Uterine fibroids are non-cancerous growths that develop in or on the wall of the uterus. These growths are common, with many individuals developing them during their childbearing years. Fibroids can vary considerably in size, ranging from tiny to quite large. This discussion focuses specifically on what is considered a “small” uterine fibroid.
How Small is “Small”?
While there is no single, universally agreed-upon definition for a “small” uterine fibroid, medical professionals often classify them based on common size parameters. Generally, a fibroid is considered small if it measures less than 2 to 3 centimeters, though some classifications extend this up to 5 centimeters in diameter. To provide a relatable understanding, these sizes are often compared to everyday objects, such as a seed, a pea, a blueberry, a cherry, or even a golf ball.
Fibroids can range in size from as small as one millimeter to over 20 centimeters, illustrating the wide spectrum of their potential growth. Whether an individual fibroid is considered small depends solely on its own dimensions. The presence of multiple fibroids in the uterus does not alter the size classification of each individual fibroid.
Symptoms and Discovery
Small uterine fibroids frequently cause no noticeable symptoms. This means many individuals are unaware they have them. Often, small fibroids are discovered incidentally during routine gynecological examinations, such as a pelvic exam, or during imaging tests for other health reasons.
While a pelvic exam might detect larger fibroids, smaller ones typically require imaging. Ultrasound is a common method to visualize the uterus and detect fibroids; magnetic resonance imaging (MRI) offers more detailed views. If symptoms occur, they are usually mild. These might include a slight feeling of pressure or minor changes in menstrual bleeding, though such symptoms are rare for small fibroids. The location of a fibroid, even a small one, can sometimes influence whether it causes symptoms.
Managing Small Fibroids
For small, asymptomatic uterine fibroids, the standard approach is “watchful waiting,” also known as active surveillance. This strategy involves regular monitoring through follow-up appointments and occasional imaging studies to track their size and observe for symptom development. Since fibroids are non-cancerous and often grow slowly, or not at all, many small fibroids do not require immediate intervention. They also tend to shrink naturally after menopause as hormone levels decrease.
Watchful waiting is appropriate when fibroids are small, do not cause symptoms, are not associated with other significant health concerns, and are not rapidly increasing in size. A healthcare provider may discuss further steps if a small fibroid shows significant growth, begins to cause unexpected symptoms, or if fertility becomes a consideration. This conservative approach helps avoid extensive medical or surgical treatments not necessary for small, asymptomatic fibroids.