In order to arrive at a diagnosis, the health care provider will first ask the patient to provide a history of symptoms, since fibroids can be caused by a variety of disorders. A series of tests will be considered: First, a pelvic exam is performed and from this exam the physician can determine whether the uterus is enlarged and/or irregular in shape. Next, an ultrasound or MR Imaging is usually advised - a painless procedure in which sound or radiofrequency waves are used to generate a picture of internal organs, respectively (See fig.1 and 2).

Fig. 1. Ultrasound of uterus shows two large fibroids (arrows) in the uterus.

Since abnormal bleeding can be an early sign of cancer of the endometrium (inner lining of the uterus), health care provider may recommend a procedure to make certain the bleeding is due to fibroids. These procedures may include an endometrial biopsy (sampling of the endometrium) or dilatation and curettage (scraping away part of the endometrium) in order to analyze the endometrial cells under a microscope to determine if cancer is present. A hysteroscopy (insertion of a scope into the uterine cavity through the vagina and cervical opening) may also be performed to visually examine the growths detected by ultrasound, obtain a specimen for biopsy and possibly resect submucosal fibroids.

Fig 2. An Mri  image of pelvis of a 39 year old woman obtained before embolization shows multiple large fibroids (double headed arrows) in a 24-week size uterus.