Uterine Fibroids
Noncancerous tumors that grow in or on the uterus. While many fibroids cause no symptoms, they can lead to heavy menstrual bleeding, pelvic pain, and other complications. Fibroids are common in women of reproductive age and are highly treatable.
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What are Uterine Fibroids?
Uterine fibroids, also called myomas, fibromas, or leiomyomas, are benign (noncancerous) tumors that grow in or on the uterus. They are among the most common tumors in women of reproductive age, affecting 30-40% of women by age 40, with even higher rates in African American women.
While many fibroids cause no symptoms and are discovered incidentally, they can sometimes become quite large and lead to heavy menstrual bleeding, severe abdominal pain, and complications affecting fertility and pregnancy.
The good news is that fibroids are benign and never become cancerous. Multiple effective treatment options exist ranging from observation to medical management to surgery, depending on fibroid size, location, symptoms, and fertility desires.
Common Symptoms
Heavy menstrual bleeding
Prolonged menstrual periods (>7 days)
Blood clots during menstruation
Severe menstrual cramping
Pelvic pain or pressure
Pain during sexual intercourse (dyspareunia)
Increased urinary frequency
Urinary urgency
Constipation
Leg pain or lower back pain
Abdominal bloating
Fullness or heaviness in lower abdomen
Types of Uterine Fibroids
- Submucosal Fibroids: Project into the uterine cavity. Extends into uterine cavity; most bleeding risk Symptoms: Heavy bleeding, prolonged periods, cramping
- Intramural Fibroids: Within the uterine wall muscle. Most common type; embedded in muscle Symptoms: Cramping, heavy bleeding, pelvic pressure
- Subserosal Fibroids: Extend outside uterus into pelvic cavity. Can grow large; may affect nearby organs Symptoms: Pelvic pressure, pain, pressure on organs
- Pedunculated Fibroids: Attached to uterus by stalk. Unique stalk attachment; risk of torsion Symptoms: Pain if stalk twists; variable symptoms
- Cervical Fibroids: Develop in cervix. Rare location; unique management challenges Symptoms: Vaginal discharge, bleeding, pain
What Causes Uterine Fibroids?
- Estrogen and Progesterone: Fibroids contain more estrogen and progesterone receptors than normal uterine muscle. Hormones stimulate fibroid growth; fibroids shrink after menopause
- Genetic Factors: Family history increases risk; inherited genetic predisposition. Women with affected mothers more likely to develop fibroids
- Growth Factors: Alterations in growth factor signaling pathways. Abnormal growth factor production promotes fibroid proliferation
- Extracellular Matrix (ECM) Abnormalities: ECM is expanded and altered in fibroids. Enhanced ECM increases fibroid stiffness and vascularity
- Uterine Injury or Inflammation: Uterine trauma triggers abnormal wound healing response. Inflammation and altered cytokine production promotes fibroids
- Altered Immune Response: Immune dysregulation allows fibroid growth. Reduced immune surveillance permits tumor proliferation
- Angiogenesis (Blood Vessel Formation): Increased vascular growth supports fibroid expansion. Extensive blood supply allows rapid fibroid growth
- Stem Cell Recruitment: Bone marrow-derived stem cells recruited to uterus. Stem cells contribute to fibroid cell populations
Who is at Risk?
- Age 30-50 Years: Fibroids most common in women during peak reproductive years
- African American Ethnicity: Higher prevalence and earlier onset in African American women
- Family History: Women with affected first-degree relatives at significantly higher risk
- Obesity: Excess weight increases estrogen levels promoting fibroid growth
- Early Menarche: Early menstruation onset increases lifetime estrogen exposure
- High Red Meat Consumption: Processed and red meat consumption associated with increased risk
- Low Vegetable/Fruit Intake: Inadequate plant-based diet increases fibroid risk
- Vitamin D Deficiency: Low vitamin D levels associated with increased fibroids
- Nulliparity (No Pregnancies): Never having children increases fibroid risk
- Hypertension: High blood pressure associated with fibroid development
- Estrogen/Progesterone Therapy: Hormone therapy may increase fibroid growth
- Sedentary Lifestyle: Lack of physical activity increases fibroid risk
- Metabolic Syndrome: Insulin resistance and metabolic dysfunction promote fibroids
- Uterine Instrumentation: Previous D&C, hysteroscopy, or instrumentation increases risk
- Polycystic Ovary Syndrome (PCOS): PCOS and associated hormonal imbalance increase fibroid risk
Symptom Severity and Impact
- Asymptomatic (30-50% of women): No noticeable symptoms; discovered incidentally Management: Monitoring; imaging surveillance; watchful waiting
- Mild Symptoms (20-30% of women): Minimal bleeding increase or occasional pelvic discomfort Management: Observation; over-the-counter pain management; iron supplementation
- Moderate Symptoms (30-40% of women): Notable heavy bleeding, cramping, or pelvic pressure Management: Medical therapy; NSAIDs, hormonal therapy, or procedural options
- Severe Symptoms (10-20% of women): Severe bleeding, significant anemia, severe pain, organ dysfunction Management: Surgical intervention; myomectomy or hysterectomy often needed
Potential Complications
- Heavy Menstrual Bleeding: Excessive bleeding during periods Symptoms: Soaking through pads/tampons, passing clots, periods lasting >7 days
- Iron Deficiency Anemia: Low hemoglobin from chronic blood loss Symptoms: Fatigue, shortness of breath, weakness, dizziness, pale skin
- Infertility or Subfertility: Difficulty conceiving or carrying pregnancy Symptoms: Failure to conceive despite regular unprotected intercourse
- Pregnancy Complications: Miscarriage, preterm labor, or delivery complications Symptoms: Vaginal bleeding, contractions, delivery complications
- Urinary Symptoms: Urinary frequency, urgency, retention, incontinence Symptoms: Frequent urination, urgent need, difficulty emptying
- Bowel Symptoms: Constipation, rectal pressure, or bowel dysfunction Symptoms: Constipation, rectal pressure, bloating, incomplete evacuation
- Pelvic Pain and Pressure: Pain in pelvis, lower abdomen, or lower back Symptoms: Chronic pelvic pain, pressure sensation, lower back pain
- Dyspareunia (Painful Intercourse): Pain during or after sexual intercourse Symptoms: Pain with intercourse, reduced sexual function
- Red Degeneration: Acute fibroid infarction and pain (pregnancy-related) Symptoms: Acute severe abdominal pain, fever, tenderness
- Fibroid Torsion: Pedunculated fibroid twists on its stalk (rare emergency) Symptoms: Acute severe pain, nausea, vomiting, fever
How Uterine Fibroids are Diagnosed
- Clinical History & Exam: Menstrual history, symptom assessment, pelvic examination findings
- Transvaginal Ultrasound: High-resolution imaging from vaginal probe; excellent for fibroid detection and characterization
- Transabdominal Ultrasound: Abdominal probe imaging; useful for larger fibroids and overall uterine assessment
- Pelvic MRI: Gold standard for fibroid mapping; shows exact location, size, type for surgical planning
- Hysterosalpingography (HSG): X-ray with contrast; shows uterine cavity distortion from submucosal fibroids
- Hysteroscopy: Direct visualization of uterine cavity; can assess submucosal fibroids and concurrent pathology
- Hemoglobin/Hematocrit: Blood tests assess anemia severity from chronic blood loss
- Iron Studies: Ferritin, TIBC assess iron stores and iron deficiency status
- Pelvic CT: Alternative imaging if MRI contraindicated; less detailed than MRI
- Sonohysterography: Ultrasound with saline infusion; excellent visualization of submucosal fibroids
Treatment Options
- Watchful Waiting (Expectant Management): Asymptomatic or minimally symptomatic fibroids. Effectiveness: Appropriate for stable, asymptomatic cases
- NSAIDs (Medical Management): Heavy bleeding and menstrual cramping. Effectiveness: Reduces bleeding by 20-30%; reduces pain
- Hormonal Contraceptives (Medical Management): Heavy bleeding, pain, fertility not desired. Effectiveness: Reduces bleeding by 30-40%; reduces cramping
- Tranexamic Acid (Medical Management): Heavy menstrual bleeding. Effectiveness: Reduces bleeding by 40-50%; non-hormonal
- GnRH Agonists (Medical Management): Severe symptoms, pre-operative fibroid shrinkage. Effectiveness: Shrinks fibroids 30-50%; reduces bleeding significantly
- Progestin-Releasing IUD (Medical Management): Heavy bleeding, contraception desired. Effectiveness: Reduces bleeding by 40-80%; very effective
- Uterine Artery Embolization (UAE) (Minimally Invasive Procedures): Moderate to severe symptoms; fertility not essential. Effectiveness: Shrinks fibroids 30-50%; symptom relief similar to surgery
- Myomectomy (Laparoscopic or Hysteroscopic) (Minimally Invasive Procedures): Desire fertility; submucosal or intramural fibroids. Effectiveness: Removes fibroids; preserves fertility potential
- Hysterectomy (Total, Subtotal, or Radical) (Surgical Management): Severe symptoms; no desire for future pregnancies. Effectiveness: 100% effective; permanent solution
- Magnetic Resonance-Guided Focused Ultrasound (MRgFUS) (Newer Procedures): Symptomatic fibroids; minimally invasive approach desired. Effectiveness: Variable; shrinks fibroids; symptom relief moderate
How to Prevent or Reduce Fibroid Risk
- Maintain healthy body weight; obesity increases estrogen levels
- Eat a diet rich in fruits and vegetables
- Limit red meat and processed meat consumption
- Maintain regular physical activity and exercise
- Manage stress through relaxation techniques
- Ensure adequate vitamin D intake; consider supplementation
- Avoid unnecessary uterine instrumentation and procedures
- Seek treatment for hormonal imbalances
- Maintain healthy blood pressure
- Avoid smoking; smoking affects estrogen metabolism
- Limit alcohol consumption
- Get adequate sleep and maintain healthy sleep patterns
- Maintain healthy diet with adequate iron intake
- Regular gynecological check-ups and screening
- Discuss family history with healthcare provider
Managing Symptoms at Home
- Take prescribed medications exactly as directed
- Use heat therapy (heating pad, warm bath) for cramping and pain
- Maintain iron-rich diet (red meat, spinach, beans, fortified cereals)
- Take iron supplements if anemia present; take with vitamin C
- Stay well-hydrated; drink plenty of water
- Rest during heavy bleeding days; don't overexert yourself
- Practice stress reduction (meditation, yoga, deep breathing)
- Regular moderate exercise; avoid strenuous activity during heavy periods
- Keep track of menstrual bleeding and symptoms in diary or app
- Wear appropriate menstrual protection (super tampons, pads, menstrual discs)
- Sleep with extra pillow for comfort; elevate legs if pelvic pressure
- Use NSAIDs preventatively starting before period begins
- Avoid prolonged sitting if pelvic pressure significant
- Maintain regular gynecological follow-up appointments
- Discuss treatment options with healthcare provider regularly
When to Seek Medical Care
- Severe Bleeding: Soaking through pads/tampons hourly; heavy clots requiring emergency care
- Severe Anemia Symptoms: Severe fatigue, shortness of breath at rest, severe dizziness or syncope
- Acute Severe Pain: Sudden severe abdominal or pelvic pain suggesting torsion or red degeneration
- Fever with Pain: Fever accompanying pelvic pain suggests infection or red degeneration
- Pregnancy with Fibroids: Pregnant with known fibroids; requires close obstetric monitoring
- Infertility: Unable to conceive after one year of trying; evaluation for fibroid impact recommended
- Urinary Retention: Inability to urinate; requires emergency evaluation
- Bowel Obstruction: Severe constipation, abdominal distention, nausea/vomiting suggesting obstruction
Uterine Fibroids are Common and Benign: Affecting millions of women worldwide, fibroids are always noncancerous and never become cancer. They are extremely manageable with modern medicine.
Many Options Exist: From observation to medical management to minimally invasive procedures to surgery, there is a solution for nearly every woman with symptomatic fibroids. Many options preserve the uterus and fertility.
Individualized Care: Our experienced gynecology team works with each patient to determine the best treatment plan based on fibroid characteristics, symptoms, and personal goals.
At MyDoc Urgent Care, we provide comprehensive uterine fibroid evaluation and management. If you're experiencing heavy periods, pelvic pain, or suspect fibroids, schedule a consultation at one of our convenient locations in Forest Hills, East Meadow, Brooklyn, Bronx, Jackson Heights, or Little Neck. We're here to help.
Uterine Fibroids FAQs & Patient Information
If you have questions about uterine fibroids, symptoms, or treatment options, our team is here to help. Below are answers to some of the most common questions we receive from patients. For more information or to discuss your specific situation, please schedule a consultation.
Frequently Asked Questions
What is urgent care and how does it work?
Urgent care centers are designed to treat those who need attention quickly but don't require an emergency room visit. At MyDoc Urgent Care, you can walk in without an appointment and receive prompt medical attention for a wide range of non-life-threatening conditions. Our clinics are open 7 days a week, 12 hours a day (8:00 AM – 8:00 PM), providing extended access beyond typical primary care hours. We offer services such as treatment for minor injuries and illnesses, diagnostic testing, vaccinations, and preventive care. Our goal is to bridge the gap between your primary care doctor and the emergency room, ensuring you get the care you need, when you need it.
Who do we treat?
We treat patients of all ages, from infants and children to adults and seniors. Whether you have a minor illness, need a physical exam, or require urgent attention for an injury, our team is equipped to help. We welcome both long-time residents and visitors to the area. Our providers are experienced in pediatric, adult, and geriatric care, and we strive to create a welcoming, compassionate environment for every patient. If you have a chronic condition and need prompt care, we can help manage your symptoms and coordinate with your primary care provider if needed.
How do I get started?
Getting care at MyDoc Urgent Care is easy. Simply walk in to any of our locations during business hours—no appointment is necessary. If you have questions or want to check wait times, you can call us at (718) 401-1510. For added convenience, you can also check in online to reduce your wait time. When you arrive, our friendly staff will help you register and guide you through the process. Most visits are completed in under an hour, so you can get back to your day quickly.
How does Urgent Care compare to the ER or a Primary Care Doctor?
Urgent care is designed for non-life-threatening conditions that require prompt attention but are not severe enough for the emergency room. The average wait time for a primary care appointment can be over 20 days, and ER visits can last over 3 hours. At MyDoc Urgent Care, most visits are completed in less than an hour. We offer a cost-effective alternative to the ER for issues like minor injuries, infections, and illnesses. For life-threatening emergencies, such as chest pain, severe bleeding, or difficulty breathing, always call 911 or go to the nearest ER.
What about insurance?
We accept most major insurance plans for medical services, including Medicaid and Medicare. If you do not have insurance, we offer affordable self-pay rates and transparent pricing. Our staff can help you understand your benefits, answer questions about coverage, and provide cost estimates before treatment. We believe everyone should have access to quality healthcare, regardless of insurance status.
What conditions do you treat at urgent care?
We treat a wide range of conditions, including cold and flu symptoms, sore throat, ear infections, minor cuts and burns, sprains and strains, rashes, urinary tract infections, allergies, minor fractures, and more. We also provide physical exams for school, work, and sports, as well as vaccinations and on-site lab testing. If you are unsure whether we can help, call us or walk in—our team will assess your needs and provide the appropriate care or referral.
Can I get prescriptions or refills at urgent care?
Yes, our providers can prescribe medications for acute illnesses and minor conditions, such as antibiotics for infections or medications for pain relief. We can also provide short-term refills for certain maintenance medications if appropriate. Please bring a list of your current medications and any relevant medical history to your visit. For long-term medication management, we recommend following up with your primary care provider.
Do you offer pediatric urgent care?
Absolutely! Our clinics are equipped to care for children of all ages, from infants to teenagers. We understand that children have unique medical needs and strive to provide a comfortable, family-friendly environment. Our providers are experienced in pediatric care and can treat common childhood illnesses, injuries, and provide physicals and vaccinations.
What should I bring to my urgent care visit?
Please bring a photo ID, your insurance card (if applicable), a list of current medications, and any relevant medical records. If you are bringing a child, please bring their immunization records if available. Having this information helps us provide the best and safest care possible. If you have paperwork for work, school, or sports, bring that as well so we can complete it during your visit.
How do I know if I should go to urgent care or the ER?
Urgent care is appropriate for non-life-threatening conditions that need prompt attention, such as minor injuries, infections, or illnesses. If you are experiencing severe chest pain, difficulty breathing, signs of stroke, severe bleeding, loss of consciousness, or any other life-threatening emergency, call 911 or go to the nearest emergency room immediately. When in doubt, it's always better to err on the side of caution and seek emergency care.
Do I need an appointment to visit MyDoc Urgent Care?
No appointment is necessary at MyDoc Urgent Care. We welcome walk-ins at all of our locations during business hours. If you prefer, you can check in online to save time and reduce your wait. Our goal is to make healthcare as accessible and convenient as possible for you and your family.
What forms of payment do you accept?
We accept most major credit cards, debit cards, cash, and many insurance plans. If you have questions about payment or billing, our front desk staff will be happy to assist you and provide clear information about costs before your visit. We strive to make the billing process transparent and stress-free.
Can I get lab tests or X-rays at urgent care?
Yes, MyDoc Urgent Care offers on-site lab testing and X-ray services for your convenience. This allows us to quickly diagnose and treat a wide range of conditions without the need to send you to another facility. Common tests include strep throat, flu, COVID-19, urinalysis, blood work, and more. X-rays are available for injuries such as sprains, fractures, and chest concerns.
How long will my visit take?
Most visits to MyDoc Urgent Care are completed in less than an hour, including registration, evaluation, and treatment. Wait times may vary depending on the time of day and the number of patients, but we strive to provide prompt, efficient care. You can check in online to further reduce your wait time.
Can urgent care help with work or school forms?
Absolutely! We can provide physical exams for work, school, sports, and camp, as well as complete any necessary forms. Please bring any required paperwork with you to your visit. Our providers will ensure all forms are filled out accurately and promptly so you can meet your deadlines.