Fibroids

What are fibroids?

Fibroids are non-cancerous growths that form in the muscle wall of your uterus. They can vary in size from a pea to a rockmelon or bigger.

This condition occurs in up to 70% of women aged under 50. After menopause, fibroids usually shrink and may disappear.

Symptoms of fibroids

About 20 to 30% of women experience some symptoms related to fibroids. For example:

• heavy or long periods
• painful periods
• bleeding between periods – this depends on the size and position of the fibroids
• iron deficiency, due to heavy periods – this might make you feel tired or dizzy.

You might also experience:

• pain during sex
• feeling heaviness or pressure in the back, bowel and bladder
• feeling like you haven’t emptied your bladder or bowel
• weeing a lot
• swelling in your lower abdomen
• pregnancy complications.

What causes fibroids?

We don’t know exactly what causes fibroids, but we do know the female hormones oestrogen and progesterone stimulate the growth of fibroids.

Some factors may increase the risk of fibroids. For example:

• a family history of fibroids
• starting your periods early
• polycystic ovary syndrome (PCOS)
• obesity
• high blood pressure.

Getting a diagnosis

Fibroids can be diagnosed in different ways. For example:

• an external ultrasound on your abdomen
• an ultrasound inside your vagina – this is more accurate than an external ultrasound
• an MRI
• a hysteroscope – a thin telescope shows the inside of your uterus
• a laparoscopy (under general anaesthetic) – a thin telescope goes into your belly button to see your pelvic organs.

Fibroids might cause infertility, miscarriage or premature labour. It’s important to get a diagnosis and treat the condition if required.

Managing fibroids

If you are diagnosed with fibroids, your doctor will explain the different treatment options depending on the size, number and location of your fibroids.

Monitoring

If your fibroids are small and not causing any problems, your doctor may monitor them for changes – or they may not need to be monitored at all.

Medical treatment

Your doctor might use a combination of hormones or other medicines to shrink your fibroids, especially if infertility is an issue. After you stop taking the medicines, your fibroids may grow back.

Radiological treatment

You may be able to treat your fibroids with radiological treatment. For example:

• uterine artery embolisation – a non-surgical procedure that blocks blood supply to part of the uterus
• high-intensity ultrasound, guided by MRI – only suitable for certain types of fibroids.

Surgery

You might need different types of surgery, depending on the size and position of your fibroids.

Your specialist may recommend a myomectomy. This can be performed as a hysteroscopy (via the vagina) or a laparoscopy (keyhole surgery). If you have large or multiple fibroids, they may recommend a hysterectomy (removal of the uterus).

Talk to your specialist about the potential benefits and risks of each option before you decide.

More information

For more detailed information, related resources, articles and podcasts, visit Jean Hailes for Women’s Health.

Where to get help

• Your GP
• Gynaecologist
• Jean Hailes for Women’s Health