Diagnosing Uterine Fibroids: From Physical Exams to Advanced Imaging Tests
You know your body better than anyone, so when something feels off—like heavy menstrual bleeding, ongoing pelvic pain, or persistent frequent urination—it’s natural to wonder what’s going on. These common symptoms can disrupt your daily life and make even simple tasks feel overwhelming.
If you’ve been experiencing any of these issues, it’s worth considering whether uterine fibroid diagnosis could be the next step in getting answers. The good news is that getting to the root of the problem doesn’t have to be complicated. Doctors have a range of tools to locate fibroids, assess their impact, and create a personalized plan to treat fibroids that fits your needs.
Physical Examination
A pelvic exam is often the first step to get uterine fibroids diagnosed. During this exam, your doctor may press on your lower abdomen to check for any irregularities in your uterine cavity, such as an enlarged or unevenly shaped uterus.
If your doctor detects anything unusual such as larger fibroids that can be felt manually, they may recommend further testing to confirm the presence, fibroid size, and location. While this exam alone can’t provide a full picture of your condition, it helps doctors determine if additional imaging tests are necessary.
It’s a good idea to schedule a routine pelvic exam if you’re experiencing the following symptoms:
- Heavy menstrual bleeding
- Pelvic pressure
- Discomfort during intercourse
Many women don’t realize they have fibroids until they see a doctor for unrelated symptoms. Even if you aren’t experiencing severe symptoms, regular exams can help catch developing fibroids early—before they begin causing more serious issues.
Imaging Tests
While a pelvic exam can suggest you have uterine fibroids, it doesn’t provide the full picture. Not all fibroids grow the same way, and their location and number play a huge role in how they affect your body.
Doctors rely on advanced imaging tests to locate fibroids, determine their fibroid size, and assess their impact on surrounding structures like the uterine cavity and fallopian tubes. These tests help differentiate fibroids from other conditions with similar symptoms so you can receive the right treatment plan.
Ultrasound
An ultrasound is one of the most common and accessible imaging tests used for a uterine fibroid diagnosis. This test uses sound waves to create real-time images of the uterus to locate fibroids, assess their fibroid size, and determine how many are present.
There are two types of ultrasound used to diagnose uterine fibroids:
- Abdominal ultrasound: A doctor may move an ultrasound probe around your lower abdomen
- Transvaginal ultrasound: A doctor inserts a small probe into the vagina and cervix for a clearer view of the inside of the uterus.
Ultrasound is often the first imaging test recommended if a pelvic exam suggests that you have uterine fibroids or if you’re experiencing heavy menstrual bleeding, pelvic pain, or other common symptoms. It’s non-invasive, does not use radiation, and provides quick results, making it a valuable tool for detecting small fibroids or larger fibroids affecting the muscular wall of the uterus.
However, while ultrasound is excellent for identifying most fibroids, it may not always provide the clearest images of intramural fibroids or submucosal fibroids. These may require additional testing.
MRI
A magnetic resonance imaging (MRI) scan provides a highly detailed view of the uterus, making it one of the most accurate imaging tests for a uterine fibroids diagnosis. Unlike an ultrasound, which uses sound waves, an MRI uses strong magnets and radio waves to create detailed images of the uterine cavity, muscular wall, and surrounding structures.
MRI is typically recommended in three scenarios:
- When a patient has multiple or larger fibroids
- When ultrasound results are inconclusive
- When planning for fibroid treatment options like uterine fibroid embolization (UFE)/uterine artery embolization (UAE)
The benefit of MRI is its ability to provide a complete, three-dimensional image of the uterus without radiation exposure. It can also help evaluate the blood supply to fibroids. If you have severe pain, bowel problems, or suspected complications from fibroids, an MRI may be the best choice for a comprehensive assessment.
CT Scan
A computed tomography (CT) scan is another imaging test that can be used to diagnose uterine fibroids, but it’s less commonly the first choice. Unlike ultrasound or MRI, a CT scan uses X-rays to create detailed cross-sectional images of the uterus and surrounding organs. While it can help locate fibroids and assess their fibroid size, it doesn’t provide as much detail about soft tissues as an MRI does.
A doctor may recommend a CT scan if they need to rule out other conditions that could be causing severe pain, bowel problems, or pressure on the fallopian tubes. It can be particularly useful when assessing the impact of larger fibroids on other organs in the abdomen or pelvis. However, CT scans are not generally the first-line test for diagnosing fibroids because they expose patients to radiation.
Hysteroscopy
A hysteroscopy is a minimally invasive procedure that allows a doctor to examine the inside of the uterus using a thin, flexible tube with a camera at the end. During the procedure, a doctor inserts the scope through the vagina and cervix and into the uterus to provide a direct view of the uterine cavity. This test is particularly useful for identifying submucosal fibroids, which grow just beneath the uterine lining and can contribute to heavy menstrual bleeding, pelvic pressure, and bowel problems.
A doctor may recommend a hysteroscopy if:
- You’re experienced abnormal bleeding
- You’re suffering repeated pregnancy loss
- An ultrasound or MRI suggests the presence of small fibroids inside the uterus
One of its major benefits is that it allows for real-time evaluation and, in some cases, treatment. If a doctor finds uterine fibroids, they can perform a procedure called a hysteroscopic myomectomy at the same time to remove fibroids without the need for major surgery. This method is highly effective for diagnosing fibroids affecting the uterine cavity and can provide immediate relief for some patients.
Laparoscopy
Laparoscopy is another minimally invasive procedure that helps diagnose and assess uterine fibroids by providing a direct view of the uterus and surrounding organs. While hysteroscopy focuses on the inside of the uterus, laparoscopy examines the outer surface of the uterus and is particularly useful for detecting intramural fibroids, subserosal fibroids, and larger fibroids that may be affecting nearby structures like the fallopian tubes or bowel problems.
During the procedure, a doctor inserts a small camera through a tiny incision in the abdomen, allowing them to inspect the uterus and identify fibroid size, number, and location. A doctor may recommend laparoscopy if:
- You have unexplained severe pain
- You’re experiencing difficulty conceiving
- Other imaging tests haven’t provided clear answers
One of the key benefits of laparoscopy is that it not only allows for an accurate uterine fibroids diagnosis but it can also be used to remove fibroids or perform treatments like radiofrequency ablation.
Living with uterine fibroids can feel overwhelming, but you don’t have to navigate this journey alone. Understanding your symptoms and getting the right uterine fibroids diagnosis is the first step toward relief. The right answers—and the right treatment—can make all the difference.
At VIP Fibroid Center, we specialize in minimally invasive treatments that allow you to regain control of your health without the risks of major surgery. Our compassionate team is here to listen, guide you through your treatment options, and provide personalized care tailored to your needs. Contact us today to take the next step toward relief and a better quality of life.