroid continues to grow larger than five centimeters, there is also a potential risk of malignancy, thus timely surgical treatment is recommended.

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How can uterine fibroids be reduced?

Uterine fibroids in women are closely related to the levels of estrogen in the body. Some women have relatively small uterine fibroids with no clinical symptoms and can be observed dynamically. Generally, after menopause, when the levels of estrogen decrease, the size of uterine fibroids in these women can naturally shrink. Additionally, certain medications can be used for treatment, such as drugs from the GnRH-a class, which act by causing ovarian ablation. This leads to a decrease in estrogen levels in the body and can also reduce the size of the uterine fibroids. Interventional treatments can also be employed to block the blood supply to the uterine fibroids, reducing their blood supply and consequently decreasing their size.

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Uterine fibroids are classified into several types.

Uterine fibroids are classified by location into two types: myometrial fibroids and cervical fibroids. Based on the relationship between the uterine fibroids and the muscular wall, there are three kinds of uterine fibroids: intramural fibroids, subserosal fibroids, and submucosal fibroids. Intramural fibroids, primarily located within the uterine wall and enclosed by a muscular layer, are recommended for surgical treatment once the fibroid's diameter exceeds four centimeters, as they tend to grow rapidly. Similarly, subserosal fibroids grow towards the peritoneal surface of the uterus and are on the exterior of the uterus. If subserosal fibroids also exceed four centimeters in diameter and are accompanied by menstrual changes, surgical treatment is advised. Furthermore, submucosal fibroids, regardless of their size, require timely surgical intervention due to their association with heavy bleeding and a high risk of anemia.

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What should I do about uterine fibroids?

Uterine fibroids first require examining the location and size of the fibroids. Uterine fibroids can be classified into subserosal fibroids, submucosal fibroids, and intramural fibroids. If it is a submucosal fibroid, no matter the size of the fibroid, it is necessary to promptly perform a hysteroscopic submucosal fibroid surgery. If the submucosal fibroid is large, it may be necessary to perform a hysterectomy through abdominal surgery. For intramural and subserosal fibroids, if the fibroid's diameter exceeds five centimeters or if the fibroid is growing rapidly, surgical treatment is recommended at that time, because there is a chance of malignant transformation in uterine fibroids, which ranges from 0.2% to 0.3%. Therefore, once such a situation occurs, surgical treatment is required.