Is there a relationship between testosterone levels and uterine (Uterus) leiomyomas (fibroids)?

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Last updated: February 21, 2025View editorial policy

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From the Guidelines

Testosterone therapy is not recommended for women with uterine fibroids due to its potential to stimulate fibroid growth through aromatization to estrogen. The relationship between testosterone levels and uterine leiomyomas (fibroids) is complex, and current evidence suggests that testosterone itself does not directly stimulate fibroid growth. However, testosterone can be converted to estrogen in the body, which can potentially lead to fibroid growth, as fibroids are estrogen-dependent tumors 1.

The most recent and highest quality study on the management of uterine fibroids, published in 2024, does not mention testosterone as a standard treatment for fibroids, instead focusing on hormonal treatments like birth control pills or GnRH agonists, uterine artery embolization, and surgical options like myomectomy or hysterectomy for severe cases 1.

Alternative treatments for fibroids include:

  • Watchful waiting for small, asymptomatic fibroids
  • Hormonal treatments like birth control pills or GnRH agonists (e.g., leuprolide) to shrink fibroids
  • Uterine artery embolization to cut off blood supply to fibroids
  • Surgical options like myomectomy or hysterectomy for severe cases

If you're experiencing symptoms that you think might benefit from testosterone (such as low libido), it's essential to discuss this with your doctor, who can help determine the underlying cause and suggest appropriate treatments that won't interfere with fibroid management 1.

Regular monitoring through ultrasounds and check-ups is crucial to track fibroid size and symptoms, especially if you have fibroids and are on any hormone therapy 1. Each case is unique, and treatment should be tailored to individual circumstances under the guidance of a healthcare professional.

From the Research

Relationship Between Testosterone Levels and Uterine Leiomyomas (Fibroids)

  • There is no direct evidence in the provided studies to suggest a relationship between testosterone levels and uterine leiomyomas (fibroids) 2, 3, 4, 5, 6.
  • The studies focus on the diagnosis, treatment, and management of uterine fibroids, including medical and surgical options, but do not mention testosterone levels as a factor 2, 3, 4, 5, 6.
  • Hormonal therapies, such as gonadotropin-releasing hormone agonists and selective progesterone receptor modulators, are discussed as treatment options for uterine fibroids, but their relationship to testosterone levels is not explored 3, 4.
  • The studies emphasize the importance of individualized treatment plans, patient-centered care, and evidence-based best practices in the management of uterine fibroids, but do not address the role of testosterone levels in the development or treatment of the condition 5, 6.

Treatment Options for Uterine Fibroids

  • Medical therapies, such as hormonal contraceptives, tranexamic acid, and nonsteroidal anti-inflammatory drugs, are available to reduce heavy menstrual bleeding and other symptoms associated with uterine fibroids 2, 3, 4.
  • Surgical options, including hysterectomy, myomectomy, uterine artery embolization, and magnetic resonance-guided focused ultrasound surgery, are also available, but may be associated with risks and complications 2, 3, 5.
  • The choice of treatment depends on the patient's symptoms, age, desire to maintain fertility, and access to treatment, as well as the experience of the physician 2, 3, 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Uterine Fibroids: Diagnosis and Treatment.

American family physician, 2017

Research

Current medical treatment of uterine fibroids.

Obstetrics & gynecology science, 2018

Research

The management of uterine fibroids in women with otherwise unexplained infertility.

Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC, 2015

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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