Uterine fibroids are benign tumors arising from the hyperplasia of uterine smooth muscle tissue. Common symptoms include uterine bleeding, pain, abdominal masses, pressure effects on adjacent organs, increased vaginal discharge, anemia, and cardiac dysfunction. Some patients are completely asymptomatic and are only diagnosed with uterine fibroids during routine gynecological screening.
Known as the "number one gynecological tumor", uterine fibroids have an extremely high prevalence. Statistical data shows that approximately 20% to 25% of women of childbearing age are affected. The highest incidence occurs among women aged 30 to 50.
Uterine fibroids are generally benign and not life‑threatening, so many patients do not take them seriously. Some cannot afford treatment due to financial hardship; others are too busy with work to seek medical care. In addition, some fibroids cause no obvious symptoms, leading many women to believe they are harmless and do not need to be removed. The question of whether uterine fibroids should be removed leaves many women in a dilemma.
Whether to remove uterine fibroids must be determined individually, not by a one‑size‑fits‑all rule.
Although uterine fibroids are benign, with a malignant or sarcomatous transformation rate of only about 0.4%, they can easily lead to a series of complications: menstrual disorders, frequent urination, urgent urination, constipation, abdominal masses, pain, increased vaginal discharge, and infertility. Prolonged vaginal bleeding can cause anemia; in severe cases, it may result in anemic heart disease, also known as “fibroid‑related heart disease”.
Furthermore, fibroids are often accompanied by other concurrent pelvic disorders, such as endometrial hyperplasia and polyps, endometriosis, polycystic ovary syndrome, endometrial adenocarcinoma, and cervical cancer. Delayed treatment of uterine fibroids may also reduce the quality of sexual life and even affect family harmony. Therefore, once diagnosed, fibroids exert negative physical and psychological impacts, and appropriate treatment should be provided in a timely manner. However, whether surgical removal is necessary depends on the patient’s specific condition.
If fibroids are small, asymptomatic, and show no signs of complications or malignant changes, removal is usually unnecessary. This is especially true for perimenopausal women, as fibroids often shrink or disappear spontaneously after menopause due to low estrogen levels. Regular follow‑up is sufficient. If follow‑up shows enlargement of fibroids or significant worsening of symptoms, further treatment may be considered, including traditional surgery, minimally invasive surgery, or non‑invasive ultrasound ablation.
Reminders for patients with uterine fibroids: Regular examinations are essential, including B‑ultrasound or gynecological checks every 3 to 6 months. In older women, rapid fibroid growth in a short period or postmenopausal vaginal bleeding requires close monitoring for possible sarcomatous degeneration. Women with excessive menstrual bleeding should actively correct anemia to prevent anemic heart disease and degenerative myocardial changes.