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Understanding Uterine Fibroids: Symptoms, Causes, Diagnosis & Treatment Options


Key Takeaways

Uterine fibroids (leiomyomas) are benign growths of the uterine muscle. Many cause no symptoms; others lead to heavy bleeding, pelvic pressure/pain, urinary changes, and fertility challenges.

There are many effective options, from watchful waiting and medications to minimally invasive procedures and hysterectomy. Treatment is personalized and based on your symptoms, goals, and imaging findings.

Certain newer therapies, such as relugolix combination therapy, expand medical options for controlling heavy menstrual bleeding due to fibroids.

If you are in Phoenix, Arizona, Arizona Gynecology Consultants (AZGYN.com) offers advanced imaging and minimally invasive expertise tailored to your goals.

Uterine fibroids (leiomyomas) are noncancerous growths of the uterine muscle. They are very common during the reproductive years, and many cause no symptoms. By midlife, a large share of people will have fibroids, though symptom severity varies. They occur in all racial and ethnic groups; U.S. health-system data show higher diagnosis rates among Black patients and, to a lesser extent, among Hispanic/Latina patients and several Asian subgroups compared with non-Hispanic White patients. These patterns reflect both biology and differences in screening and access to care, so diagnosis rates are not the same as true community prevalence. If you are in Arizona, our team can evaluate symptoms, explain imaging results, and help you choose a treatment that fits your goals.

What Are Uterine Fibroids?

What Are Uterine Fibroids?

Fibroids are benign (noncancerous) tumors arising from the smooth muscle of the uterine wall. They can occur as a single growth or as multiple growths and may range in size from a seed to grapefruit-sized masses that enlarge the uterus.

Types of fibroids (by location):

  • Intramural: within the uterine muscular wall (most common).
  • Submucosal: just beneath the uterine lining; can protrude into the uterine cavity and are often associated with heavy bleeding or fertility issues.
  • Subserosal: on the outer surface of the uterus; more likely to cause bulk or pressure symptoms.
  • Pedunculated: attached by a stalk, either inside the cavity (submucosal) or outside the uterus (subserosal).

A helpful visual is to think of fibroids as ‘knots’ in muscle tissue, small bulges that can grow within or on the surface of the uterine wall.  They push the normal uterine muscle outward as they grow.

How Common Are Fibroids and Who Is at Risk?

How Common Are Fibroids

Fibroids are among the most common gynecologic conditions. Prevalence increases with age through the 30s and 40s, and significant racial and ethnic disparities exist, with a higher burden among Black women who also tend to develop fibroids at younger ages. Additional risk factors include family history, early menarche, obesity, and possible vitamin D deficiency; research continues to explore biologic and social drivers of these patterns.

What Causes Fibroids?

The exact cause remains unclear, but fibroids are sensitive to estrogen and progesterone. Many fibroids have somatic gene mutations, most commonly in MED12, that are thought to drive growth and influence behavior. Hormonal influences help explain why fibroids often grow during the reproductive years and may shrink after menopause.  In the 5-10 years prior to menopause, fibroids can grow more rapidly due to estrogen dominance which is caused by age-related decrease in progesterone.  This is often seen with irregular bleeding that worsens during this time of a woman’s life.  Another estrogen stimulated disease, such as endometriosis, is found in nearly 50% of women with fibroids.

Signs and Symptoms of Uterine Fibroids

Many people first notice fibroids because of changes in their menstrual cycle or pelvic discomfort. While some fibroids cause no symptoms, others can lead to heavy bleeding, discomfort, or fertility challenges. Recognizing the signs early allows for better management and a wider range of treatment options.

Common Uterine Fibroid Symptoms and Possible Complications

Symptoms depend on size, number, and location. Many people have no symptoms at all.

  • Heavy menstrual bleeding (sometimes with clots) or periods longer than 7 days
  • Breakthrough bleeding (bleeding outside of the normal cycle time)
  • Pelvic pressure or pain; a sense of fullness or abdominal enlargement
  • Frequent urination or difficulty emptying the bladder
  • Constipation
  • Pain with intercourse
  • Lower back or leg pain
  • Fertility or pregnancy challenges (location-dependent)

Potential complications include anemia from heavy bleeding and, less commonly, acute pain from degeneration (when a fibroid outgrows its blood supply). Seek prompt care for severe pain, lightheadedness, or suddenly heavy bleeding.

How Are Fibroids Diagnosed?

Diagnosis begins with a medical history and pelvic exam. First-line imaging is typically transvaginal ultrasound because it is accurate, widely available, and does not use radiation. Depending on symptoms and surgical planning, clinicians may use saline infusion sonography to assess the uterine cavity, or magnetic resonance imaging (MRI) to map number, size, and location in complex cases. Laboratory testing such as a complete blood count can evaluate anemia when heavy bleeding is present.

When Should I Seek Treatment?

  • Your bleeding or pain affects daily life, work, or emotional well-being.
  • You are experiencing increased pelvic pressure, pain with intercourse or protrusion of the abdomen.
  • You notice decrease bladder capacity (more frequent urination)
  • You are trying to conceive and have been told fibroids might be contributing.
  • You are unsure whether your bleeding is normal.
  • You have a diagnosis of fibroids and want to understand all options, including minimally invasive  and uterine preserving approaches available in Phoenix, Arizona.

Related Reading: What Happens if Uterine Fibroids Go Untreated?

Treatment Options for Uterine Fibroids

Treatment Options for Uterine Fibroids

There is no single “best” treatment for everyone. The right plan depends on your symptoms, goals (including future pregnancy), fibroid characteristics on imaging, age and overall health. AZGYN emphasizes shared decision-making and minimally invasive options whenever appropriate.

1) Watchful Waiting

If fibroids are small and not causing symptoms, monitoring may be all that is needed, especially near menopause when hormones naturally decline. Your clinician can help track symptoms and repeat imaging if your situation changes.  We recommend annual visits, at least, for patients with known fibroids in order to prevent later diagnosis of rapidly growing fibroids.

2) Medications

NSAIDs

Over-the-counter nonsteroidal anti-inflammatory drugs can reduce cramps and menstrual pain, although they do not shrink fibroids.

Tranexamic acid (TXA)

An antifibrinolytic taken only on heavy days, TXA can reduce menstrual blood loss and help lower the risk of anemia. Your clinician will review clotting risk and drug interactions before prescribing.

Hormonal contraception

Combined oral contraceptives and progestin-only methods may regulate cycles and lighten periods. A levonorgestrel intrauterine system –  (52 mg) is highly effective for heavy bleeding in appropriate candidates, though it typically does not reduce fibroid size.

GnRH analogs and antagonists

Gonadotropin-releasing hormone (GnRH) agonists and antagonists lower estrogen levels, decreasing bleeding and temporarily shrinking fibroids. Long-term use can be limited by side effects. Therapy duration is generally limited to reduce bone-density risk.

3) Minimally Invasive, Uterus-Sparing Procedures

Hysteroscopic myomectomy

Removes submucosal fibroids through the cervix using a “hysteroscope”, a fiberoptic camera attached to a telescope with a very small channel for intrauterine surgical instruments. It is often ideal when heavy bleeding is the main symptom and a fibroid protrudes into the uterine cavity. It preserves the uterus and can support future fertility when clinically appropriate.  It also provides tissue for pathologic analysis.

Laparoscopic or robotic myomectomy

Removes fibroids while preserving the uterus, typically for intramural or subserosal fibroids. Surgery is done through small incisions on the abdomen under general anesthesia.  Experienced minimally invasive surgeons discuss incision size, recovery, and recurrence expectations.  The usual recovery period is 2-3 weeks.  The surgeons at AZGyn are experts in this procedure.

Uterine artery embolization (UAE/UFE)

An image-guided procedure by interventional radiology that blocks blood flow to fibroids, causing them to shrink and improving bleeding and bulk symptoms. Most candidates go home the same day and recover over a few weeks, with symptom relief increasing over weeks to months. Fertility plans, fibroid characteristics, and personal preferences are part of shared decision-making.

Radiofrequency ablation (RFA)

Uterine preserving therapy that uses ultrasound guided heat energy to ablate fibroid tissue. Laparoscopic and transcervical systems are available. Systematic reviews suggest RFA can reduce symptoms and improve quality of life with low complication rates in appropriately selected patients.  This is not the same procedure as endometrial ablation (cautery of the lining of the uterus).

MRI-guided focused ultrasound (MRgFUS/HIFU)

A noninvasive technique that focuses ultrasound energy to ablate fibroids under MRI guidance. Relief builds as treated fibroids shrink. Suitability depends on the number, size, and location of fibroids, as well as MRI features.  There are limited centers in the US that provide this therapy and the patients that qualify are limited.

4) Hysterectomy (Definitive Treatment)

Because hysterectomy removes the uterus with the fibroids, it permanently resolves bleeding and prevents fibroid regrowth. It can be life-changing for some, especially with very large or recurrent fibroids, but many patients prefer uterus-sparing options. Hysterectomy does not include removal of the ovaries (produce the female hormones) which is commonly misunderstood.  Sometimes, removal of the ovaries is done in combination with a hysterectomy if indicated.  When a hysterectomy is appropriate, minimally invasive approaches (laparoscopic or vaginal) may shorten recovery for eligible patients.  Most patients need 2-3 months for full recovery but often resume many low-stress activities after a couple of weeks.  The surgeons at Arizona Gynecology Consultants are experts in all types and approaches for hysterectomy.

How AZGYN Helps You Choose: A Simple Decision Framework

  • Your goals: preserve fertility, minimize downtime, avoid hormones, or seek the most durable option.
  • Your primary symptoms: bleeding vs bulk/pressure vs pain.
  • Imaging details: size, number, and location (submucosal, intramural, subserosal).
  • Medical factors: anemia, other conditions, prior surgeries and childbirth.

Tradeoffs: speed of relief, durability/recurrence risk, recovery time, and future pregnancy considerations.

AZGYN Fibroid Treatment

Our clinicians co-create a plan with you, often starting conservatively and progressing to procedural options only if needed, consistent with major guidelines.

Fibroids, Fertility, and Pregnancy

Fibroids can coexist with a healthy pregnancy, but certain types, especially submucosal fibroids that distort the uterine cavity, are more likely to affect implantation, miscarriage risk, or pregnancy course. Before trying to conceive, some patients benefit from myomectomy depending on fibroid size, number, and location. During pregnancy, most fibroids are managed conservatively with symptom control and monitoring; invasive treatment during pregnancy is uncommon and reserved for specific situations. Not all fibroids affect fertility; decisions about surgery before trying to conceive are individualized.

Living With Fibroids: Practical Tips and Emotional Support

  • Track cycles and symptoms so decisions are data-informed.
  • Address anemia risk with clinician-guided iron therapy if appropriate.
  • Exercise, nutrition, and weight management can support overall well-being and help to lower the effects of estrogen dominance; some risk factors such as obesity are modifiable.
  • Get regular exams to monitor the size of the fibroids and understand treatment options.

It is common to feel frustrated or overwhelmed. Our team will listen, validate your experience, and help you move forward confidently.

Uterine Fibroids Frequently Asked Questions (FAQ)

If you’ve been diagnosed with uterine fibroids or think you might have them, it’s natural to have questions. Fibroids are common, but every woman’s experience is unique. Whether you’re exploring symptoms, treatment options, or what recovery might look like, we’ve gathered some of the most frequently asked questions to help you feel informed and confident in your next steps.

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Do all fibroids need treatment?

No. If you are asymptomatic and imaging is reassuring, watchful waiting with periodic follow-up is reasonable. Treatment is guided by symptoms, goals, and imaging findings.

What imaging do I need and why?

Ultrasound is first-line for diagnosis and monitoring; MRI or saline infusion sonography may be used to plan procedures or evaluate complex cases.

Can fibroids turn into cancer?

No. Fibroids are benign. A rare cancer called leiomyosarcoma does occur in the uterus, but it is not known to arise from a benign fibroid. Clinicians use your history, exam, and imaging to plan safely.

Will fibroids go away after menopause?

Some fibroids shrink after menopause as estrogen and progesterone levels decline, and symptoms often improve though not always; new or heavy bleeding after menopause should be evaluated.

How fast do fibroids grow?

Growth varies widely: some fibroids remain stable for years, while others enlarge more quickly during the reproductive years or pregnancy; monitoring is individualized.  Each fibroid within the same patient’s uterus has its own microscopic make-up and they each function differently from the others.

Do birth control pills make fibroids grow?

Hormonal contraception can help control bleeding but usually does not shrink fibroids and is not known to drive significant growth in most patients.

Which treatments help me avoid surgery?

Depending on candidacy, options include medications (e.g., tranexamic acid, hormonal therapies and GnRH analogs/antagonists).  Less invasive therapies such as hysteroscopic myomectomy and transcervical radio frequency ablation of the fibroids are outpatient therapies that allow patients to return to normal activities the following day.

Are there non?hormonal options to reduce heavy menstrual bleeding?

Yes. Tranexamic acid (TXA) taken only on heavy days can significantly reduce blood loss for many patients; your clinician will review safety and interactions.

What’s the difference between myomectomy and hysterectomy?

Myomectomy removes fibroids and preserves the uterus, hysterectomy removes the uterus and is definitive for bleeding due to fibroids.

If I want to get pregnant, which option is best?

It depends on fibroid type, size, and location. Myomectomy is often considered when cavity distorting fibroids are implicated (the fibroids grow into the space that holds the pregnancy).  Fibroid ablation can also be considered but the data is limited on the safety for patients that desire a future pregnancy.  Endometrial ablation (different from fibroid ablation)  is not appropriate if you might desire pregnancy in the future. Many fibroids don’t affect the ability to conceive, and recommendations are tailored to each person’s situation.

Is uterine artery embolization (UFE) a good option if I want children?

UFE can reduce bleeding and pressure, but evidence for future fertility is mixed. When having children is a top priority, myomectomy and sometimes radio-frequency ablation is often recommended because it removes or decreases fibroid size while preserving the uterus. Discuss your goals with your surgeon.

Does MR-guided focused ultrasound (HIFU/MRgFUS) work for all fibroids?

No. Candidacy depends on number, size, location, and MRI features; some patterns respond better than others and careful selection is important.  There are limited centers for this procedure.

How long is recovery for common procedures?

Typical recovery is 1-2 days after hysteroscopic myomectomy, about 2–4 weeks after laparoscopic/robotic myomectomy, and a couple of weeks after UFE, RFA, or MRgFUS, though it varies by case.

How fast will I feel better after a procedure?

Timelines vary. Some patients see quicker bleeding reduction after myomectomy or ablation-type therapies, while relief after embolization or focused ultrasound builds over weeks to months as fibroids shrink.

Are vitamins or lifestyle changes enough to treat fibroids?

Healthy weight, exercise, and treating anemia can help overall well-being. Vitamin D is being studied, but supplements do not replace medical or procedural treatments when symptoms are significant.

AZGYN’s Approach to Fibroid Care in Phoenix, Arizona

Fibroid Care in Phoenix, Arizona

Accurate diagnosis with advanced in-office ultrasound and access to MRI when needed.

Personalized, minimally invasive fibroid treatment plans with an emphasis on rapid recovery and fertility preservation when possible.

Full spectrum of options: medical therapy; hysteroscopic, laparoscopic, or robotic myomectomy; uterine artery embolization (with interventional radiology partners); radiofrequency ablation; MR-guided focused ultrasound referrals; minimally invasive hysterectomy when appropriate.

At AZGYN, our goal is to help you feel better, faster—with care that fits your body, your goals, and your life. From accurate diagnosis to advanced, minimally invasive treatments, our team is here to guide you every step of the way. If you’re experiencing symptoms or have questions about uterine fibroids, we’re here to help.

Schedule a consultation today and take the next step toward relief and renewed confidence in your health.

Keep Reading to Learn More

Editor’s Note: This article is an updated combination of articles originally published August 5, 2017 and February 15, 2019.

 

Sources:

American College of Obstetricians and Gynecologists. Management of Symptomatic Uterine Leiomyomas. ACOG Practice Bulletin No. 228. 2021. Accessed October 2, 2025. https://www.acog.org/clinical/clinical-guidance/practice-bulletin/articles/2021/06/management-of-symptomatic-uterine-leiomyomas

Society of Interventional Radiology. The Fibroid Fix: What Women Need to Know. July 8, 2024. Accessed October 2, 2025. https://www.sirweb.org/media/0xhk5umb/sir_2024_fibroid_fix_report_fnl.pdf

U.S. Food & Drug Administration. MYFEMBREE (relugolix, estradiol, and norethindrone acetate) Prescribing Information. Revised 2025. Accessed October 2, 2025. https://www.accessdata.fda.gov/drugsatfda_docs/label/2025/214846s012lbl.pdf

U.S. Department of Veterans Affairs, Pharmacy Benefits Management Services. Relugolix, Estradiol, Norethindrone (MYFEMBREE) National Drug Monograph. March 2024. Accessed October 2, 2025. https://www.va.gov/formularyadvisor/DOC_PDF/MON_Relugolix_Estradiol_Norethindrone_MYFEMBREE_Monograph_Mar_2024.pdf

Marsh EE, Wegienka G, Williams DR. Uterine fibroids. JAMA. 2024;331(17):1492-1493. Accessed October 2, 2025. https://jamanetwork.com/journals/jama/fullarticle/2817458

Office on Women’s Health, U.S. Department of Health and Human Services. Uterine fibroids. Updated 2025. Accessed October 2, 2025. https://www.womenshealth.gov/a-z-topics/uterine-fibroids

American College of Radiology. ACR Appropriateness Criteria: Fibroids (Management and Imaging). 2024. Accessed October 2, 2025. https://acsearch.acr.org/docs/69508/Narrative/

Stewart EA, Laughlin-Tommaso SK. Uterine Fibroids. N Engl J Med. 2024;391:1721-1733. doi:10.1056/NEJMcp2309623 Accessed October 2, 2025. https://www.nejm.org/doi/full/10.1056/NEJMcp2309623

Expert Panel on Interventional Radiology (Makary MS, Zane K, Hwang GL, et-al). ACR Appropriateness Criteria® Management of Uterine Fibroids: 2023 Update. J Am Coll Radiol. 2024;21(6S):S203-S218. Accessed October 2, 2025. https://www.jacr.org/article/S1546-1440(24)00263-1/fulltext

National Institute for Health and Care Excellence (NICE). CKS: Menorrhagia (heavy menstrual bleeding) — Tranexamic acid: Prescribing information. Last revised November 2024. Accessed October 2, 2025. https://cks.nice.org.uk/topics/menorrhagia-heavy-menstrual-bleeding/prescribing-information/tranexamic-acid/

Bofill Rodriguez M, Lethaby A, Low C, et-al. Progestogen-releasing intrauterine systems for heavy menstrual bleeding. Cochrane Database Syst Rev. 2020;8:CD002126. Accessed October 2, 2025. https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002126.pub4/full

International Society for Gynecologic Endoscopy. Hysteroscopic myomectomy guidelines. 2023. Accessed October 2, 2025. https://www.isge.org/wp-content/uploads/2023/10/ISGE_Hysteroscopic_myomectomy_The_guidelines.pdf

AAGL Practice Guideline Committee. Evidence-based practice for minimization of blood loss during laparoscopic myomectomy. J Minim Invasive Gynecol. 2025;32(2):113-132. doi:10.1016/j.jmig.2024.09.021. Accessed October 2, 2025. https://www.jmig.org/article/S1553-4650(24)00429-1/fulltext

Society of Interventional Radiology. Uterine fibroids and UFE. Updated September 2024. Accessed October 2, 2025. https://www.sirweb.org/for-patients/conditions-and-treatments/uterine-fibroids/

Chen I, Berman JM, Balk EM, et-al. Radiofrequency ablation for the treatment of uterine fibroids: a systematic review and meta-analysis. J Minim Invasive Gynecol. 2025;32(1):74-91. doi:10.1016/j.jmig.2024.09.011. Accessed October 2, 2025. https://www.jmig.org/article/S1553-4650(24)00416-3/fulltext

Cohen ND, Lin E, Shields JK, Kho KA. Laparoscopic radiofrequency fibroid ablation: a review of current use and future applications. Curr Obstet Gynecol Rep. 2024;13:66-71. doi:10.1007/s13669-024-00382-1. Accessed October 2, 2025. https://link.springer.com/article/10.1007/s13669-024-00382-1

Liu Y, Xiao Z, Luo Y, et-al. Predictive value of contrast-enhanced MRI for the regrowth of residual uterine fibroids after high-intensity focused ultrasound treatment. Insights Imaging. 2024;15(1):274. doi:10.1186/s13244-024-01839-w. Accessed October 2, 2025. https://insightsimaging.springeropen.com/articles/10.1186/s13244-024-01839-w

Practice Committee of the American Society for Reproductive Medicine. Removal of myomas in asymptomatic patients to improve fertility and/or reduce miscarriage rate: a guideline. Fertil Steril. 2017;108(3):416-425. doi:10.1016/j.fertnstert.2017.06.034. Accessed October 2, 2025. https://www.asrm.org/practice-guidance/practice-committee-documents/removal-of-myomas-in-asymptomatic-patients-to-improve-fertility-andor-reduce-miscarriage-rate-a-guideline-2017/

Tzanis AA, Antoniou SA, Gkegkes ID, Iavazzo C. Uterine artery embolization vs myomectomy for the management of women with uterine leiomyomas: a systematic review and meta-analysis. Am J Obstet Gynecol. 2024;231(2):187-195.e1. doi:10.1016/j.ajog.2024.01.014. Accessed October 2, 2025. https://www.ajog.org/article/S0002-9378(24)00044-9/fulltext

Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in Black and White women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107. doi:10.1067/mob.2003.99. https://pubmed.ncbi.nlm.nih.gov/12548202/

Roberson ML. The intersection of structural racism and health services research in characterizing the epidemiology of uterine fibroids. JAMA Netw Open. 2024;7(4):e244165. doi:10.1001/jamanetworkopen.2024.4165. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2817008

Mitro SD, Dyer W, Lee C, et-al. Uterine fibroid diagnosis by race and ethnicity in an integrated health care system. JAMA Netw Open. 2025;8(4):e255235. doi:10.1001/jamanetworkopen.2025.5235. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2832108

The post Understanding Uterine Fibroids: Symptoms, Causes, Diagnosis & Treatment Options appeared first on AZGyn.



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What Causes Abnormal Pap Tests?


A Pap test, also known as a Pap smear, is a screening procedure that checks for changes in cervical cells. If changes occur over time, it may indicate a problem that requires further investigation. In fact, a Pap test is one of the most effective ways of preventing cervical cancer by catching changes early. However, there are different causes of abnormal Pap tests. Most of these conditions are temporary and can be treated with the proper follow-up care.

Hearing that you’ve had an abnormal test can be scary, but these results aren’t uncommon. It doesn’t automatically mean you have cancer, which is a natural fear when hearing these results read. If you’ve received an abnormal result, there is hope. Most abnormal pap smears are attributed to expected and healthy outcomes that aren’t dangerous.

Explore the reasons for abnormal Pap test results, understand the abnormalities, and learn how follow-up steps can help you continue on your health journey with peace of mind and clarity. The team at Arizona Gynecology Consultants is here to support you every step of the way.

What Is a Pap Test and Why Is It Important?

A Pap test helps detect abnormal cell changes in the cervix. Your gynecologist will gently use a small brush to remove a small sample of cervical cells. These cells are then examined under a microscope to inspect for abnormalities. This screening can help doctors detect early signs of certain conditions, such as precancerous changes, cervical dysplasia, and infections.

Prevention is key, as cervical cancer usually develops slowly over time. Identifying cervical abnormalities early on can help you initiate intervention that will prevent negative changes from progressing. Pap tests are considered one of the most effective tools available in women’s healthcare.

An ideal Pap testing frequency depends on your age, health history, and whether you’ve had abnormal test results in the past.

Pap Test

The Centers for Disease Control and Prevention (CDC, 2025) recommends the following timeline for screenings: 

Ages 21-29

The first Pap test should be done around the age of 21.
After this, the CDC recommends repeating the test every three years or sooner if you have concerns.

30-65

Pap tests can be performed every three years. You may also opt for a Pap plus HPV co-test, which can be done every five years.

After 65

If your test results were consistently normal, Pap testing may no longer be necessary.

Since many cervical abnormalities are linked to the human papillomavirus (HPV), combining a Pap test with an HPV test can be beneficial. This is called HPV co-testing and is considered a more accurate screening than a stand-alone Pap test.

Pap tests are more than just a routine appointment or part of your yearly exam. This test can save lives by detecting problems early so you can schedule the necessary treatments to avoid more serious health issues in the future.

What Does “Abnormal” Actually Mean?

Receiving an abnormal Pap test result can be a frightening experience. You may automatically assume that this is a sign of cancer, but that’s not always the case. An abnormal test result simply means that changes have occurred in the cervical cells. This could have been caused by infection, irritation, or a virus, such as HPV. These indications may resolve on their own, while at other times, they may require closer monitoring.

According to the American College of Obstetrics and Gynecology (ACOG, 2025), Pap smear abnormalities can also be more specifically described as:

  • Atypical squamous cells of undetermined significance (ASC-US). This is the most common reason for an abnormal test. The designation simply means that the cells look unusual without a clear explanation and are often linked to HPV or mild irritation.
  • Low-grade squamous intraepithelial (LSIL). This result indicates a mild change, usually because of an HPV infection. Changes typically correct themselves, especially within younger patients.
  • High-grade squamous intraepithelial lesion (HSIL). An HSIL result typically indicates a more significant change in cells that may become precancerous without treatment. Your doctor may recommend follow-up testing after an abnormal Pap test with this result.
  • Atypical glandular cells (AGC). Detecting a change in glandular cells may require more detailed testing.
  • Atypical squamous cells cannot exclude high-grade squamous intraepithelial lesion (HSC-H). This indicates that abnormal changes are present in the cervical cells, raising concern that an HSIL lesion may be present.

Results can vary widely, from irritation to precancerous changes. Abnormal simply means that your doctor will want to examine you closely to find answers.

Common Causes of Abnormal Pap Results

HPV Infection

There are many reasons for an abnormal Pap test result, but most are treatable and temporary. Some examples include: 

  • HPV Infection – HPV and abnormal Pap results often occur together. High-risk strains can alter cervical cells, but many infections resolve without the need for medical intervention.
  • Cervical Dysplasia – This refers to precancerous changes in cervical cells and ranges from mild to severe. Dysplasia may require follow-up visits and additional treatment, but it is very treatable.
  • Infections – Various infections can cause abnormal results, such as yeast infections, bacterial vaginosis, and trichomoniasis, which is a sexually transmitted infection that can cause cervical irritation.
  • Inflammation or Irritation – Some causes of cervical inflammation can include:
    • Sexual activity shortly before your Pap test
    • Tampon use
    • A recent pelvic exam
    • Vaginal douching
  • Hormonal Changes – Menopause can lead to low estrogen levels, which can impact cervical cells. Pregnancy hormones can also temporarily alter cervical cells, making them appear abnormal.
  • Additional Benign Causes – Noncancerous growths, known as cervical polyps, can appear abnormal under a microscope. Additionally, if you’ve recently undergone surgery, the healing tissue can mimic an abnormal change.

While these causes of abnormal Pap smears can still sound concerning, most of them aren’t cancer or indicators of cancer.

Human Papillomavirus (HPV) and Its Role

Human papillomavirus (HPV) is the most common cause of abnormal Pap results. HPV comprises a group of viruses that are primarily transmitted through sexual contact. In 2024, the Centers for Disease Control and Prevention reported that over 43 million Americans had been infected with HPV (CDC, 2024).

HPV can be separated into two categories:

  • Low-Risk Types – These may cause genital warts, but it doesn’t lead to cancer.
  • High-Risk Types – These can cause cervical dysplasia. If left untreated, high-risk types may lead to cancer.

HPV causes changes in cervical cells by integrating its DNA with that of the host cells. This can make cells appear abnormal on Pap test results. Most people’s immune systems clear HPV naturally, and the affected cervical cells return to normal.

Because of this, Pap test follow-up steps are very important. If your test shows HPV-related changes, your doctor might recommend another Pap test in a year or a colposcopy after the abnormal Pap to get a better understanding of the cause.

Preventative measures can also help. The HPV vaccine is highly effective at protecting against dangerous strains of the virus alongside regular screenings.

What Happens After an Abnormal Pap Test?

If your Pap comes back abnormal, there’s no need to panic. An abnormal result doesn’t always mean cancer, but rather a result that is different from what’s expected. Your healthcare provider will review the results in more detail and determine the next steps for your care.

Sometimes, minor Pap smear abnormalities are due to infection, irritation, or recent intercourse. If this is the case, your AZGYN provider may suggest repeating the test in a few months to recheck the cells.

Because HPV and abnormal Pap results can be related, your provider may order a test for high-risk HPV strains. This test helps determine whether abnormal cells are linked to HPV, which is the main cause of cervical dysplasia.

If your Pap test results are more concerning, you may need a colposcopy. This in-office procedure involves your doctor using a scope to closely examine the cervix. If the area looks unusual, a small tissue sample may be taken for further study. The biopsy allows your doctor to examine the cervical cells directly under a microscope, confirming whether the changes are mild or significant.

Every woman is different. Your AZGYN provider considers your age, medical history, and test results when determining your follow-up care. It’s important to follow your provider’s instructions. Regular follow-up appointments ensure that problems don’t escalate.

Will I Need Treatment?

Cryotherapy Treatment for Abnormal Pap Smear

Learning you have an abnormal Pap result can be worrisome, but remember – many reasons for abnormal Pap test results don’t require additional treatment. Many changes are mild and tend to resolve on their own, especially in younger women.

Your AZGYN provider may recommend different management options depending on your age, health history, and type of cell changes.

Common options for treatment include: 

  • Cryotherapy – This treatment involves freezing abnormal cells so healthy tissue can grow back
  • Loop Electrosurgical Excision Procedure (LEEP) – The process involves removing abnormal cells with a thin electrical wire
  • Close Monitoring – Careful observation with repeated Pat tests and HPV testing can monitor for any changes

When caught early, most reasons for Pap smear abnormalities are highly treatable. That’s what makes screenings so important. Early detection can help prevent cervical cancer later on, giving you the confidence that you’re protecting your long-term health goals.

Preventing Abnormal Results

While not all abnormal Pap results can be prevented, you can take certain steps to reduce your risk of the associated conditions:

  • Practice safe sex to reduce your exposure to HPV, the most common cause of abnormal Pap smears. Using protection and limiting the number of sexual partners can also lower your risk.
  • Getting the HPV vaccine can be a powerful intervention tool. It protects against strains of HPV that are most likely to cause cervical cancer and precancerous changes.
  • Don’t skip annual exams. These visits enable your doctor to monitor your overall reproductive health and note any significant changes.
  • Get regular Pap tests in accordance with CDC guidelines for your age and health history.
  • Avoid douching or harsh vaginal products that can irritate cervical tissues, disrupt the natural balance of bacteria, and potentially leave you vulnerable to infections.
  • Maintain a healthy lifestyle by not smoking and supporting your immune system.

When to Call AZGYN

If you’ve had an abnormal Pap smear and haven’t followed up on the next steps, it’s time to make a call. Even if you’re feeling fine, follow-up testing is essential to understand the reasons behind the abnormal Pap result and its implications for your health.

You should also contact us if you’re experiencing symptoms, such as bleeding between periods, unusual discharge, or pain after intercourse. While these symptoms don’t necessarily mean something is wrong, they deserve attention from an experienced gynecological professional.

Additionally, if you’re due for a regular checkup, an HPV test, or a Pap test, scheduling an appointment with AZGYN can help you take charge of your health. Our caring team can guide you through what to expect, including testing and treatment options, and provide the support you need to care for your health and future.

You’re Not Alone, We’re Here to Help

AZGYN Review

An abnormal Pap test can feel overwhelming and frightening, but you’re not alone. With the right care and follow-up, most Pap smear abnormalities can be easily managed without much medical intervention.

At AZGYN, we can explain your results, answer any questions you may have, and guide you through the next steps and options. If you’ve had abnormal results or are due for screening, schedule a visit with us today. The team at AZGYN is dedicated to delivering compassionate, expert care, giving you confidence in your health and future.

Schedule a visit with us today. Arizona Gynecology Consultants offers locations throughout Phoenix and the surrounding areas.

Editor’s Note: This article was originally published Jul 9, 2017 and has been updated October 6, 2025.

Sources:

  1. Centers for Disease Control and Prevention. (2024, January 8). Cervical cancer screening. U.S. Department of Health & Human Services. https://www.cdc.gov/cervical-cancer/screening/index.html
  2. American College of Obstetricians and Gynecologists. (2023, February). Abnormal cervical cancer screening test results. https://www.acog.org/womens-health/faqs/abnormal-cervical-cancer-screening-test-results
  3. Centers for Disease Control and Prevention. (2023, October 6). About HPV. U.S. Department of Health & Human Services. https://www.cdc.gov/hpv/about/index.html

The post What Causes Abnormal Pap Tests? appeared first on AZGyn.



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