Uterine fibroids in your 30s and 40s: symptoms and treatments (Banpo Station OB/GYN)

Hello, this is Blanc OB/GYN. Hearing "uterine fibroids are visible" during a health check-up naturally causes immediate concern for anyone. To put it simply, uterine fibroids are very common benign tumors in women in their 30s and 40s, and surgery is not required in all cases; often, follow-up observation alone is sufficient, depending on symptoms and circumstances.

What is Uterine Fibroid Disease?

Uterine fibroids are benign tumors that develop in the muscular wall of the uterus. Most do not progress to cancer, but they can cause various symptoms depending on their size and location. In the clinic, it is quite common for them to be incidentally discovered during an ultrasound examination without any particular symptoms.

Uterine fibroids are reported to have the following characteristics:

• Relatively common in women aged 30-40.
• Known to be associated with the female hormone estrogen.
• Often decrease in size after menopause.

If These Symptoms Recur, a Check-up is Needed

If the following changes recur, it is advisable to check for uterine fibroids:

• Menorrhagia (suddenly heavy menstrual bleeding)
• Menstrual period lasting longer than 7 days
• Menstrual cramps becoming progressively worse
• A heavy, pressing sensation in the lower abdomen
• Frequent urination or sensation of incomplete bladder emptying
• Difficulty conceiving

Especially, many people postpone check-ups due to busy schedules and only visit the clinic after symptoms become clear. If you experience changes in menstrual pain or bleeding volume that feel different from usual, we advise against taking it lightly. Frequent urination or residual urine sensation caused by fibroids pressing on the bladder is also a signal worth checking.

The risk of uterine fibroids is not determined solely by their "size." Even with the same size, the management approach can vary completely depending on the location and symptoms.

What are the Causes of Uterine Fibroids?

The exact causes are not yet fully understood, but the following factors are known to play a role:

First, hormonal factors. Estrogen and progesterone are reported to be involved in fibroid growth. Second, genetic factors. The likelihood of occurrence may increase if there is a family history. Third, lifestyle factors. Obesity, stress, and irregular lifestyle patterns are said to be influential.

These factors interact with each other, so it is difficult to attribute the cause to just one factor.

What Criteria Determine Treatment?

The treatment approach is not determined solely by the size of the fibroid. In the clinic, we make decisions by comprehensively considering the following:

Considering these factors together allows us to find the right approach for each individual without unnecessary interventions.

Management for Cases with Few Symptoms

If symptoms are not pronounced, surgery is not immediately considered. In such cases, management involves the following:

• Ultrasound follow-up is conducted every 6 to 12 months.
• Review and manage lifestyle habits.
• Concurrently check for iron deficiency due to menorrhagia.

If there are no significant changes in size and no discomfort in daily life, regular check-ups to monitor the condition are often sufficient. The habit of undergoing regular well-woman checkups is the most reliable management method.

Approaches Considered for Pronounced Symptoms

If menorrhagia leads to anemia, or if there is pain severe enough to interfere with daily life, or if it affects pregnancy plans, active treatment is considered. Representative methods include the following:

First, medication. This can help by regulating hormones to suppress growth and reduce bleeding. Second, myomectomy. This is a surgical procedure to remove only the fibroids while preserving the uterus. Third, hysterectomy. This method is carefully considered in cases of high recurrence risk or around the perimenopausal period.

Regardless of the method, it is advisable to make a decision together after thoroughly consulting about the patient's condition, pregnancy plans, and living circumstances. Especially if you are preparing for pregnancy, it is helpful to discuss the timing and method of treatment in advance.

When Should You Get a Check-up?

If any of the following apply, a check-up is recommended:

• When menstrual bleeding has become noticeably heavier than before
• When symptoms of anemia recur
• When you have pregnancy plans and want to check your uterine condition in advance
• When you want to have a regular annual well-woman check-up even without specific symptoms

Since the uterine condition can be checked relatively thoroughly via transvaginal ultrasound, if you have postponed check-ups until now, we recommend taking this opportunity to get checked.

Uterine fibroids are common, but if left untreated, they can affect quality of life. Surgery is not always the answer; accurate diagnosis followed by personalized management is most important. If you are concerned about symptoms or check-up results, rather than worrying alone, we recommend calmly confirming them through a general consultation.

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Dr. Eun-Jin Lee, Chief Director (Samsung Medical Center OB/GYN Specialty, Regular Member of Korean Society of Obstetrics and Gynecology, Regular Member of Korean Society of Menopause) Dr. Eun-Jin Lee's Profile First Published 2025-11-28 / Last Reviewed 2026-06-17 This content provides general medical information, and symptoms and progression may vary individually. Please confirm the accurate diagnosis and treatment plan through consultation with an OB/GYN specialist.