# Miomas uterinos

Reviewed educational content from Círculo Ginecológica. This is a shared clinic page, not exclusive to one physician.

Having fibroids does not automatically mean surgery is needed, nor that the uterus must be removed. Depending on symptoms, age, number, size and location of the fibroids, pregnancy desire and personal goals, management can be watchful waiting, medical treatment, or, when necessary, surgery. Today, minimally invasive surgery is the preferred approach when feasible, even for many uteruses with large or multiple fibroids; open surgery should be far less common and should not be assumed based on size alone.

## Symptoms fibroids may cause

Heavy or prolonged menstrual bleeding, iron-deficiency anemia, pelvic pain/pressure/heaviness, increased abdominal volume, relevance to a fertility evaluation depending on location, or a prior surgical proposal that can be reviewed.

## Location matters, not just size

- Submucosal: grow into the uterine cavity; often related to bleeding, sometimes treatable by hysteroscopy.
- Intramural: develop mainly within the uterine muscular wall.
- Subserosal: grow toward the outside of the uterus, often causing pressure or volume symptoms.

Treatment decisions also weigh size, number, symptoms, bleeding, anemia, growth, pain, pressure, age, reproductive desire and relationship to the uterine cavity. In selected patients, a progestin-releasing IUD can be a medical alternative when the cavity allows it and the goal is bleeding control.

## Surgical options when surgery is needed

- Myomectomy: removes fibroids while preserving the uterus; relevant when reproductive desire or uterine preservation matter. New fibroids can develop later, so gynecologic follow-up continues.
- Hysterectomy: removes the uterus; a definitive option in selected patients who no longer wish to preserve it.
- Approaches: hysteroscopy (through the cervix, no abdominal incisions, for fibroids growing into the cavity), laparoscopy (small abdominal incisions), and robotic-assisted surgery (a minimally invasive tool for select, more complex cases, highlighted with Dr. Guillermo Pérez Ornelas at this clinic).

## Related topics covered on this page

Fibroids and anemia/iron deficiency (lab work-up and IV iron when indicated, in coordination with Médica Círculo Country), fibroids and fertility (integrating a fertility specialist when needed), requesting a second opinion using existing studies, and what to bring to a consultation (recent ultrasound, MRI if available, prior biopsies/labs, any prior surgical proposal).

## Care team

Dra. María Fernanda Castillo, Dra. Vania, and Dr. Guillermo Pérez Ornelas all perform minimally invasive gynecologic surgery at Círculo Ginecológica; a patient can learn about each physician and choose who to schedule with.

## Seek care

For heavy bleeding, severe pain, or another urgent symptom, seek medical care rather than relying on website content.

## Official links

- [Full human-readable page](https://www.ginecomariafercastillo.com/miomas-uterinos/)
- [Contact and appointments](https://www.ginecomariafercastillo.com/#contacto)
- [Agent instructions](https://www.ginecomariafercastillo.com/llms.txt)