Natural history of uterine fibroids during perimenopause and menopause

Since fibroids are known to be hormonally receptive tumors, it is biologically plausible that fibroids decrease in size after menopause. Patients may opt for more conservative therapy or expectant management if fibroid growth could be predicted[1](#ref-0001). Studies assessing fibroid growth in premenopausal patients have shown that individual tumors in a single uterus grow at different rates and can grow consistently or in short bursts . These variations and the unknown effect of natural menopause make patient counseling difficult. Studies that include only symptomatic menopausal patients or those undergoing treatment can result in selection bias towards fibroids that are increasing in size . The objective of our study was to estimate fibroid growth course before and after menopause among women not specifically seeking fibroid treatment. Our hypothesis was that fibroid growth would decline after menopause.