Occasionally, we will see them enlarge when a woman uses oral contraceptives. They usually become much smaller and less troublesome after menopause. They may or may not increase in size if a postmenopausal women is given hormone replacement therapy. They may also intensify cramps. The presence of a big lump right under the endometrium may interfere with the clotting process that regulates the amount of blood lost during your period.
Treatment depends entirely upon the severity of symptoms that the fibroids are producing.
In some cases, giving women iron to maintain the blood count is all that's necessary. Fibroids used to be a major reason for doing hysterectomies. But many women are now more wary of the operation, and surgeons are becoming more skilled at removing only the offending fibroid, while leaving the rest of the organ intact. If a woman with fibroids can get to menopause without requiring surgery, then the fibroids will probably diminish in size. Hormone replacement therapy can certainly be started if there's no other reason not to.