Fibroids vs Cysts: Key Differences, Symptoms & Treatments

Natik Sungra
Aug 18
4 min read

When it comes to women’s reproductive health, two common conditions that often cause confusion are fibroids and ovarian cysts. While both can affect the uterus or ovaries and sometimes share similar symptoms like pelvic pain or irregular periods, they are very different conditions in terms of origin, growth, diagnosis, and treatment.

This article will help you understand the key differences between fibroids and cysts, their symptoms, and the treatment options available.

What are Fibroids?

Fibroids, also known as uterine fibroids or leiomyomas, are non-cancerous growths that develop in or around the uterus. They are made up of muscle and fibrous tissue and can vary greatly in size — from tiny, pea-sized nodules to large growths that distort the uterus.

Location: Inside the uterine wall, on the outer surface, or within the uterine cavity.
Nature: Solid, muscular tissue growths.
Hormone dependence: Estrogen and progesterone fuel their growth, which is why they commonly develop during reproductive years.

What are Cysts?

Ovarian cysts are fluid-filled sacs that develop on or inside the ovaries. They are quite common, especially during a woman’s reproductive years, and most of them are harmless and go away on their own.

Location: On or inside the ovary.
Nature: Fluid-filled sacs, sometimes containing blood or tissue.
Hormone dependence: Some cysts are related to the menstrual cycle, while others can form independently.

Fibroids vs Cysts: Key Differences

Feature	Fibroids	Cysts
Type	Solid growth made of muscle and fibrous tissue	Fluid-filled sac (sometimes blood/tissue)
Location	In or around the uterus	On or inside the ovaries
Causes	Hormonal imbalance (estrogen & progesterone), genetics, lifestyle factors	Hormonal changes, ovulation, endometriosis, polycystic ovary syndrome (PCOS)
Symptoms	Heavy periods, pelvic pain, bloating, frequent urination, fertility issues	Irregular periods, pelvic pain, bloating, pain during sex, sometimes no symptoms
Size	Can range from small nodules to large masses	Usually small, may disappear on their own; some can grow large or rupture
Risk of Cancer	Very rare (uterine sarcoma <1%)	Some cysts (complex cysts) may carry a risk of ovarian cancer
Treatment	Medications, hormonal therapy, surgery (myomectomy, hysterectomy)	Watchful waiting, birth control pills, surgery if large, persistent, or suspicious

Symptoms of Fibroids

Not all women with fibroids experience symptoms, but when they do, they can include:

Heavy or prolonged menstrual bleeding
Pelvic pressure or pain
Backache or leg pain (if fibroid presses on nerves)
Frequent urination or difficulty emptying the bladder
Constipation
Pain during intercourse
Fertility or pregnancy complications

Symptoms of Ovarian Cysts

Most ovarian cysts are small and cause no symptoms, but larger or problematic cysts may cause:

Pelvic pain (dull or sharp, usually on one side)
Bloating or abdominal fullness
Irregular menstrual cycles
Pain during or after sex
Difficulty emptying bladder or bowel
Nausea, especially if a cyst ruptures
Sudden, severe pain (may indicate rupture or twisting of the ovary — medical emergency)

Causes and Risk Factors

Fibroids

Hormonal imbalance (high estrogen/progesterone levels)
Family history of fibroids
Early onset of menstruation
Obesity
Vitamin D deficiency
High alcohol or red meat consumption

Cysts

Hormonal fluctuations during menstrual cycle
Polycystic Ovary Syndrome (PCOS)
Endometriosis (causes endometriomas)
Pregnancy (functional cysts may form)
Severe pelvic infections

Diagnosis

Both fibroids and cysts can be diagnosed through imaging and tests:

Ultrasound: First-line imaging to detect both fibroids and cysts.
MRI: Provides detailed imaging for fibroids and complex cysts.
Blood tests: For hormonal imbalance and tumor markers (like CA-125 for ovarian cancer risk).
Pelvic exam: Doctors may feel enlarged uterus (fibroids) or tenderness (cysts).

Treatment Options

Fibroids Treatment

Treatment depends on symptoms, size, and future pregnancy plans:

Medications
- Hormonal birth control (to control heavy bleeding)
- GnRH agonists (to shrink fibroids temporarily)
- Tranexamic acid (for heavy bleeding)
Minimally Invasive Procedures
- Uterine artery embolization (blocks blood supply to fibroid)
- MRI-guided focused ultrasound
Surgery
- Myomectomy (removal of fibroids, uterus preserved)
- Hysterectomy (removal of uterus, permanent solution)

Ovarian Cysts Treatment

Most ovarian cysts disappear naturally within a few months. Treatment is required if cysts are large, painful, or suspicious:

Watchful Waiting
- Regular check-ups and ultrasounds
Medications
- Birth control pills to prevent new cysts
- Pain relief medicines for discomfort
Surgery
- Laparoscopic cystectomy (removal of cyst while preserving ovary)
- Oophorectomy (removal of ovary, only if necessary)

Can Fibroids and Cysts Affect Fertility?

Fibroids: Large fibroids or those inside the uterine cavity can cause infertility, miscarriage, or pregnancy complications.
Cysts: Most do not affect fertility, but conditions like PCOS and endometriosis-related cysts can cause difficulty conceiving.

When to See a Doctor

Seek medical attention if you experience:

Severe pelvic or abdominal pain
Sudden bloating or swelling
Very heavy menstrual bleeding
Difficulty conceiving
Pain during sex or urination
Family history of ovarian/uterine cancer

Conclusion

While fibroids and ovarian cysts may present with overlapping symptoms, they are distinct conditions with different causes, risks, and treatments. Understanding the differences is crucial for timely diagnosis and management.

Fibroids are solid, non-cancerous growths in the uterus that may cause heavy periods and fertility problems.
Cysts are fluid-filled sacs on the ovary, often harmless but sometimes painful or risky if they rupture.

Early diagnosis, lifestyle changes, and the right treatment plan can help women manage both conditions effectively and maintain reproductive health.