Uterine Fibroids: Symptoms, Types, and Treatment in New York City

Uterine fibroids are non-cancerous growths made of muscle and fibrous tissue that develop in or around the wall of the uterus. Also called leiomyomas or myomas, they are among the most common gynecologic conditions, affecting up to 80% of women by age 50. Many fibroids cause no symptoms at all. When they do, the effects can range from mildly inconvenient to significantly disruptive to daily life, work, and reproductive health.

At Kim Gyn on Park Avenue, Dr. Kim specializes exclusively in minimally invasive gynecologic surgery (MIGS) to treat fibroids with precision, fewer complications, and faster recovery than traditional open surgery. Every patient works directly with Dr. Kim from the first appointment through recovery - no handoffs, no surprises.

What Causes Uterine Fibroids?

The exact cause of uterine fibroids is not fully understood, but research consistently points to a combination of hormonal and genetic factors.

Estrogen and progesterone are the primary drivers. Fibroids tend to grow during reproductive years when these hormones are highest, and typically shrink after menopause. This is why fibroid symptoms often intensify in the years leading up to menopause, when hormonal fluctuations are most pronounced.

Genetic predisposition also plays a meaningful role. If your mother or sister had fibroids, your risk is higher. Black women are disproportionately affected, experiencing fibroids at younger ages, with greater severity, and with higher rates of symptoms than women of other racial backgrounds.

Other contributing factors include:

• Obesity or excess body weight, which increases circulating estrogen
• Vitamin D deficiency
• A diet high in red meat and low in green vegetables and fruit
• High blood pressure (hypertension)

What are the Symptoms of Uterine Fibroids?

Not all fibroids cause symptoms. When they do, severity depends on the number of fibroids, their size, and where they are located within or around the uterus.

The most common uterine fibroid symptoms include:

• Heavy or prolonged menstrual bleeding - soaking through a pad or tampon in an hour or less, or periods lasting longer than seven days
• Pelvic pressure or fullness - a sensation of heaviness or bloating in the lower abdomen
• Pelvic pain or cramping - including pain during menstruation (dysmenorrhea) that goes beyond typical period cramps
• Frequent urination or difficulty emptying the bladder - caused by fibroids pressing on the bladder
• Constipation or rectal pressure - caused by fibroids pressing on the bowel
• Pain during sex (dyspareunia)
• Lower back pain or leg pain - from fibroids that press on nerves or pelvic structures
• Fatigue and anemia - from chronic blood loss caused by heavy periods
• Difficulty conceiving or carrying a pregnancy to term

More than 60% of women with fibroids report symptoms that interfere with work, intimacy, exercise, or everyday routines. If any of these apply to you, your symptoms deserve a thorough evaluation.

Types of Uterine Fibroids and Where They Grow

Understanding where fibroids grow helps explain why symptoms vary so widely from one woman to another. Fibroids are classified based on their location relative to the layers of the uterus.

• Intramural fibroids grow within the muscular wall of the uterus and are the most common type. When large, they can distort the shape of the uterine cavity and cause heavy bleeding, pressure, and fertility challenges.
• Submucosal fibroids develop just beneath the inner lining of the uterus (the endometrium) and grow into the uterine cavity. Even small submucosal fibroids can cause very heavy bleeding and significantly affect implantation and fertility.
• Subserosal fibroids grow on the outer surface of the uterus, projecting into the pelvis. They are more likely to cause pressure, back pain, urinary symptoms, and bowel symptoms than bleeding.
• Pedunculated fibroids are attached to the uterus by a thin stalk. They can be subserosal (extending into the pelvis) or submucosal (extending into the uterine cavity). Pedunculated fibroids can twist on their stalk, causing sudden, sharp pelvic pain.

Fibroids range in size from a few millimeters - smaller than a pea - to more than 15 centimeters, roughly the size of a grapefruit. Many women have multiple fibroids of varying types and sizes simultaneously.

How Are Uterine Fibroids Diagnosed?

Diagnosis begins with a conversation about your symptoms and a pelvic examination. From there, imaging confirms what is present and informs treatment planning.

• Pelvic ultrasound is the standard first-line imaging tool. It is non-invasive, widely available, and effective at identifying most fibroids, their size, and their location.
• Saline infusion sonography (SIS) or hysterosonography involves injecting a small amount of saline into the uterine cavity during an ultrasound to better visualize submucosal fibroids and the uterine lining. This is particularly useful for women with unexplained heavy bleeding or fertility concerns.
• MRI (magnetic resonance imaging) provides the most detailed picture of fibroid number, size, location, and proximity to surrounding structures. It is an essential tool for surgical planning, particularly when robotic or laparoscopic myomectomy is being considered.
• Hysteroscopy allows direct visualization of the inside of the uterus using a thin, lighted scope. This is useful when submucosal fibroids are suspected or when the relationship between fibroids and the uterine cavity needs to be assessed precisely.

At Kim Gyn, Dr. Kim reviews your imaging personally and interprets findings in the context of your symptoms, your goals, and your reproductive plans. You will never receive a diagnosis through a patient portal message without a real conversation.

Uterine Fibroids and Fertility

Fibroids are one of the most commonly evaluated findings in women who are trying to conceive. The relationship between fibroids and fertility is nuanced, depending heavily on the type, size, and location of the fibroids.

Submucosal fibroids have the most direct impact on fertility. By distorting the uterine cavity, they can interfere with embryo implantation and increase the risk of early pregnancy loss. Removal of submucosal fibroids has been shown to improve pregnancy outcomes.

Intramural fibroids that are large or that impinge on the cavity can also reduce implantation rates and increase the risk of miscarriage. The evidence for treating intramural fibroids that do not distort the cavity is more nuanced and requires individualized discussion.

Subserosal fibroids that grow outward and do not affect the uterine cavity generally have less direct impact on fertility, though very large ones can complicate pregnancy.

If you are trying to conceive and fibroids have been identified, a conversation with Dr. Kim will clarify whether, which, and when treatment makes sense in relation to your fertility goals. Myomectomy, which removes fibroids while leaving the uterus intact, is the standard surgical treatment for women who wish to preserve or pursue pregnancy.

Uterine Fibroid Treatment Options at Kim Gyn

The goal at Kim Gyn is always to offer the most effective treatment with the least impact on your body and your life. Dr. Kim evaluates each patient’s fibroid characteristics, symptoms, fertility goals, and personal preferences before recommending any approach.

Watchful Waiting (Active Monitoring)

If fibroids are small, slow-growing, or causing minimal symptoms, periodic monitoring with ultrasound may be the most appropriate initial approach. This is particularly relevant for women approaching menopause, when fibroids often shrink naturally as estrogen levels decline.

Watchful waiting is not the same as ignoring the problem. Regular follow-up allows Dr. Kim to detect any changes in size, number, or symptom severity before they become harder to manage.

Medical Management

Medications do not permanently eliminate fibroids, but they can provide meaningful temporary relief. Medications are often used to manage symptoms, reduce fibroid size before surgery, or bridge a patient toward another treatment.

Options include:

• Hormonal contraceptives (birth control pills, hormonal IUDs, or injectable progestin) to manage heavy bleeding and pelvic pain
• GnRH agonists (such as Lupron) to temporarily suppress estrogen, shrink fibroids, and reduce bleeding - often used for three to six months before surgery
• GnRH antagonists (such as Orlissa/elagolix or Myfembree/relugolix) are newer oral medications that reduce fibroid-related heavy bleeding and pain with a more convenient dosing schedule and fewer side effects than older injectable options
• Tranexamic acid to reduce bleeding during periods without hormonal effects
• NSAIDs to manage menstrual pain and, to a modest degree, reduce blood loss

Medication is often an important part of a treatment plan, but it is rarely the final answer for women who want lasting relief.

Laparoscopic Myomectomy

Laparoscopic myomectomy is a minimally invasive surgical procedure that removes fibroids through small incisions in the abdomen using a camera (laparoscope) and specialized instruments. The uterus is left intact, making this the preferred approach for women who want to preserve their fertility or their uterus.

Compared to traditional open myomectomy, the laparoscopic approach results in less blood loss, lower risk of infection, a shorter hospital stay, and significantly faster recovery. Most patients return to normal activity within two to three weeks.

Laparoscopic myomectomy is well-suited for subserosal and intramural fibroids that are not amenable to hysteroscopic removal. It requires advanced surgical skill, particularly when fibroids are large, numerous, or in challenging locations.

Robotic-Assisted Myomectomy

Robotic-assisted myomectomy uses the da Vinci surgical system to extend the precision, dexterity, and visualization available to the surgeon during minimally invasive fibroid removal. The robotic platform allows Dr. Kim to perform complex dissections and suturing with greater control than standard laparoscopy, particularly in cases involving large fibroids, fibroids in difficult anatomical locations, or when the uterine wall needs meticulous reconstruction.

For patients, the benefits are similar to laparoscopic myomectomy with the added advantage of precision that can make a meaningful difference in complex cases.

Hysteroscopic Myomectomy

Hysteroscopic myomectomy is performed through the cervix with no external incisions at all. A thin surgical scope is passed through the vagina and cervix into the uterine cavity, where submucosal fibroids are removed directly using resection tools.

This approach is the gold standard for submucosal fibroids that are distorting the uterine cavity. It is an outpatient procedure, typically performed under light sedation, with a very short recovery. For women with submucosal fibroids causing heavy bleeding or recurrent pregnancy loss, hysteroscopic myomectomy can produce immediate and significant improvement in both bleeding and fertility potential.

Radiofrequency Ablation (Acessa Procedure)

The Acessa procedure uses laparoscopically guided radiofrequency energy to ablate fibroid tissue from within, causing fibroids to shrink and lose their ability to cause symptoms. Unlike myomectomy, this procedure does not remove the fibroid; it destroys it in place so the body reabsorbs it over time.

Acessa is a well-studied, FDA-cleared option for women with symptomatic fibroids who want a minimally invasive approach with a quick recovery and preservation of the uterus. It is particularly well-suited for women with multiple fibroids or fibroids in locations that would make traditional myomectomy more complex.

Most patients return home the same day and resume normal activities within three to five days.

Hysterectomy

A hysterectomy is the surgical removal of the uterus and the only treatment that definitively eliminates the possibility of fibroid recurrence. It is reserved for women who have completed their family or who have no desire for future pregnancy, and for whom other treatments have not provided adequate relief or are not appropriate.

At Kim Gyn, when hysterectomy is indicated, Dr. Kim performs it laparoscopically or with robotic assistance whenever possible, avoiding a large abdominal incision and allowing for a significantly shorter, more comfortable recovery than traditional open surgery.

Hysterectomy is never the default recommendation. It is one well-considered option among several, offered when it genuinely serves a patient’s long-term wellbeing and goals.

Why the Kim Gyn Approach Is Different

Women who come to Kim Gyn are often professionals, mothers, and individuals with full lives that cannot accommodate months of recovery, revolving-door care teams, or treatment plans that were not built around their specific circumstances.

Dr. Kim’s practice is intentionally small and intentionally focused. Every patient is seen by Dr. Kim directly - not a PA, not a covering physician. You have direct call and text access throughout your care. Appointments are not rushed. Your imaging is reviewed by the physician who will treat you, not interpreted remotely by someone you will never meet.

The practice is located at 877 Park Avenue, easily accessible from the Upper East Side, Carnegie Hill, Lenox Hill, and the surrounding neighborhoods.

What sets Kim Gyn apart:

• Exclusive focus on minimally invasive gynecologic surgery
• One physician, one patient relationship from consultation through recovery
• Direct call and text access to Dr. Kim (not a call center)
• Advanced technology: da Vinci robotic system and Acessa radiofrequency ablation
• Uterus-preserving treatment as the default priority
• Transparent, personalized treatment planning built around your fertility goals and lifestyle

For women who value continuity, expertise, and access, this level of care makes a meaningful difference.

What to Expect at Your First Appointment

Your first visit with Dr. Kim is a consultation, not a procedure. The goal is to understand your symptoms fully, review any prior imaging, and give you a clear picture of what is happening and what your options are.

You should expect:

• A thorough review of your symptoms, cycle history, and reproductive goals
• Physical examination
• Review of existing ultrasound or MRI imaging, or a referral for imaging if none has been done
• A clear explanation of your fibroid type, size, and location
• An honest discussion of all treatment options, including their risks, benefits, and what recovery looks like
• Time to ask questions without feeling rushed

There is no pressure to commit to any treatment at the first visit. Many patients leave with a clear diagnosis and a plan for the first time after years of being told their symptoms were normal.

What Conditions are Related to Uterine Fibroids?

Fibroids are common but not the only condition that can cause heavy bleeding, pelvic pain, or fertility challenges. In some cases, fibroids coexist with other gynecologic conditions that require coordinated evaluation and treatment.

• Adenomyosis occurs when endometrial tissue grows into the muscle wall of the uterus. It often causes heavy, painful periods and can coexist with fibroids, making it important to distinguish between the two in diagnosis and treatment planning.
• Endometrial polyps are small, benign growths of the uterine lining that can cause abnormal bleeding and may affect fertility. Like submucosal fibroids, they are often diagnosed and treated hysteroscopically.
• Endometriosis is a condition in which tissue similar to the uterine lining grows outside the uterus. It can cause severe pelvic pain, heavy periods, and fertility problems - symptoms that overlap significantly with fibroids. A thorough evaluation distinguishes between the two.

If your symptoms have not fully resolved with fibroid-directed treatment, or if your diagnostic picture is complex, Dr. Kim will help clarify whether another condition is contributing to what you are experiencing.

Book a Consultation with Dr. Kim

Living with heavy bleeding, pelvic pain, and fatigue does not have to be a permanent condition. At Kim Gyn, Dr. Kim has helped many patients find minimally invasive paths to lasting relief.

Whether you are seeking a diagnosis for the first time, a second opinion, or a surgeon to perform a procedure you have already decided on, you are welcome here.

Kim Gyn is located at 877 Park Avenue, New York, NY 10075 at the center of the Upper East Side.

Frequently Asked Questions About Uterine Fibroids

What is the difference between a fibroid and a cyst?

Fibroids are solid growths made of muscle and fibrous tissue that form in the wall of the uterus. Ovarian cysts are fluid-filled sacs that form on or within the ovaries. They are entirely different structures arising from different tissues, though both can cause pelvic symptoms and are often diagnosed together.

Can fibroids become cancerous?

The vast majority of fibroids are benign and do not become cancerous. A very rare type of uterine cancer called leiomyosarcoma can sometimes resemble fibroids on imaging, which is one reason proper evaluation matters. Rapid fibroid growth, particularly after menopause, warrants additional investigation.

Do fibroids always need to be treated?

No. Fibroids that are small, not growing, and not causing symptoms often require no treatment - only periodic monitoring. The decision to treat is always based on how fibroids are affecting your quality of life, your health, and your reproductive goals.

Will fibroids come back after treatment?

Myomectomy removes existing fibroids, but it does not prevent new fibroids from forming. Recurrence rates vary based on the number and type of fibroids removed, and on age and hormonal status. Radiofrequency ablation has similar recurrence considerations. Hysterectomy is the only procedure that eliminates recurrence entirely, since the uterus is removed.

Can I get pregnant after fibroid treatment?

Yes. Myomectomy - whether laparoscopic, robotic, or hysteroscopic - is specifically designed to remove fibroids while preserving the uterus and optimizing the uterine environment for pregnancy. Many women go on to successful pregnancies after myomectomy. The timing of attempting pregnancy after surgery is something Dr. Kim will discuss with you based on the type of procedure performed and the extent of uterine reconstruction required.

How long is recovery after fibroid surgery?

Recovery depends on the procedure. Hysteroscopic myomectomy typically requires a few days. Laparoscopic and robotic myomectomy generally allow a return to office work within one to two weeks and full activity within three to four weeks. Traditional open myomectomy, which is not performed at Kim Gyn, carries a significantly longer recovery.

Does Kim Gyn accept insurance?

Kim Gyn is a private, out-of-network practice. Patients receive detailed superbills that can be submitted to insurance for potential reimbursement. The practice serves patients who value direct access to an experienced specialist and the ability to make care decisions without insurance-imposed constraints. To learn more about how care is priced and what to expect, please contact the office directly.

I have been told I need a hysterectomy. Is that my only option?

Not necessarily. Many patients who arrive at Kim Gyn have been told by another provider that a hysterectomy is their only option, only to learn that minimally invasive alternatives exist and are appropriate for their situation. A second opinion is always worthwhile before proceeding with uterine removal.