Can Fibroids Come Back After Surgery? Risks and Causes

A myomectomy removes the fibroids that are there. It doesn’t change the conditions that allowed them to form, which is why new fibroids may develop afterwards, particularly in the years when oestrogen levels remain high.

How likely that happens varies with age, how many fibroids were removed, and how close you are to menopause. Here’s why fibroids may return after surgery, what influences the likelihood, and what follow-up usually involves. 

What are fibroids?

Uterine fibroids are non-cancerous growths that develop around or within your uterus (womb). They are made of muscle and fibrous tissue and could range from very small (about the size of a pea) to several centimetres across. 

They are most commonly diagnosed during a woman's reproductive years, typically between the ages of 30 and 50. This is because, although the exact cause of fibroids is not fully understood, oestrogen and progesterone – the hormones that regulate your menstrual cycle – play a role in stimulating their growth.

Can fibroids come back after surgery?

Fibroid recurrence is most often seen after a myomectomy, regardless of whether the approach is hysteroscopic (through the cervix), laparoscopic myomectomy, or open abdominal surgery.

This is because a myomectomy procedure removes existing fibroids while preserving the uterus, so it may not change the underlying conditions that allow them to grow. New fibroids may also develop over time due to:

• Ongoing hormone activity:

  • Your body continues to produce oestrogen and progesterone after surgery, which may naturally stimulate new fibroid growth

• Genetic factors:

  • If fibroids run in your family, it could increase your likelihood of redeveloping these growths.

• Small fibroids already present:

  • Very small fibroids may be present at the time of surgery but are too small to be detectable and may grow gradually over time.

Studies suggest that approximately 15% to 33% of women may develop fibroids again within five years of a myomectomy. However, the likelihood of recurrence varies depending on factors such as age, number of fibroids, type of surgery and length of follow-up. 

If you suspect that your fibroid is recurring following surgery, a consultation with a specialist may help assess its location and size and suggest suitable next steps for your care. Request an appointment with Thomson Medical.

Who is more likely to experience fibroid regrowth?

Although uterine fibroids may recur in any woman who has undergone a myomectomy, certain factors may increase your personal risk.

You may be at higher risk if you:

• Have previously had multiple or large fibroids

• Are younger, particularly under the age of 40

• Have a family history of uterine fibroids

• Carry excess weight, as higher body fat levels may raise oestrogen levels

Recurrence is more common in younger women because they have more years of hormonal activity ahead of them, during which time new fibroids could develop. However, even if some of these factors apply to you, it does not mean that fibroids will definitely return.

Some women may not experience any recurrence, while others may notice new growths over time. Knowing your risk may help to inform what follow-up care you might need, including closer monitoring or discussing fibroid treatment options with your doctor.

How soon could fibroids come back?

Fibroids do not return overnight, so this is not something you need to worry about immediately after surgery.

In most cases, recurrence is often seen withinfive to ten years after a myomectomy, though this varies from woman to woman. Factors such as age and hormonal activity play an important role in how quickly fibroids may return.

What you could do to support lower recurrence risk

There is no guaranteed way to prevent fibroids from returning, but some lifestyle changes may help support your hormonal balance and reduce the conditions that encourage their growth.

You may find the following helpful:

• Maintaining a healthy weight:

  • Excess body fat may raise oestrogen levels, which may promote fibroid growth.

• Eating a balanced diet:

  • Reducing your intake of red meat, caffeine, and alcohol may be beneficial.

• Getting enough vitamin D:

  • Through safe sun exposure or supplements, as low vitamin D levels have been linked to fibroid growth.

• Managing stress:

  • Ongoing stress could affect hormone balance, so making time to rest and unwind may support your wellbeing.

These steps support overall health, but they cannot guarantee that fibroids will not return. Your doctor may also discuss whether any medical or procedural options are right for you alongside these lifestyle measures.

What are your treatment options if fibroids come back?

If fibroids return after myomectomy, the options available depend on your fibroid symptoms, the size and location of the new fibroids, and whether preserving fertility or other reproductive goals is important to you.

Hormonal therapies

Hormonal therapies may not be able to remove or permanently shrink fibroids, but they may help regulate oestrogen and progesterone levels, which may slow fibroid growth and ease symptoms. 

Depending on what suits you, these may include:

• Oral contraceptive pills

• Hormonal injections

• An intrauterine device (IUD)

Uterine artery embolisation

Uterine artery embolisation (UAE) is a minimally invasive procedure that works by blocking the blood supply to fibroids, causing them to shrink. It may also help slow the development of new fibroids over time, making it a useful option for women who want to avoid further surgery.

Hysterectomy

Hysterectomy is the surgical removal of the uterus and is the only option that fully eliminates the possibility of fibroids returning. 

This is usually considered when other treatments have not provided enough relief and a future pregnancy is not planned. It may provide lasting relief for women who have had several recurrences and exhausted other options.

If you have experienced repeated recurrences, your conversations with your doctor may shift from treating individual fibroids to addressing the hormonal factors that continue to encourage their growth.

If your fibroids have returned after treatment, a gynaecologist could assess your condition and advice you on the next steps in your care. Request an appointment with Thomson Medical.

FAQ

How many times can you have a myomectomy?

A myomectomy can be performed more than once, often up to two or three times depending on the development of new fibroids. However, repeat surgeries may be more complex due to the formation of scar tissue (adhesions) in the pelvis from previous procedures.

Is fibroid surgery my only option for removal?

No, fibroid removal surgery is not the only option. Minimally invasive treatments such as uterine artery embolisation (UAE) and radiofrequency ablation are also available. These procedures work by shrinking fibroids rather than surgically removing them.

Does every recurrence mean treatment is needed?

Treatment is not always necessary if fibroids return. If they grow slowly and do not cause symptoms, regular monitoring with ultrasound may be sufficient.

What are the common symptoms of returning fibroids?

Common symptoms may include prolonged or heavy menstrual bleeding, bleeding between periods, pelvic pain, lower back pain, frequent urination, difficulty fully emptying the bladder, and constipation.

How effective are medications in preventing new fibroids?

Is the UAE an alternative to fibroid surgery?

Uterine artery embolisation (UAE) is a minimally invasive option that avoids surgery. It uses imaging guidance to insert a catheter into the uterine arteries and deliver small particles that block blood flow to fibroids. Over time, the fibroids shrink and symptoms improve while preserving the uterus and avoiding surgical incisions or general anaesthesia.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique conditions, request a consultation with Thomson Medical.

Reference:

Kramer, K. J., Ottum, S., Gonullu, D., Bell, C., Ozbeki, H., Berman, J. M., Recanati, M. (2021). Reoperation rates for recurrence of fibroids after abdominal myomectomy in women with large uterus. PLoS ONE, 16(12), e0261085. https://doi.org/10.1371/journal.pone.0261085