Fibroids seen by chance on a scan

What the report means

Fibroids are growths of muscle cells and other tissue in and around the wall of the womb (uterus). They can be one growth or a cluster, and they vary in number and size. (MedlinePlus) The medical names are leiomyoma or myoma. (ACOG)

Reports often say where a fibroid sits. The NICHD describes these terms: (NICHD)

Submucosal: just under the womb lining, growing into the inside of the womb.
Intramural: within the muscle wall of the womb.
Subserosal: on the outside of the womb.
Pedunculated: on a stalk, growing out from the surface or into the inside of the womb.

The NICHD says fibroids can grow, shrink or stay the same size over time. (NICHD)

How common they are

The Office on Women's Health says about 20 to 80 percent of women develop fibroids by age 50, and that they are most common in the 40s and early 50s. (OWH) ACOG says they are most common at 30 to 40 but can occur at any age, and are more common, start younger and grow faster in Black women. (ACOG) The NHS says fibroids mainly affect women who have not been through the menopause, and that anyone with a womb can get them. (NHS)

Many people with fibroids have no symptoms and do not know they have them. (MedlinePlus)(NHS)

When no follow-up is needed

ACOG says fibroids that do not cause symptoms, are small, or occur in a woman who is nearing menopause often do not need treatment. (ACOG) MedlinePlus says that if you have no symptoms, you may not need treatment, and the NHS says treatment is not always needed if fibroids are not causing symptoms. (MedlinePlus)(NHS) ACOG also says CT and MRI may be used but are rarely needed for fibroids, and the NHS says a GP who thinks you might have fibroids will usually refer you for an ultrasound scan. (ACOG)(NHS)

When to see a doctor

The NHS lists these possible fibroid symptoms: (NHS)

heavy or painful periods
stomach pain or lower back pain
peeing more often, needing to pee suddenly, or not being able to control when you pee
problems pooing, such as bloating or pain
pain or discomfort during sex
difficulty getting pregnant

The NHS says to see a GP if you have symptoms of fibroids, if they affect your everyday life, work and relationships, or if painkillers are not helping. (NHS) ACOG lists signs that may mean fibroids need care: heavy or painful periods that cause anemia or disrupt normal activities, bleeding between periods, uncertainty whether the growth is a fibroid or another kind of growth such as an ovarian tumor, a rapid increase in growth, infertility, and pelvic pain. (ACOG)

In the UK, for women with heavy periods, NICE says to offer a pelvic ultrasound if the womb can be felt through the belly, a pelvic mass is suspected, or the examination is unclear, and to consider referral to specialist care for further tests when fibroids are 3 cm or more across. (NICE NG88)

A new or growing fibroid after menopause

Fibroids usually stop growing or shrink after menopause. (OWH)(ACOG) That is why a report of a new or larger fibroid after menopause is worth raising with your doctor:

A 2023 consensus statement in Radiology says a new or rapidly enlarging mass in the womb muscle in postmenopausal women "(who are not on postmenopausal estrogen therapy) should be viewed as highly suspicious for a uterine sarcoma unless proven otherwise". (Hindman 2023)
The same statement says rapid growth before menopause is no longer seen as a reliable sign of sarcoma, because benign fibroids can also grow quickly. (Hindman 2023)
Uterine sarcoma is rare. The statement reports about one in 770 women (0.13%) among removed masses thought to be fibroids, with incidence over age 50 more than four times that in younger women. (Hindman 2023) A hospital case-control study found women with sarcoma were older and much more often postmenopausal than women with fibroids. (Chen 2018)

Any bleeding after menopause has its own guidance, covered on the thick womb lining found by chance after menopause page.

Cervical screening stays the same

Fibroids grow in the body of the womb, while cervical screening checks the cervix, the opening of the womb. Neither screening schedule below lists fibroids as a reason to change it:

USPSTF (US, 2018; update in progress): screening every 3 years with cervical cytology at 21 to 29, and at 30 to 65 every 3 years with cytology, every 5 years with high-risk HPV testing alone, or every 5 years with both. (USPSTF cervical)
NHS (England): women aged 25 to 64 are invited every 5 years, and everyone with a cervix should be offered screening. (NHS cervical screening)

The full picture is on the cervical cancer screening page.

Other things on the same report

A pelvic scan often notes more than one finding. See ovarian cyst found by chance, thick womb lining found by chance after menopause and after an abnormal screening result.

Where they differ:

Peak age. ACOG says fibroids are most common at 30 to 40; the Office on Women's Health says the 40s and early 50s. (ACOG)(OWH)
How rare cancer is. The Office on Women's Health gives less than one in 1,000 for a cancerous fibroid; the 2023 consensus statement gives about one in 770 among removed masses thought to be fibroids. (OWH)(Hindman 2023)
Rapid growth. ACOG lists a rapid increase in growth as a sign that may need care; the consensus statement says rapid growth before menopause does not reliably point to sarcoma, but a new or fast-growing mass after menopause does need checking. (ACOG)(Hindman 2023)
Which scan. ACOG says CT and MRI are rarely needed; NICE ties a pelvic ultrasound to heavy periods with an enlarged womb, a suspected mass or an unclear examination. (ACOG)(NICE NG88)
Cervical screening ages. The USPSTF covers 21 to 65; the NHS invites 25 to 64. (USPSTF cervical)(NHS cervical screening)

Your doctor decides what your result means for you.

Questions people ask

Are fibroids cancer?

No. The NHS calls fibroids common, non-cancerous growths in or around the womb, and ACOG says they are benign (not cancer) growths of the womb muscle. The Office on Women's Health says a cancerous fibroid (leiomyosarcoma) is rare, less than one in 1,000, and that having fibroids does not raise the risk of it. (NHS) (ACOG) (OWH)

How common are fibroids?

Very common. The Office on Women's Health says about 20 to 80 percent of women develop fibroids by age 50. MedlinePlus calls them the most common noncancerous tumors in women of childbearing age, and ACOG the most common type of growth found in the pelvis. (OWH) (MedlinePlus) (ACOG)

Do fibroids found by chance need follow-up?

Often not. ACOG says fibroids that do not cause symptoms, are small, or occur in a woman nearing menopause often do not need treatment, and MedlinePlus says you may not need treatment if you have no symptoms. The NHS says to see a GP if you have symptoms. Your doctor decides with you. (ACOG) (MedlinePlus) (NHS)

What if a fibroid is new or growing after menopause?

Fibroids usually shrink after menopause (OWH, ACOG). A 2023 radiology consensus statement says a new or rapidly enlarging mass in the womb muscle after menopause, in women not on postmenopausal estrogen therapy, should be viewed as highly suspicious for a uterine sarcoma unless proven otherwise. Tell your doctor if a report says a fibroid is new or larger after menopause. (OWH) (ACOG) (Hindman 2023)

Does a fibroid change my cervical screening?

No. Fibroids grow in the body of the womb, and cervical screening checks the cervix. The schedules from the USPSTF and the NHS are set by age and past results, and neither lists fibroids as a reason to change them. (USPSTF cervical) (NHS cervical screening)