Uterine fibroids are noncancerous growths that develop within or on the wall of the uterus. They are among the most common gynecologic conditions affecting women during their reproductive years, and one of the most frequently cited reasons women seek both medical management and gynecologic surgery.
Despite how common they are, fibroids are not a single, uniform condition. Two women with the same diagnosis can have entirely different experiences — one may have no symptoms at all, while another finds that her daily life is significantly disrupted by heavy bleeding, pelvic pressure, or persistent pain. The size, number, and precise location of fibroids within the uterus all determine how — and whether — they affect you.
At Lapeer Women’s Health, fibroid care is approached with both the thoroughness of a comprehensive general gynecologist and the precision of a trained minimally invasive surgeon. Dr. Ramona D. Andrei, MD, PhD, FACOG evaluates and treats fibroids across the full spectrum — from watchful observation when that is appropriate, to robotic-assisted surgery when it is the right choice — with the goal of matching each patient’s plan to her specific anatomy, symptoms, and life goals.
Fibroid symptoms vary widely depending on the size, number, and location of the growths. Some women experience several of the following; others experience none at all. If you recognize any of these patterns, an evaluation with Dr. Andrei can help clarify whether fibroids are involved — and what, if anything, should be done about them.
- Heavy or prolonged menstrual periods that have worsened over time
- Passing large blood clots during your period
- Pelvic pressure or a sense of fullness and heaviness in the lower abdomen
- Pelvic pain or cramping that is more intense than typical menstrual discomfort
- Frequent urination or difficulty emptying the bladder completely
- Constipation or a sensation of rectal pressure
- Lower back pain or discomfort radiating into the upper thighs
- Bloating or a visibly enlarged abdomen
- Spotting or bleeding between periods
- Periods lasting longer than seven consecutive days
- Fatigue, weakness, or dizziness from chronic blood loss and anemia
- Pain or discomfort during sexual intercourse
Some women with fibroids have no symptoms at all. Fibroids found incidentally during a routine exam or imaging study may not require immediate treatment — but they do benefit from appropriate evaluation and monitoring over time.
Most fibroid symptoms develop gradually and can be addressed through a scheduled appointment. However, the following patterns warrant earlier contact — same day when possible — rather than waiting for a routine visit:
- A sudden, significant worsening of heavy bleeding or pelvic pain
- Soaking through a pad or tampon every hour for two or more consecutive hours
- Bleeding accompanied by fever, chills, or other signs of infection
- Rapid or unexplained increase in abdominal size over a short period
- Persistent dizziness, shortness of breath, or extreme fatigue during or between periods
- Any vaginal bleeding that occurs 12 or more months after your last menstrual period
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Fibroids are not a single, uniform condition. Their clinical significance — and the treatment approach most appropriate for them — depends substantially on where they are located within or around the uterus, how many there are, and how large they have grown. Understanding these distinctions is central to building the right management plan.
Submucosal Fibroids
These grow into the inner cavity of the uterus, directly beneath the endometrial lining. Even when small, submucosal fibroids have an outsized effect on menstrual bleeding — they are among the most common fibroid types associated with heavy periods, prolonged bleeding, and difficulty with fertility. They are also among the most amenable to hysteroscopic treatment, a minimally invasive approach that requires no external incisions.
Intramural Fibroids
The most common fibroid type, intramural fibroids grow within the muscular wall of the uterus itself. Depending on their size and number, they may cause heavy or prolonged bleeding, pelvic pressure, increased urinary frequency, and a visibly enlarged uterus. When large or numerous, intramural fibroids can also distort the uterine cavity in ways that affect fertility and menstrual regularity.
Subserosal Fibroids
These grow outward from the outer surface of the uterus and can become quite large before causing significant symptoms. Pelvic pressure, lower back pain, bladder or bowel symptoms, and a sense of heaviness or fullness in the lower abdomen are common presentations. Heavy menstrual bleeding is typically less prominent than with submucosal fibroids, though large subserosal fibroids can still affect overall uterine function.
Pedunculated Fibroids
Some fibroids grow on a stalk — a fibrous extension that connects the fibroid to the outer uterine surface or, less commonly, extends into the uterine cavity. A pedunculated fibroid can occasionally twist on its stalk, causing acute pelvic pain that requires prompt evaluation. Location and the presence of a stalk are both relevant to determining the most appropriate surgical approach.
What Is Known About Fibroid Development
The precise cause of fibroid formation is not fully understood, but several contributing factors are well recognized. Estrogen and progesterone both promote fibroid growth, which is why fibroids typically develop during the reproductive years and often shrink after menopause. A family history of fibroids significantly increases a woman’s likelihood of developing them. Fibroids are also considerably more common and tend to present at younger ages and with greater severity in Black women than in white women — a disparity that warrants proactive awareness and evaluation.
Fibroids themselves do not become cancerous. A very rare uterine malignancy called leiomyosarcoma can occasionally resemble a fibroid on imaging — which is one of several reasons accurate diagnosis and appropriate evaluation matter.
Because different fibroid types respond differently to different treatments, the foundation of any fibroid management plan is understanding exactly what you are working with. Pelvic ultrasound is typically the first and most important step in that process.
Your first appointment is a conversation, not a procedure. Care is led by Dr. Ramona D. Andrei, MD, PhD, FACOG — with a commitment to thorough evaluation, clear communication, and a treatment plan that is built around your specific situation rather than a standard protocol.
Step 1 — Listen & Evaluate
Dr. Andrei reviews your symptoms, menstrual history, and prior imaging in detail. A pelvic exam and pelvic ultrasound are used to assess the size, number, and location of fibroids — the information that makes every subsequent recommendation specific to you rather than general.
Step 2 — Understand Your Options
You will receive a thorough explanation of every treatment approach appropriate to your situation — from observation and medical management to minimally invasive surgery. Questions are expected and welcomed. No recommendation is made without a clear explanation of the reasoning behind it.
Step 3 — A Plan Built for You
Your treatment plan reflects your diagnosis, your symptoms, your reproductive goals, and your preferences. There is no single right answer for every fibroid patient — and the goal is always to match the level of intervention to the level of problem, not to default to the most aggressive option available.
Dr. Andrei takes a stepwise, individualized approach — beginning with the least invasive options and advancing only when appropriate for your fibroid characteristics, your symptoms, and your goals. Not every fibroid requires treatment, and not every treatment is right for every patient.
Not every fibroid requires immediate intervention. For women with small or asymptomatic fibroids, or those approaching menopause when natural fibroid regression is likely, periodic monitoring may be the most appropriate initial approach. For women with mild symptoms, targeted conservative measures can meaningfully improve comfort and quality of life without medical or surgical treatment.
Several medical options can reduce bleeding volume, temporarily shrink fibroids, or manage symptoms effectively over time. These approaches do not permanently eliminate fibroids, but they can be highly effective — particularly for women who are not ready for surgery, who are nearing menopause, or who need to improve their health status before a planned procedure.
Surgery is recommended when conservative and medical options have not provided adequate relief, when fibroids are significantly affecting quality of life or fertility, or when fibroid characteristics make surgical removal the most appropriate choice. Dr. Andrei performs advanced minimally invasive and robotic-assisted fibroid surgery, with a strong emphasis on approaches that minimize recovery time and — when consistent with a patient’s goals — preserve uterine health.
For patients whose fibroids require surgical treatment, Dr. Andrei’s advanced training in minimally invasive and robotic-assisted techniques translates directly into a wider range of surgical options, shorter recovery times, and a surgeon who is experienced and credentialed in the approaches most appropriate for fibroid disease.
Robotic & Laparoscopic Surgery
Dr. Andrei performs robotic-assisted and laparoscopic fibroid surgery — including myomectomy and hysterectomy — using techniques that allow for precise, minimally invasive access with smaller incisions, less operative blood loss, and faster recovery compared to traditional open surgery. Robotic-assisted approaches are particularly well-suited for complex cases involving multiple fibroids or fibroids in anatomically challenging locations.
Hospital Affiliations
Surgical procedures are performed at McLaren Lapeer Region, McLaren Flint Hospital, and Henry Ford Rochester Hospital — giving patients access to facilities that support the full range of minimally invasive gynecologic surgical approaches. These affiliations provide convenient access for patients from both the Lapeer and Rochester Hills service areas.
No Referral Required
You do not need a referral from another provider to schedule a fibroid consultation with Dr. Andrei. Whether you are coming in for a first evaluation, following up on a known diagnosis, or seeking a second opinion on a prior treatment recommendation, our team can schedule you directly at either the Lapeer or Rochester Hills office.
Many women with fibroids have been told to wait — sometimes for years — while their symptoms gradually worsened and their quality of life quietly declined. Some have been told that hysterectomy is their only surgical option. Others have been managing symptoms with medications that were never designed to be permanent solutions. If any of that sounds familiar, it is not the complete picture.
Fibroid treatment has evolved considerably. The range of available options — from targeted medications to uterus-preserving robotic surgery — is broader than it has ever been. What has not changed is the importance of working with a provider who takes the time to understand your specific anatomy, your symptoms, and your goals before making a recommendation.
Dr. Ramona D. Andrei and the team at Lapeer Women’s Health are here to provide that evaluation — and to ensure that every patient leaves with a clear understanding of her diagnosis, her options, and the path forward that makes the most sense for her.
Uterine Fibroids & Fibroid Treatment
Whether you are newly diagnosed, managing long-standing symptoms, or considering surgery for the first time, Dr. Andrei and the team at Lapeer Women’s Health are ready to help you move forward with a clear plan — at both our Lapeer and Rochester Hills offices.
Schedule a Gynecologic VisitThe information on this page is intended for educational purposes only and does not constitute medical advice. Individual symptoms, diagnoses, and treatment options vary significantly. Reading this content does not establish a physician-patient relationship with Dr. Ramona D. Andrei or Lapeer Women’s Health. If you are experiencing a medical emergency, call 911 or go to the nearest emergency room immediately. Please consult a qualified healthcare provider for advice specific to your situation. Content reviewed by Dr. Ramona D. Andrei, MD PhD FACOG.
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Lapeer Women’s Health — Rochester Hills
2710 S Rochester Rd, Suite 2
Rochester Hills, MI 48307
Serving patients in Lapeer, Rochester Hills, and surrounding communities throughout Southeast Michigan.