Finding out you have uterine fibroids when you are trying to start or grow your family can feel alarming. Questions often follow: Will I be able to get pregnant? Could fibroids cause a miscarriage? Do I need surgery before trying?

These are valid concerns. The good news is that many women with fibroids become pregnant and have healthy pregnancies. However, fibroids can affect fertility and pregnancy differently depending on their size, number, and especially their location.

Can You Get Pregnant with Fibroids?

Yes. Having fibroids does not automatically mean you will have difficulty getting pregnant. Many women with fibroids conceive without fertility treatment.

In some cases, however, fibroids can interfere with fertility, particularly when they change the shape of the uterine cavity. The effect depends largely on where the fibroid is located rather than simply whether a fibroid is present.

How Can Fibroids Affect Fertility?

Fibroids may affect fertility by:

• Distorting the uterine cavity, which can interfere with implantation
• Affecting the uterine lining and its ability to support implantation
• Occasionally affecting the fallopian tubes or the normal anatomy of the reproductive tract
• Causing changes in the uterus that may make conception or implantation more difficult

Not every fibroid causes these problems, and many women with fibroids have no fertility-related complications.

Which Fibroids Are More Likely to Affect Fertility?

Location matters.

Submucosal fibroids, which grow into the uterine cavity, are the type most consistently associated with reduced fertility and pregnancy rates. Removing cavity-distorting submucosal fibroids may improve the chances of pregnancy in appropriately selected patients.

Intramural fibroids, which grow within the muscular wall of the uterus, have a more complicated relationship with fertility. Larger intramural fibroids, particularly those that distort the uterine cavity, may affect reproductive outcomes. However, surgery is not automatically recommended for every intramural fibroid.

Subserosal fibroids, which grow on the outside of the uterus, generally have less effect on fertility because they do not directly distort the uterine cavity.

Fibroids and Pregnancy

Many women with fibroids have uncomplicated pregnancies. However, fibroids can be associated with an increased risk of certain pregnancy complications, including:

• Miscarriage
• Preterm birth
• Placental abnormalities
• Fetal malposition, such as breech presentation
• Cesarean delivery

The risk varies according to factors such as fibroid size, number, and location.

Fibroids may also change in size during pregnancy. Some grow, particularly in early pregnancy, while others remain stable or become smaller. Rapid changes can sometimes cause pelvic or abdominal pain.

Do Fibroids Need to Be Treated Before Pregnancy?

Not necessarily.

Whether treatment is appropriate depends on the fibroid’s location and size, your symptoms, your fertility history, and whether it is affecting the uterine cavity.

Small fibroids that are not distorting the uterine cavity and are not causing significant symptoms may simply be monitored.

When treatment is recommended, myomectomy—surgical removal of fibroids while preserving the uterus—may be considered for women who wish to become pregnant. The approach can include hysteroscopic surgery for certain submucosal fibroids or laparoscopic/open surgery for other types.

Myomectomy has potential benefits and risks, including scar tissue formation and, depending on the depth and location of the uterine incision, possible implications for delivery in a future pregnancy.

Can You Have Fertility Treatment with Fibroids?

Yes. Women with fibroids may pursue fertility treatments such as IUI or IVF. However, whether fibroids should be treated before fertility treatment depends on the individual situation.

If you have fibroids and are trying to conceive, an OB-GYN or fertility specialist can assess the number, size, and location of your fibroids and determine whether they are likely to affect your fertility or pregnancy.

At IVANA MD, we provide individualized gynecologic care and can help you understand your options and coordinate care with fertility specialists when needed.

Schedule your women’s health consultation with IVANA MD in Missouri City, TX.
346-585-4077
4220 Cartwright Road, Suite 201, Missouri City, Texas 77459

References: 

American College of Obstetricians and Gynecologists. (2025). Uterine fibroids. https://www.acog.org/womens-health/faqs/uterine-fibroids 

Stewart, E. A. (2015). Uterine fibroids. New England Journal of Medicine, 372(17), 1646–1655. https://doi.org/10.1056/NEJMcp1411029 

Stewart, E. A., Cookson, C. L., Gandolfo, R. A., & Schulze-Rath, R. (2017). Epidemiology of uterine fibroids: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 124(10), 1501–1512. https://doi.org/10.1111/1471-0528.14640 

Pritts, E. A., Parker, W. H., & Olive, D. L. (2009). Fibroids and infertility: An updated systematic review of the evidence. Fertility and Sterility, 91(4), 1215–1223. https://doi.org/10.1016/j.fertnstert.2008.01.051

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Introduction

Uterine fibroids are among the most common benign growths affecting the uterus, particularly during the reproductive years. At IVANA MD, Dr. Ivana provides gynecologic care to help patients understand fibroids, manage symptoms, and discuss treatment options based on their individual needs and reproductive goals.

If you have been diagnosed with fibroids or are experiencing symptoms that may be related to them, understanding your options can help you make informed decisions about your care. For personalized evaluation, call 346-585-4077 to schedule an appointment with Dr. Ivana.

What Are Uterine Fibroids?

Uterine fibroids, also called leiomyomas or myomas, are noncancerous growths made up primarily of smooth muscle and fibrous tissue. They can develop within the uterine wall, beneath the inner lining, or on the outer surface of the uterus.

Fibroids vary considerably in size and number. Some are so small that they cause no symptoms, while others can become large enough to enlarge or distort the uterus.

Fibroids are very common, although estimates of how many women develop them vary depending on the population studied and the method used to detect them.

Types of Fibroids

1. Intramural Fibroids – Grow within the muscular wall of the uterus and are the most common type.
2. Subserosal Fibroids – Grow toward the outer surface of the uterus and may extend into the pelvic cavity.
3. Submucosal Fibroids – Develop beneath the inner lining of the uterus and may protrude into the uterine cavity. These fibroids can be particularly associated with heavy menstrual bleeding and may affect fertility in some women.
4. Pedunculated Fibroids – Attached to the uterus by a stalk and can develop on either the inner or outer surface.

Symptoms of Uterine Fibroids

Many women with fibroids have no symptoms. When symptoms occur, they can depend on the size, number, and location of the fibroids.

Possible symptoms include:

• Heavy or prolonged menstrual bleeding
• Pelvic pain or pressure
• Frequent urination
• Difficulty emptying the bladder
• Constipation or pressure in the rectum
• Lower back or abdominal pain
• Pain during intercourse
• An enlarged abdomen
• Difficulty becoming pregnant in some cases

Heavy menstrual bleeding caused by fibroids can also lead to iron-deficiency anemia, which may cause fatigue, weakness, or shortness of breath.

Fibroids may affect fertility in some women, particularly when they distort the uterine cavity. However, many women with fibroids become pregnant without fertility problems.

Causes and Risk Factors

The exact cause of fibroids is not fully understood. Their development appears to involve genetic, hormonal, and other biological factors.

• Hormones: Estrogen and progesterone can influence fibroid growth.
• Genetics: Having a close family member with fibroids may increase your risk.
• Age: Fibroids are most commonly diagnosed during the reproductive years.
• Race: Fibroids are more common and tend to develop at younger ages and cause greater symptom burden among Black women. The reasons for these differences are not fully understood.
• Body weight and lifestyle: Obesity and certain dietary patterns have been associated with fibroid risk, but these factors do not explain all cases.

Having one or more risk factors does not mean that you will develop fibroids.

Diagnosis at IVANA MD

Your healthcare provider may suspect fibroids based on your symptoms and pelvic examination. Imaging is usually used to confirm the diagnosis and determine the size and location of the fibroids.

Depending on your symptoms and medical history, evaluation may include:

• Pelvic examination
• Ultrasound imaging
• MRI when additional information is needed
• Hysterosonography or hysteroscopy in selected cases

Not every woman with fibroids needs every type of test. Your evaluation should be based on your symptoms and individual circumstances.

Treatment Options for Uterine Fibroids

Treatment depends on your symptoms, the size and location of the fibroids, your age, overall health, and whether you wish to become pregnant.

1. Watchful Waiting

If fibroids are not causing significant symptoms, treatment may not be necessary. Your healthcare provider may recommend monitoring your symptoms rather than treating the fibroids immediately.

2. Medication

Medications may help manage symptoms, particularly heavy menstrual bleeding and pain.

• Hormonal birth control: May reduce heavy menstrual bleeding but does not necessarily shrink fibroids.
• Tranexamic acid: A non-hormonal medication that can reduce heavy menstrual bleeding.
• GnRH agonists or antagonists: Can temporarily reduce fibroid size and bleeding in appropriate patients. Their use depends on the specific medication, treatment goals, and individual health considerations.

3. Minimally Invasive Procedures

• Uterine Fibroid Embolization (UFE): Blocks blood flow to the fibroids, causing them to shrink. Its suitability depends on factors including symptoms and reproductive goals.
• Radiofrequency ablation: Uses heat to destroy fibroid tissue and reduce its size. Different techniques are available.
• Focused ultrasound: Uses focused energy to treat selected fibroids without traditional surgery.

Not every procedure is appropriate for every type or location of fibroid, so your provider can discuss the potential benefits and limitations.

4. Surgical Options

• Myomectomy: Removes fibroids while leaving the uterus in place. It may be an option for women who wish to preserve fertility, although the effect on future pregnancy depends on the number, size, and location of the fibroids and the type of surgery performed.
• Hysterectomy: Removes the uterus and is the definitive treatment for fibroids. Because pregnancy is no longer possible after hysterectomy, it is generally considered only when a patient does not desire future pregnancy.

Lifestyle and Fibroids

There is no guaranteed way to prevent fibroids from developing. However, maintaining a healthy lifestyle can support your overall health.

Helpful habits include:

• Eating a balanced diet with plenty of fruits, vegetables, whole grains, and other nutrient-rich foods
• Maintaining a healthy weight
• Staying physically active
• Getting adequate sleep
• Managing stress in ways that work for you
• Addressing heavy menstrual bleeding early to reduce the risk of anemia

Lifestyle changes should complement, rather than replace, appropriate medical evaluation and treatment.

Living with Uterine Fibroids

Fibroids can affect menstrual health, comfort, intimacy, daily activities, and, in some cases, fertility. But a diagnosis does not automatically mean you need surgery.

If you are experiencing heavy periods, pelvic pressure, pain, or other symptoms, your gynecologist can help determine whether fibroids are responsible and discuss treatment options that fit your health and reproductive goals.

At IVANA MD, Dr. Ivana provides individualized gynecologic care to help you understand your diagnosis and make informed decisions about your treatment.

4220 Cartwright Road, Suite 201, Missouri City, Texas 77459
346-585-4077

References

American College of Obstetricians and Gynecologists. (2025). Uterine fibroids. https://www.acog.org/womens-health/faqs/uterine-fibroids 

American College of Obstetricians and Gynecologists. (2021). Uterine artery embolization. https://www.acog.org/womens-health/faqs/uterine-artery-embolization 

Donnez, J., & Dolmans, M.-M. (2016). Uterine fibroid management: From the present to the future. Human Reproduction Update, 22(6), 665–686. https://doi.org/10.1093/humupd/dmw023 

Laughlin, S. K., Herring, A. H., Savitz, D. A., Olshan, A. F., Fielding, J. R., Nylander, E., & Hartmann, K. E. (2010). Pregnancy-related fibroid reduction. Fertility and Sterility, 94(6), 2421–2423. https://doi.org/10.1016/j.fertnstert.2009.12.043 

National Institute for Health and Care Excellence. (2019). Heavy menstrual bleeding: Assessment and management (NG88). https://www.nice.org.uk/guidance/ng88

The post You Have Fibroids. Now what? Understanding Your Treatment Options appeared first on IvanaMd.

Most fibroids do not cause symptoms and may never require treatment. Fibroids themselves are not cancer, and having uterine fibroids does not appear to increase the risk of developing uterine cancer. A rare type of cancer called uterine leiomyosarcoma can resemble a fibroid, but it is not thought to develop from an existing benign fibroid.

Fibroids can be very small or can grow several inches in size. Some women have a single fibroid, while others have multiple fibroids. Their size and location can affect whether they cause symptoms.

Various Forms of Uterine Fibroids

Fibroids are generally classified according to where they are located:

• Intramural fibroids grow within the muscular wall of the uterus and are the most common type.
• Submucosal fibroids develop beneath the inner lining of the uterus and can sometimes contribute to heavy menstrual bleeding or fertility problems.
• Subserosal fibroids grow toward the outside of the uterus and may become quite large.
• Pedunculated fibroids are attached to the uterus by a stalk and can occur on either the inner or outer surface.

A woman can have more than one type at the same time.

How Symptoms Present Themselves

Many women with fibroids have no symptoms. When symptoms do occur, they can vary depending on the size, number, and location of the fibroids.

Possible symptoms include:

• Heavy or prolonged menstrual bleeding
• Pelvic pressure or pain
• Lower back or abdominal pain
• Pain during sex
• Frequent urination or difficulty emptying the bladder
• Constipation or pressure in the rectum
• An enlarged abdomen
• Bleeding between periods

Heavy menstrual bleeding can sometimes lead to iron-deficiency anemia, which may cause fatigue, weakness, or shortness of breath.

Fibroids can also affect fertility in some women, particularly when they distort the inside of the uterine cavity. However, many women with fibroids become pregnant without difficulty.

How Are Fibroids Diagnosed?

Your healthcare provider may suspect fibroids during a pelvic examination if the uterus feels enlarged or irregular. Imaging is usually needed to confirm the diagnosis and determine the size and location of the fibroids.

Ultrasound is commonly used to evaluate the uterus and identify fibroids. Depending on your symptoms and circumstances, your provider may recommend additional imaging or procedures.

Treatment

Treatment depends on your symptoms, the size and location of the fibroids, your age, and whether you hope to become pregnant.

If you have no symptoms or your symptoms are mild, your provider may recommend monitoring the fibroids rather than treating them immediately.

When treatment is needed, options may include medications to help control heavy bleeding or pain, minimally invasive procedures, or surgery. A myomectomy removes fibroids while preserving the uterus and may be an option for some women who want future pregnancies. A hysterectomy removes the uterus and is a definitive treatment for fibroids, but it is not appropriate for everyone.

Your gynecologist can help you choose an approach based on your symptoms, reproductive goals, and overall health.

When to See a Gynecologist

Talk with your healthcare provider if you experience unusually heavy or prolonged periods, pelvic pain or pressure, bleeding between periods, pain during sex, difficulty becoming pregnant, or changes in urination or bowel movements.

Fibroids are common and treatable, and having them does not automatically mean you need surgery. The right treatment depends on your individual situation.

Find a Gynecologist for Fibroids

If you need more information about fibroids, treatment options, or surgical management, contact IVANA MD.

4220 Cartwright Road, Suite 201, Missouri City, Texas 77459
346-585-4077

References

American College of Obstetricians and Gynecologists. (2025). Uterine fibroids. https://www.acog.org/womens-health/faqs/uterine-fibroids

Stewart, E. A. (2015). Clinical practice. Uterine fibroids. New England Journal of Medicine, 372(17), 1646–1655. https://doi.org/10.1056/NEJMcp1411029

Stewart, E. A., Cookson, C. L., Gandolfo, R. A., & Schulze-Rath, R. (2017). Epidemiology of uterine fibroids: A systematic review. BJOG: An International Journal of Obstetrics & Gynaecology, 124(10), 1501–1512. https://doi.org/10.1111/1471-0528.14640

Laughlin, S. K., Schroeder, J. C., & Baird, D. D. (2010). New directions in the epidemiology of uterine fibroids. Seminars in Reproductive Medicine, 28(3), 204–217. https://doi.org/10.1055/s-0030-1251477 

The post Fibroids: What Your Body May Be Trying to Tell You Women’s Health | IVANA MD | Missouri City, TX appeared first on IvanaMd.

But sexual health is part of your overall health, and asking questions should never be a source of shame.

Why Sexual Health Can Be Difficult to Talk About

Messages we receive from family, culture, religion, relationships, and society can shape how we think about sex and our bodies. Some women may have grown up being taught that sexual topics should not be discussed openly.

Previous negative healthcare experiences, fear of an STI diagnosis, concerns about sexual pain, or embarrassment about changes in desire can make these conversations even harder.

Avoiding the conversation, however, can mean that treatable problems go unaddressed.

What You Can Talk About With Your Provider

You do not need to wait until something feels seriously wrong before bringing up a sexual health concern.

Your healthcare provider can help you discuss topics such as:

• Pain during or after sex
• Vaginal dryness or irritation
• Changes in sexual desire
• Difficulty with arousal or orgasm
• Concerns about contraception
• STI testing and prevention
• Changes in vaginal discharge or odor
• Concerns about sexual function after childbirth or during menopause
• Questions about sexual health after a new diagnosis or treatment

These are legitimate healthcare concerns, and your provider’s role is to listen and help—not judge.

How to Start the Conversation

You do not have to know the medical terminology or explain everything perfectly.

You can simply say, “I’ve noticed a change in my sexual health and I’d like to talk about it.”

If you feel embarrassed, you can say that too. Letting your provider know that the topic is difficult for you can help them approach the conversation with greater sensitivity.

It may also help to write down your questions before your appointment. This can make it easier to bring up something you might otherwise avoid.

When You Should Seek Help

Sexual health concerns are worth discussing with a healthcare professional, particularly when symptoms are persistent, painful, or affecting your quality of life.

Pain during sex, unusual bleeding, sores, persistent itching or irritation, unusual discharge, or concerns about possible STI exposure should be evaluated rather than ignored.

Changes in sexual desire or function can also have many possible causes, including medications, hormonal changes, relationship factors, stress, mental health, medical conditions, and physical discomfort. There is no single explanation for every woman.

The Bottom Line

There is nothing shameful about asking questions about your sexual health.

A healthy conversation with your healthcare provider can help you understand what is happening, identify possible causes, and find appropriate treatment when needed.

Your questions are valid. Your concerns deserve to be heard. And you deserve healthcare where you can talk openly without feeling judged.

Schedule your women’s health appointment with IVANA MD in Missouri City, TX. 346-585-4077. 4220 Cartwright Road, Suite 201, Missouri City, Texas 77459.

References:

Shifren, J. L., Monz, B. U., Russo, P. A., Segreti, A., & Johannes, C. B. (2008). Sexual problems and distress in United States women: Prevalence and correlates. Obstetrics & Gynecology, 112(5), 970–978. https://doi.org/10.1097/AOG.0b013e3181898cdb 

McCabe, M. P., Sharlach, M., Lewis, E., Atalla, E., Balon, R., Fisher, A. D., Laumann, E., Lee, S. W., & Segraves, R. T. (2016). Risk factors for sexual dysfunction among women and men: A consensus statement from the Fourth International Consultation on Sexual Medicine 2015. Journal of Sexual Medicine, 13(2), 153–167. https://doi.org/10.1016/j.jsxm.2015.12.015 

Nappi, R. E., Cucinella, L., Martella, S., Rossi, M., Tiranini, L., & Martini, E. (2016). Female sexual dysfunction (FSD): Prevalence and impact on quality of life. Maturitas, 94, 87–91. https://doi.org/10.1016/j.maturitas.2016.09.013 

World Health Organization. (2022). Sexual health. https://www.who.int/health-topics/sexual-health 

Centers for Disease Control and Prevention. (2021). STI screening recommendations. https://www.cdc.gov/std/treatment-guidelines/screening-recommendations.htm

The post Sexual Health Conversations — Reducing Shame and Stigma Women’s Health | IVANA MD | Missouri City, TX appeared first on IvanaMd.

Weight is influenced by many factors, including nutrition, physical activity, sleep, medications, genetics, age, stress, and certain medical conditions.

How Hormones Can Affect Weight

Hormones do play an important role in regulating body weight. Insulin, thyroid hormones, cortisol, estrogen, and other hormones are involved in metabolism, appetite, energy use, and fat distribution.

Some medical conditions can contribute to weight gain. For example, an underactive thyroid can slow metabolism and cause symptoms such as fatigue and weight gain. Polycystic ovary syndrome (PCOS) can also be associated with weight gain or difficulty losing weight, partly because of insulin resistance and other metabolic changes.

During perimenopause and menopause, changes in estrogen and the natural effects of aging can contribute to changes in body composition, including increased abdominal fat and loss of muscle mass.

However, not every change in weight means your hormones are “out of balance.”

Why Weight Gain Can Happen

Weight gain can happen for many reasons, and several factors can occur at the same time.

• Changes in eating habits or activity levels
• Loss of muscle with age
• Poor or insufficient sleep
• Chronic stress
• Certain medications
• Pregnancy and postpartum changes
• Perimenopause and menopause
• PCOS
• Thyroid disorders
• Other medical conditions

This is why simply taking a “hormone-balancing” supplement is unlikely to solve unexplained weight gain.

What Can You Do?

Start by looking at the bigger picture rather than focusing on one hormone.

Prioritize regular movement, adequate protein and fiber, balanced meals, sufficient sleep, and stress management. Strength training is particularly helpful as you age because maintaining muscle supports strength, function, and metabolic health.

If you are gaining weight without an obvious explanation, or if the weight gain is accompanied by symptoms such as irregular periods, excessive hair growth, persistent fatigue, feeling unusually cold, or significant changes in your menstrual cycle, talk with your healthcare provider.

Depending on your symptoms and medical history, your provider can determine whether testing for conditions such as thyroid disease, PCOS, or other causes is appropriate.

The Bottom Line

Hormones can influence weight, but weight gain is rarely explained by hormones alone. There is no single “hormone imbalance” responsible for everyone’s weight changes.

Instead of blaming yourself—or assuming you need a hormone-balancing product—focus on identifying the factors that may be affecting your health. If your weight has changed unexpectedly, a healthcare professional can help determine whether an underlying medical condition may be contributing.

Schedule your women’s health appointment with IVANA MD in Missouri City, TX. 346-585-4077. 4220 Cartwright Road, Suite 201, Missouri City, Texas 77459.

References:

Hall, K. D., & Kahan, S. (2018). Maintenance of lost weight and long-term management of obesity. Medical Clinics of North America, 102(1), 183–197. https://doi.org/10.1016/j.mcna.2017.08.012 

Teede, H. J., Tay, C. T., Laven, J. J. E., et al. (2023). Recommendations from the 2023 International Evidence-based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertility and Sterility, 120(4), 767–793. https://doi.org/10.1016/j.fertnstert.2023.07.025 

Ross, D. S., Burch, H. B., Cooper, D. S., et al. (2016). 2016 American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis. Thyroid, 26(10), 1343–1421. https://doi.org/10.1089/thy.2016.0229 

The North American Menopause Society. (2022). The 2022 hormone therapy position statement of The North American Menopause Society. Menopause, 29(7), 767–794. https://doi.org/10.1097/GME.0000000000002028 

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