How to Tell the Difference Between Cysts, Fibroids, Polyps, & Tumors

There’s no doubt that women’s healthcare has been seriously understudied and underfunded for far too long. Many of us have heard terms like uterine fibroids and ovarian cysts, but few of us — unless we’ve personally experienced them — know how to identify symptoms or understand treatment options.

When it comes to fibroids, cysts, lumps, and tumors, knowledge is power. When our health is compromised, it’s easy to feel powerless. Knowing when to see a doctor, what questions to ask, and being clear about options is crucial and can provide a small sense of control in times when we need it most.

SheKnows spoke to the experts to help us understand the differences among all the various lumps we might have in our body, especially our reproductive system, and what specific questions we should ask to make the best decision for our health.

The lump difference

Many types of lumps can form throughout the body, and despite pervasive fears, not all link to cancer. The most common lumps women may develop in their reproductive system include fibroids, cysts, polyps, or tumors. “The key differences between these are what they are made of, where they can grow, and what symptoms they may cause,” notes board-certified OB-GYN Dr. Kelly Culwell.

Fibroids

Uterine fibroids, also known as leiomyomas or myomas, are common benign growths of uterine muscle that develop on the uterus during childbearing years. They “affect roughly 70-80 percent of women,” Dr. Ndeye-Aicha Gueye, physician partner and reproductive endocrinologist at Reproductive Medicine Associates (RMA) explained to SheKnows, but “are only clinically impactful in 40 percent of women, leading to heavy or prolonged periods, pelvic pain, and pressure, constipation and bladder issues, or poor pregnancy outcomes.”

Fibroids vary in shape, size, and location, but they’re commonly firm, rubbery masses distinct from their surroundings. A small percentage of women can experience chronic symptoms from fibroids — such as heavy menstrual bleeding and pelvic pain — and may need them surgically removed or treated through hormone therapy.

“Depending on the size and location, fibroids can be removed via robotic, laparoscopic, or open surgery, either through the abdomen or hysteroscopically through the vagina,” says Dr. Gueye. “If untreated, fibroids can cause serious fertility issues, miscarriage, placenta abruption, fetal growth restriction, malpresentation (breach), pre-term labor, or pre-term birth.”

While uterine fibroids can happen to anyone, it’s important to note that “Black women are two to three times more likely to be affected by fibroids and more likely to develop them at a younger age compared to white women,” says Dr. Gueye. “Not only do 80 percent of Black women have fibroids, they tend to be larger and more vascular, leading to higher surgical complication rates, longer post operative hospitalizations, and severe anemia. Black women are also less likely to receive minimally invasive surgical care as a result of the healthcare disparities in the U.S.”

Cysts

Cysts are sacs filled with fluid, air, or other materials, often making them somewhat soft to the touch. They can form anywhere in the body — including bones, organs and soft tissue — and can be caused by infections, excessive production from sebaceous glands, chronic inflammatory conditions, hormones, obstructions to the flow of fluids, or foreign bodies. Some cysts are discovered during physical examinations, while others require ultrasound imaging for diagnosis.

Cysts are typically benign (aka noncancerous) but can be indicators of more serious problems elsewhere and can pose health risks if ruptured. Therefore, many physicians remove cysts and have pathologists examine them.

In the reproductive system, “cysts are most commonly seen in the ovaries,” Dr. Culwell tells SheKnows, “and can be completely normal because a cyst is formed every month after ovulation.”

“The vast majority of cysts are very simple and small and resolve spontaneously,” according to Ed Coats, consultant gynaecologist and specialist in reproductive medicine and surgery and co-founder of Total Fertility. “They are rarely abnormal in a young fertile woman but they may disrupt your menstrual cycle and affect your hormones temporarily.”

Complex cysts called endometriomas can occur in some people and those “are destructive to the ovary and may reduce your egg reserve,” notes Coats. In those instances, and in instances where there is a concern for potential cancer, surgery may be required.

Polyps

Polyps are abnormal growths on any tissue with a blood supply. Most polyps are benign, but they can grow to be malignant.

In the reproductive system, they “most commonly occur in the womb cavity and are identified with ultrasound,” says Coats. “They often cause irregular bleeding either after intercourse or in between your periods.”

Though polyps are rarely cancerous, doctors usually elect to remove polyps for further testing. According to Coats, polyps “should be removed particularly if you are struggling to conceive.”

They can be removed “hysteroscopically through the vagina” says Dr. Gueye.

Tumors

Tumors, commonly referred to as neoplasms, are abnormal tissue masses that can grow on nearly any body part. Though tumor tissue usually grows faster than normal tissue, not all tumors are harmful. “Tumors can be benign (like fibroids) or malignant (cancer) and can occur anywhere in the reproductive system,” notes Dr. Culwell.

Benign tumors aren’t dangerous unless they interfere with normal bodily functions. However, malignant tumors can pose serious health risks by invading surrounding tissues or spawning additional tumors. Most physicians recommend biopsies to determine the tumor’s nature or grade.

What to Ask Your Doctor About Your Lump

Any new or ongoing pelvic or abdominal pain, painful periods, irregular vaginal bleeding, or bleeding after sex is a sign that it’s time to see a doctor. Dr. Culwell urges patients to “speak to their doctor anytime new symptoms appear or if symptoms persist despite initial evaluation and treatment, particularly if these symptoms are impacting quality of life.”

Dr. Gueye agrees, emphasizing that “[i]t’s important for patients to identify issues with fibroids, ovarian cysts, or endometrial polyps, as leaving them untreated can lead to fertility problems.” 

Educating yourself about lumps is only the first step; the next is making a doctor’s appointment for a proper examination and diagnosis.

Instead of going to your consultation afraid, prepare a list of questions to help you better understand your situation, such as:

Finding a lump can be unsettling, but empowering yourself with information can help you eliminate fear and turn your next consultation into a productive discussion about how to get your health back on track.

Dr. Judy Wolf is the chief medical officer at Vermillion, Inc. She received her medical degree from the Northeast Ohio Medical University College of Medicine, and her clinical and research interests are in gynecologic cancers — specifically ovarian cancer.

Originally published November 2015. Updated September 2017 and June 2024.