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Both fibroids and cysts are common in females, especially before menopause.

Fibroids are a type of noncancerous tumor that forms in the muscular wall of the uterus. In contrast, ovarian cysts are fluid-filled pouches that develop in or on the ovaries. And despite them occurring in different places, the symptoms alone can leave you wondering what’s wrong.

Let’s look at the similarities and differences between uterine fibroids and ovarian cysts. We’ll also explain why it’s vital to get a diagnosis.

Uterine fibroidsOvarian cysts
Develop from the muscle layer of the uterusDevelop in or on the ovaries
Dense, firm noncancerous tumorFluid-filled sac, usually benign
Common, especially before menopauseCommon, especially before menopause
May be related to hormonal changes or endometriosisTypically linked to the menstrual cycle
Pelvic pain, abdominal bloating, and menstrual and urinary problemsPelvic pain, abdominal bloating, one-sided abdominal pain
Don’t always need treatment but can interfere with conceptionMost resolve without treatment but can burst or cause ovarian torsion, where the ovary becomes twisted around its supporting structures

Fibroids and cysts don’t always trigger symptoms. You may not realize you have them until your doctor discovers them during a routine pelvic exam. On the other hand, if you have many of them, or they become large, they can cause a range of symptoms.

Fibroid symptoms

Fibroids can be as small as apple seeds, or they can grow as large as grapefruits. Symptoms can include:

  • pelvic pain
  • bloating, protruding abdomen
  • heavy periods that can lead to anemia
  • frequent urination
  • rectal pressure
  • enlarged abdomen

Fibroids may grow faster or larger during pregnancy and tend to shrink after menopause or if you take a certain type of hormone medication.

Cyst symptoms

Cysts tend to vary in size, but they are usually half an inch to 4 inches or larger and can cause:

  • a sharp or dull abdominal ache, often on only one side
  • a bloating, protruding abdomen
  • pain in the lower back or thighs
  • pain during sex
  • painful periods
  • breast tenderness
  • frequent urination or trouble emptying your bladder
  • abnormal uterine bleeding
  • bowel problems
  • weight gain

A cyst can rupture or cause twisting of the ovary around its supporting structures, leading to:

  • sudden, intense abdominal pain
  • fever or vomiting
  • dizziness or fainting
  • rapid breathing
  • heavy bleeding

Fibroids and cysts can trigger pelvic pain and bloating of the abdomen. Two key symptoms can offer clues as to which one you might have. Firstly, abdominal pain on only one side is more likely due to ovarian cysts than uterine fibroids. In contrast, heavy menstrual bleeding problems are more likely to result from uterine fibroids than ovarian cysts.

Many of these symptoms could be due to other health problems as well. That’s why seeing your doctor and finding out exactly what’s going on is the best approach.

Fibroids and cysts can occur at any time. Fibroids are most common during your 40s and early 50s, and they may grow in clusters. Most cysts are functional cysts that commonly develop in those who haven’t reached menopause.

Fibroid causes

It’s not clear what causes uterine fibroids, but female sex hormone levels and genetics may play a role. And they’re increasingly common after age 30 through menopause. Other risk factors include:

  • a family history of fibroids
  • being Black, which researchers think may be due to greater overall stress
  • obesity
  • a diet consisting of lots of red meat

Cyst causes

Some causes of ovarian cysts are:

Your doctor may suspect you have fibroids or cysts based on your symptoms and a pelvic exam. Certain imaging tests may offer up more information, including whether there are abnormal growths and exactly where they are. These tests may include:

If these growths are in or on the uterine wall, they’re most likely fibroids, which are also called myomas or leiomyomas.

If there’s a mass on an ovary, it’s most likely a cyst. Ultrasound imaging can help determine if the mass is solid or filled with fluid. In the case of the latter, it’s an ovarian cyst, which is almost always benign.

However, if the mass is solid or partially solid, you’re past menopause or at high risk of ovarian cancer, your doctor may order a cancer antigen 125 (CA-125) blood test. A high level of CA-125 in your blood could be due to various health conditions, including ovarian cancer.

Fibroids and cysts don’t always need treatment. However, if they’re large enough to interfere with conception or cause severe symptoms, options may include:

  • watchful waiting with regular exams and ultrasounds to see if they resolve or are growing
  • hormonal contraceptives to help reduce heavy bleeding
  • surgical removal of fibroids
  • surgical removal of the uterus, which is known as a hysterectomy, if you aren’t planning on getting pregnant in the future
  • endometrial ablation
  • uterine fibroid embolization to cut off the fibroid’s blood supply

Treatment options for cysts are:

  • watchful waiting with regular exams and ultrasounds to see if they resolve or are growing
  • hormonal contraceptives to lower the risk of cyst formation
  • minimally invasive surgery to remove a smaller cyst
  • surgery to remove the ovary, known as oophorectomy

Polyps are abnormal growths of tissue. Endometrial polyps protrude from the endometrial lining inside the uterus, within the uterine cavity. They can grow large enough to fill the entire uterus, which can interfere with conception. And while they don’t always trigger symptoms, they can lead to heavy bleeding during your period.

Endometrial polyps are also known as uterine polyps. They’re usually benign, but they can be cancerous. For that reason, your doctor may recommend a biopsy.

Uterine fibroids and uterine polyps share similar symptoms. But fibroids grow from the muscular lining of the uterus. In contrast, polyps first occur in the endometrium that lines the inside of the uterus and grow within the uterine cavity.

Small uterine polyps may resolve on their own, but you can have them removed if they become troublesome.

Fibroids and cysts are both common, particularly before menopause. The big difference between the two is that fibroids first develop in the muscular lining of the uterus, while cysts form in or on the ovaries.

They don’t always produce symptoms and are usually benign, so you don’t always need to treat them. When they do cause severe symptoms, there are safe and effective treatments. You can choose a treatment based on your personal preferences and if you want to get pregnant in the future.

Speak with your doctor if you have symptoms like bloating, pelvic pain, and heavy periods. It’s crucial to find out if you have uterine fibroids, ovarian cysts, endometrial polyps, or some other treatable condition.