Medically reviewed by Dr. Shweta Agarwal, MBBS, DGO. Last updated: July 2026.
Information on this page is educational and does not replace a medical consultation. Outcomes depend on individual clinical factors.
What exactly are uterine fibroids (गर्भाशयातील गाठी), and are they dangerous?
Uterine fibroids are benign (non-cancerous) growths arising from the muscle of the uterus, according to the American College of Obstetricians and Gynecologists (ACOG). They do not "turn into cancer"; a rapidly growing or unusual mass is a separate concern that needs its own evaluation. Many fibroids cause no symptoms at all and are found incidentally on an ultrasound done for another reason.
In Marathi, patients most often say गर्भाशयातील गाठी or गर्भाशयाच्या गाठी (uterine lumps); in Hindi, बच्चेदानी में गांठ or uterus me gaanth; some also use रसौली. The medical names — leiomyoma, myoma, fibroid uterus — all describe the same benign growth.
The Government of India's ICMR/DHR Standard Treatment Workflow for Uterine Fibroids and Polyps (December 2025) is clear on the key principle: management should be individualised by age, symptoms, fertility plans and other health conditions — and not all patients need hysterectomy. In plain Marathi: प्रत्येक गाठीसाठी ऑपरेशन किंवा गर्भाशय काढणे गरजेचे नसते.
What symptoms do fibroids cause, and when should I see a gynaecologist?
Fibroids need attention when they cause heavy or prolonged periods, anaemia, pelvic pain or pressure, urinary symptoms, or difficulty conceiving. The ICMR/DHR 2025 workflow lists these as the recognised symptom groups; the US FDA's women's health guidance adds that heavy blood loss can cause iron-deficiency anaemia. Many fibroids cause none of these and only need monitoring.
Common symptoms:
- Heavy or prolonged periods (पाळीत खूप किंवा जास्त दिवस रक्तस्राव) — the most common problem, and a cause of anaemia
- Painful periods or persistent pelvic pain
- Lower-abdominal heaviness, pressure or a felt mass (पोटाच्या खालच्या भागात जडपणा किंवा दाब)
- Frequent urination (वारंवार लघवी लागणे) or difficulty emptying the bladder
- Difficulty conceiving (गर्भधारणेत अडचण) — see the fertility section below
Red flags needing prompt assessment, per the ICMR/DHR 2025 workflow: severe anaemia, severe pain (for example fibroid degeneration or torsion), excessive bleeding not responding to medicines, and acute urinary retention. These should not wait for a routine appointment slot.
If your main problem is heavy or irregular periods, a clinical examination and a blood count are the starting point — the UK's NICE guideline NG88 recommends a full blood count (CBC) for anyone with heavy menstrual bleeding.
What are the types of fibroids, and why does location matter?
Fibroid location — not size alone — is the most useful patient-facing way to understand symptoms and fertility relevance. The comparison below reflects the ICMR/DHR 2025 workflow, NICE NG88 and the American Society for Reproductive Medicine (ASRM) 2017 guideline. Doctors may also use the detailed FIGO 0–8 classification; the three-group view is what matters for most decisions.
| Type | Where it sits | Why it matters |
|---|---|---|
| Submucosal / cavity-distorting | Projects into or changes the uterine cavity | Most relevant to heavy bleeding and fertility; hysteroscopic assessment or removal may be considered (NICE NG88; ASRM 2017) |
| Intramural | Within the muscular uterine wall | Fertility effect is uncertain when the cavity is not distorted; no fixed size rule (ASRM 2017) |
| Subserosal | Projects from the outer surface | More likely to cause bulk/pressure symptoms; evidence that removal improves fertility is insufficient (ASRM 2017) |
Location alone does not decide treatment — symptoms, size, number, anaemia and pregnancy plans complete the picture.
Patients sometimes confuse fibroids with other findings. A "पाण्याची गाठ" (fluid-filled lump) usually means an ovarian cyst, not a fibroid, and adenomyosis is a different condition that can also cause heavy, painful periods. An examination and ultrasound distinguish them.
How are fibroids diagnosed in Chandrapur?
Diagnosis starts with your history and a pelvic examination, followed by a blood count (CBC) and a pelvic ultrasound — the two tests the ICMR/DHR 2025 workflow treats as essential. Further tests are selective, not routine: NICE NG88 recommends outpatient hysteroscopy when the history suggests a fibroid inside the cavity, and reserves MRI for surgical planning in selected cases.
- Ultrasound (pelvic / transvaginal) — identifies the number, approximate size and location of fibroids.
- Hysteroscopy — a thin camera passed through the cervix to inspect the cavity directly, used selectively when a submucosal fibroid or other cavity problem is suspected; in some suitable cases assessment and treatment can be combined, though this cannot be promised for every patient.
- Saline-infusion sonography and MRI — not routine first-line tests; MRI may be considered when more detail on fibroid position, size or number is needed before surgery (NICE NG88).
A practical tip for your Chandrapur consultation: bring your ultrasound report and be ready to discuss three things — your bleeding/pain symptoms, your pregnancy plans, and whether the report mentions the uterine cavity being distorted. The treatment decision itself still needs clinical assessment, not report review alone.
Sex determination is illegal under the PCPNDT Act and is not performed here. All scans discussed on this page are for fibroid diagnosis only.
When do fibroids need treatment — and when is observation enough?
Not every fibroid needs treatment. The ICMR/DHR 2025 workflow gives observation as the pathway for asymptomatic fibroids and notes that, in the Indian workflow, asymptomatic fibroids under 5 cm generally do not need treatment — though cavity distortion, growth pattern, pregnancy plans and symptoms can change that. Treatment is considered when fibroids cause heavy bleeding, anaemia, pain, pressure or fertility concerns.
Size alone does not decide surgery. NICE NG88 and the ICMR/DHR workflow both frame the choice around symptoms plus fibroid size, number and location plus your own preferences — including whether you wish to retain your uterus or fertility.
What are the treatment options: observation, medicines, myomectomy or hysterectomy?
Four care pathways exist, and the right one is individual: observation for fibroids that cause no meaningful problems; medicines to manage bleeding or pain; myomectomy to remove fibroids while keeping the uterus; and hysterectomy as a definitive option for selected patients who have completed childbearing. This framing follows the ICMR/DHR 2025 workflow and NICE NG88.
| Option | When it may fit | What it can and cannot do | Fertility / uterus point |
|---|---|---|---|
| Observation | No or mild symptoms; no current indication to intervene | Monitoring, not removal | Uterus preserved; review plan is individual |
| Medicines | Heavy bleeding or pain, when clinically appropriate | May reduce bleeding/pain; not a permanent removal or cure | Some hormonal options prevent pregnancy while used — discuss pregnancy plans first |
| Myomectomy | Symptoms, or selected cavity-distorting fibroids, when the uterus is to be kept | Removes selected fibroid(s); new fibroids can still form later | Uterus retained; pregnancy timing and mode of birth need individual advice |
| Hysterectomy | Significant symptoms after counselling, usually when childbearing is complete | Removes the uterus; definitive for uterine fibroids — but not required for every patient | Ends the ability to carry a pregnancy; ovaries are a separate decision |
About medicines: the ICMR/DHR pathway includes options such as NSAIDs, iron supplementation for anaemia, tranexamic acid, hormonal treatment and a hormonal intrauterine system where the cavity is suitable; NICE NG88 lists a similar menu. These are clinician-selected symptom management — no medicine "dissolves" fibroids permanently, and no medicine should be self-started. Some hormonal medicines can temporarily reduce fibroid size or symptoms; the effect is not permanent for everyone.
About surgical routes: for fibroids inside the cavity, NICE NG88 recommends considering hysteroscopic removal via hysteroscopy. Intramural or subserosal fibroids may suit a laparoscopic (keyhole) or open approach — the route depends on location, size, number and surgical assessment, not a fixed size cutoff. Procedure detail is on the dedicated myomectomy page. Uterine artery embolisation and other specialist non-surgical procedures exist at some centres; their suitability, especially when future pregnancy is desired, needs individual counselling.
Can I get pregnant with fibroids? Do fibroids need removal before IVF?
Yes — many women with fibroids conceive naturally. The ASRM notes that most women with fibroids are not infertile, so a fertility evaluation should not stop at the fibroid; other female and male factors also need assessment. The most useful distinction is whether the fibroid distorts the uterine cavity.
Per the ASRM 2017 guideline, myomectomy may be considered for cavity-distorting fibroids, where there is fair evidence it may improve pregnancy rates. Removal is generally not advised solely to improve fertility when a fibroid is not distorting the cavity and causes no symptoms — the evidence of benefit there is insufficient, and no universal size cutoff has been confirmed.
In pregnancy: many pregnancies with fibroids are uncomplicated. Some fibroids are associated with miscarriage, preterm birth, abnormal fetal position, caesarean birth or postpartum bleeding (NICHD), but individual risk cannot be predicted from "fibroid present" alone — it depends on size, location and symptoms. Some fibroids may change in size during pregnancy; monitoring is individual. Surgery during pregnancy is rarely required. If you have had a myomectomy, tell your obstetric team, because delivery planning depends on the operative details.
If you are trying to conceive, fibroid care and fertility care are assessed together — a cavity check is part of a standard fertility evaluation, and IVF is a treatment for infertility, not for the fibroid itself. You can also seek a free second opinion on an existing fibroid or fertility report.
Fibroid care at Aansh Hospital, Chandrapur
Evaluation and management of fibroids in Chandrapur is led by Dr. Shweta Agarwal, MBBS, DGO — a female gynaecologist — as part of the hospital's gynaecology care and women's health services. Consultations are available in Marathi, Hindi and English. Aansh Hospital & IVF Center is a government-registered Level-2 ART clinic — you can verify the registration; fibroid care itself is gynaecology care, not an ART procedure.
To book an evaluation, contact the Chandrapur clinic or call 8005685160.
References
- ICMR / Department of Health Research, MoHFW, Government of India. Standard Treatment Workflow: Uterine Fibroids and Polyps, December 2025.
- NICE. Heavy menstrual bleeding: assessment and management (NG88).
- ASRM Practice Committee. Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline (2017).
- ASRM / ReproductiveFacts. Fibroids and Fertility.
- ACOG. Uterine Fibroids (patient FAQ).
- NICHD. Other Uterine Fibroids FAQs.
- US FDA Office of Women's Health. Uterine Fibroids.