How big a uterine fibroid can be without requiring treatment?

Written by Huang Shuai
Obstetrics and Gynecology
Updated on February 09, 2025
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The size of uterine fibroids is one of the indicators we consider for whether treatment and surgery are necessary. It is generally believed that surgery is indicated when the diameter of a fibroid exceeds 6cm, or when the entire uterus is larger than the size it would be at ten weeks of pregnancy.

However, in reality, the size of a uterine fibroid is not an absolute indicator for surgery. This means that even if the fibroid exceeds 6cm, or the entire uterus reaches around ten weeks in size, it doesn’t necessarily require surgery. At this point, other factors are usually also considered, such as whether there are symptoms, whether the large fibroids cause heavy menstruation and anemia, whether there are compression symptoms, the radiological appearance of the fibroids, whether they resemble malignant conditions, whether the fibroids are rapidly growing, and whether the fibroids are located in special areas like the cervix, the hip ligament, or submucosal. Thus, the size of the uterine fibroids is just one aspect we consider for treatment or surgery; the presence of symptoms and whether the fibroids are malignant, among others, are actually more important.

Other Voices

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Written by Li Shun Hua
Obstetrics and Gynecology
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What are the symptoms of uterine fibroids?

If the uterine fibroids are relatively small, they generally do not show symptoms. However, submucosal uterine fibroids, regardless of their size, can cause heavy menstrual bleeding and prolonged periods. Intramural uterine fibroids, if protruding into the uterine cavity, can also lead to heavy menstrual bleeding and prolonged periods. If the uterine fibroids are large and press against the bladder in front, symptoms such as frequent urination and urinary urgency can occur. If they press against the rectum in the back, it can lead to difficulty in defecation or a feeling of downward pain. Therefore, if symptoms are present with uterine fibroids, surgical treatment is necessary.

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Written by Li Shun Hua
Obstetrics and Gynecology
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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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Written by Wang Jing Hua
Obstetrics and Gynecology
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How often should uterine fibroids be checked?

The follow-up timing after uterine fibroids depends on the current size of the fibroids and the symptoms. If the fibroids are particularly small and there are no symptoms, a follow-up after one year is generally acceptable. However, if during the follow-up the fibroids are found to have grown quickly, or if there are symptoms such as increased menstrual flow or a shortened cycle, a follow-up every six months may be warranted. Most uterine fibroids do not cause any symptoms and simply exist; they tend to grow gradually with age and generally shrink and disappear after menopause.

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Written by Li Lin
Obstetrics and Gynecology
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Can you eat sea cucumber with uterine fibroids?

People with uterine fibroids can eat sea cucumber. The cause of uterine fibroids is not very clear at present. Studies have shown that uterine fibroids may be caused by chromosomal genetic misplacement in the body. However, since most uterine fibroids shrink after menopause, it is considered that uterine fibroids are related to increased levels of sex hormones in the body. Sea cucumber is a food that can enhance the immune system and has no relation to the formation of uterine fibroids. Therefore, people with uterine fibroids can eat sea cucumber.

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Written by Shen Li Wen
Obstetrics and Gynecology
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Early symptoms of uterine fibroid malignancy

Uterine fibroids are a type of benign lesion and generally grow slowly. Sometimes, even after several years of continuous re-examinations, the size of the uterine fibroids may not show significant changes. However, when uterine fibroids become malignant, their growth rate can accelerate, causing women to experience hidden pain in the lower abdomen. After the malignancy of uterine fibroids and an increase in size, they can also compress the pelvic floor nerves, leading to an intensification of abdominal pain; they can press forward against the bladder, causing frequent urination and urgency; and press backward against the rectum, resulting in changes in the characteristics of stools. Additionally, when some women's uterine fibroids turn malignant, they can also affect the surface area of the endometrium, impacting the menstrual cycle, such as causing irregular vaginal bleeding.