Understand Fibroids

What is Fibroids

Fibroids (also known as uterine fibroids or leiomyomas) are benign (non-cancerous) growths that develop from the muscle layer of the uterus (womb).

Fibroids are very common, affecting up to 70–80% of women during their lifetime. Many women have fibroids without symptoms, while others may experience significant symptoms affecting quality of life.

Fibroids can vary in:

• Size (from very small to large masses)

• Number (single or multiple)

• Location within the uterus

Types of Fibroids

Fibroids are classified according to where they grow within the uterus.

Intramural Fibroids

These develop within the muscle wall of the uterus and are the most common type.

Submucosal Fibroids

These grow into the uterine cavity and may cause heavy bleeding and fertility problems.

Subserosal Fibroids

These grow on the outer surface of the uterus and may cause pressure symptoms.

Pedunculated Fibroids

These grow on a stalk either inside or outside the uterus.

Understanding the type of fibroid helps guide treatment decisions.

Common Symptoms of Fibroids

Many women have fibroids without symptoms. When symptoms occur, they may include:

• Heavy menstrual bleeding

• Prolonged periods

• Pelvic pain or pressure

• Lower abdominal swelling

• Frequent urination

• Constipation

• Pain during intercourse

• Back pain

• Difficulty conceiving

• Recurrent miscarriage

Heavy menstrual bleeding may lead to iron deficiency anaemia, causing fatigue and breathlessness.

When Should You Seek Medical Advice?

You should consider seeing a specialist if you experience:

• Heavy periods affecting daily life

• Bleeding lasting longer than 7 days

• Pelvic pressure or abdominal swelling

• Symptoms of anaemia (fatigue, dizziness)

• Difficulty conceiving

• Rapid increase in abdominal size

Early assessment allows appropriate treatment planning.

Causes and Risk Factors

The exact cause of fibroids is not fully understood, but several factors may contribute.

Risk factors include:

• Hormonal influence (oestrogen and progesterone)

• Family history of fibroids

• Increasing age (especially 30–50 years)

• Early onset of menstruation

• Obesity

• Ethnic background (higher prevalence in some populations)

Fibroids often shrink naturally after menopause.

How are Fibroids Diagnosed?

Diagnosis usually begins with a detailed history and clinical examination.

Investigations may include:

Pelvic Ultrasound Scan

This is the first-line investigation and helps determine:

• Size of fibroids

• Number of fibroids

• Location within the uterus

Ultrasound is widely available and highly effective for diagnosis.

MRI Scan

MRI provides more detailed information and is particularly useful when:

• Fibroids are large or multiple

• Surgical planning is required

• Fertility preservation is important

Hysteroscopy

A hysteroscopy involves inserting a small camera through the cervix to examine the uterine cavity.

This is particularly useful for diagnosing:

• Submucosal fibroids

• Causes of abnormal uterine bleeding

Treatment Options for Fibroids

Treatment depends on:

• Severity of symptoms

• Size and location of fibroids

• Age

• Desire for future fertility

• Overall health

Not all fibroids require treatment.

Conservative (Non-Surgical) Management

If fibroids are small and symptoms are mild, monitoring alone may be appropriate.

This may include:

• Regular follow-up scans

• Symptom monitoring

Medical Treatment

Medical therapy focuses on controlling symptoms rather than removing fibroids.

Options may include:

• Hormonal contraception

• Progesterone-based treatments

• Hormonal intrauterine system (coil)

• Tranexamic acid to reduce bleeding

• Non-steroidal anti-inflammatory drugs (NSAIDs)

• GnRH analogues (short-term use)

Medical treatment may reduce bleeding but does not permanently remove fibroids.

Surgical Treatment

Surgery may be recommended when symptoms are severe or fertility is affected.

Options include:

Myomectomy

This involves surgical removal of fibroids while preserving the uterus.

It may be performed using:

• Hysteroscopic approach (through the cervix)

• Laparoscopic (keyhole) surgery

• Open abdominal surgery (in selected cases)

Myomectomy is often recommended for women wishing to preserve fertility.

Hysterectomy

A hysterectomy involves removal of the uterus and provides a permanent solution to fibroids.

This option is considered when:

• Symptoms are severe

• Fertility is no longer desired

• Other treatments have failed

Minimally invasive hysterectomy techniques may be suitable in selected cases.

Uterine Artery Embolisation (UAE)

This is a minimally invasive procedure that reduces blood supply to fibroids, causing them to shrink.

This option may be considered in selected patients.

Fibroids and Fertility

Fibroids may affect fertility depending on:

• Their size

• Their location

• Whether they distort the uterine cavity

Submucosal fibroids are more likely to affect fertility.

Treatment options may include:

• Hysteroscopic removal

• Laparoscopic myomectomy

• Fertility planning support

Individualised assessment is essential.

Living with Fibroids

Many women live with fibroids successfully.

Lifestyle and supportive measures may include:

• Monitoring symptoms

• Managing anaemia

• Maintaining a healthy weight

• Regular follow-up with your clinician

When to Seek Urgent Medical Advice

Seek urgent medical attention if you experience:

• Very heavy bleeding soaking pads hourly

• Severe sudden pelvic pain

• Dizziness or fainting

• Signs of severe anaemia

• Sudden increase in abdominal swelling

FAQs

Are fibroids cancerous?

Fibroids are benign (non-cancerous). Cancer arising from fibroids is extremely rare.

Can fibroids shrink naturally?

Why Choose Specialist Care?

Do all fibroids need treatment?

Can fibroids return after surgery?

Fibroids vary significantly between individuals, and treatment should be tailored to your symptoms and reproductive goals.

Specialist care provides:

• Accurate diagnosis

• Individualised treatment planning

• Access to minimally invasive surgical options

• Fertility-preserving treatments when required

• Ongoing monitoring and support

Fibroids may recur after myomectomy, particularly in younger women.

Fibroids often shrink after menopause due to reduced hormone levels.

No. Many fibroids require only monitoring if symptoms are mild.

Can fibroids affect pregnancy?

Fibroids can sometimes affect pregnancy depending on their size and location.

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