Can fibroids be cancerous? 5 things to know

Women's Health

by Alan Johns, MD

Jun 25, 2025

Most women will develop fibroids at some point in their lives. Uterine fibroids are noncancerous growths that are surprisingly common and often manageable. Fibroids develop on or in the uterus and can vary greatly in size, shape and impact.

Understanding more about uterine fibroids can help empower you to make informed decisions about your health. Let’s address some of the most common questions about fibroids and walk through the key facts, helping to address your worries and provide more clarity.

What are uterine fibroids?

Uterine fibroids are noncancerous (or benign) growths of muscle tissue in the uterus that can vary in size, from as small as a pinhead to as large as a basketball. They are the most common tumors in women of childbearing age, affecting up to 70% of white women and 80% of Black women by age 50, according to the National Institutes of Health. 

There are three uterine locations where fibroids may develop, including:

  • Inside the uterus (in the uterine cavity) — these are called submucosal fibroids
  • Within the muscle of the uterine wall — these are called intramural fibroids
  • Outside surface of the uterus — these are called subserosal fibroids

Most fibroids, however, are located across these areas at the same time.

Symptoms of fibroids

The most common symptoms of uterine fibroids are:

  • Constipation
  • Frequent urination or trouble urinating
  • Heavy menstrual bleeding or painful periods
  • Longer or more frequent periods
  • Pain in the stomach are or lower back, or pain during sex
  • Pelvic pressure or pain

In many cases, fibroids do not have any symptoms and women may be unaware they have them.

What causes fibroids and who is at risk for them?

Although fibroids may be worrisome for some women, I see patients with uterine fibroids every day, and I have been diagnosing and treating problems associated with uterine fibroids for many years. Although we have not discovered the cause of fibroids, research has given us better treatment alternatives. We also have a much better understanding of which fibroids require treatment, and which ones do not.

There are several risk factors that can make it more likely that you’ll develop fibroids in your lifetime. They include:

  • Age: Until menopause, your risk for fibroids increases as you age. Once you have reached menopause, your risk for fibroids decreases.
  • Ethnicity: In the United States, Black women are more likely to develop fibroids due to genetics.
  • Family history: If a family member has had fibroids, you are more likely to develop fibroids.
  • Obesity: Being overweight can increase the risk of fibroids.

Can fibroids affect your ability to get pregnant?

With the exception of submucosal fibroids, most small fibroids have no effect on your ability to get pregnant. Submucosal fibroids, which are those that grow inside the uterine cavity, are most likely to produce problems, specifically heavy and crampy menses. These fibroids may also make it more difficult to become pregnant.

If you’re thinking about pregnancy and are living with uterine fibroids, reach out to your OBGYN with any concerns.

5 things to know about uterine fibroids

If you’re living with uterine fibroids, you may have questions about symptoms, diagnosis and what your treatment options are. Here are five common questions about fibroids.

1. Are fibroids causing my pelvic pain?

Usually, fibroids are not the cause of your pelvic pain. Most fibroids are asymptomatic, meaning they don’t cause symptoms. Small fibroids (those measuring one to six inches or less) that are not inside the uterus usually pose no risk to the person and do not require treatment.

Uterine fibroids rarely cause pain but can be associated with heavy menses, crampy menses and when they are large enough — pelvic pressure. They are completely unrelated to ovarian cysts, uterine polyps or other types of growths in the pelvis.

2. How are fibroids diagnosed?

Fibroids are diagnosed by ultrasound and an MRI scan, not by pelvic examination. A gynecologist may suspect that a person has fibroids from a pelvic examination, but imaging is required to make the diagnosis.

3. Can fibroids be cancerous?

Uterine fibroids are noncancerous growths. Uterine fibroids aren’t associated with an increased risk of uterine cancer and are very rarely cancerous. Only 0.1% of masses in the uterus that appear to be fibroids are actually cancer (known as leiomyosarcoma). These rare tumors usually occur in women in their mid-40s or later.

4. Do I need surgery for fibroids?

Treatment recommendations depend on a person’s age, the size and location of the fibroids, her desire for pregnancy, her symptoms and her overall health. If you are told you need surgery for your fibroids, a second opinion is always a good idea.

5. What are the treatment options for uterine fibroids?

There are a wide variety of treatment options available for women with fibroids if you are experiencing symptoms. Treatment options may include:

  • High intensity focused ultrasound (HIFU)
  • Hysterectomy
  • Hysteroscopic surgery
  • Laparoscopic or robotic surgery
  • Medical therapy
  • Myolysis
  • No treatment, if your symptoms aren’t affecting your quality of life

Your gynecologist can help you make the best decision to treat fibroids based on your circumstances.

When to see a doctor for fibroids

Contact your doctor if you have symptoms such as:

  • Heavy or painful periods that impact your everyday life
  • Ongoing tiredness and weakness
  • Pelvic pain that doesn’t go away
  • Spotting or bleeding between periods
  • Trouble emptying your bladder

Uterine fibroids are a common concern, but they aren’t a reason to panic. Understanding their nature and the many treatment options available can help you feel empowered and make informed decisions about your care.

If you’re experiencing symptoms or have been diagnosed with fibroids, reach out to a specialist for expert guidance. Find one near you.

About the Author

Dr. Alan Johns is an OBGYN on the medical staff at Baylor Scott & White All Saints - Fort Worth.

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