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 Sun Shan Shan
Obstetrics and Gynecology
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How to treat uterine fibroids?

Uterine fibroids are the most common benign tumors of the female reproductive organs, consisting of smooth muscle and connective tissue, mostly seen in women aged 30-50. Uterine fibroids can be classified into fibroids of the uterine body and cervical fibroids. Depending on their location, the treatments differ. Fibroids of the uterine body are further divided into intramural fibroids, subserosal fibroids, and submucosal fibroids. In cases of submucosal fibroids, prompt symptomatic treatment is necessary once detected, as these fibroids grow towards the uterine cavity and protrude into it, covered only by the endometrium on the surface. Hence, timely surgical intervention and regular physical examinations are crucial for submucosal fibroids.

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Written by Zhao Xiao Dong
Obstetrics and Gynecology
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How many days after uterine fibroid surgery can I wash my hair?

Uterine fibroid surgery, including myomectomy and hysterectomy, does not require the postpartum practice of "sitting the month," and there are no prohibitions against washing hair or bathing, unlike after childbirth. Generally, the surgical wound will fully heal about a week after the operation, at which point it is possible to wash hair and even bathe. Of course, it is important to monitor the recovery process after uterine fibroid surgery. If there are signs of infection at the surgical site, such as redness, hardening, or discharge of pus, the wound generally needs to be opened, the stitches removed, and the dressing changed regularly. Antibiotic and anti-infection treatments are administered until the wound fully heals, after which washing hair and bathing are permissible.

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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 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 Sun Shan Shan
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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.