Fibroids: Symptoms, Diagnosis, and Treatment Options

Fibroids are one of the most common gynaecological conditions, affecting up to two in three women at some point in their lives. Despite being common, they can still cause anxiety — particularly when symptoms affect your daily life or fertility. The good news is that fibroids are almost always benign (non-cancerous) and can be effectively managed once diagnosed.

What are Fibroids?

Fibroids, also known as uterine leiomyomas or myomas, are non-cancerous growths that develop in or around the uterus. They vary in size from small, pea-sized nodules to large masses that can distort the womb.

They are made of muscle and fibrous tissue and tend to grow slowly under the influence of oestrogen.

Types of Fibroids

The symptoms and effects depend on where the fibroids are located:

• Intramural fibroids: Grow within the wall of the uterus (the most common type).
• Submucosal fibroids: Develop just under the lining of the womb and can cause heavy bleeding.
• Subserosal fibroids: Grow on the outside of the uterus and may press on nearby organs.
• Pedunculated fibroids: Grow on stalks extending from the womb wall and may twist, causing pain.

What Causes Fibroids?

The exact cause isn’t fully understood, but several factors increase the likelihood of developing them:

• Hormones: Oestrogen and progesterone promote fibroid growth.
• Genetics: A family history increases your risk.
• Age: Most common between 30 and 50.
• Ethnicity: Fibroids are more common and may occur earlier in women of African or Caribbean descent.
• Lifestyle: Being overweight and having a diet high in red meat may contribute to risk.

Symptoms of Fibroids

Some women never experience symptoms, while others notice significant changes in their cycle or comfort levels. Common symptoms include:

• Heavy or prolonged periods
• Bleeding between periods
• Pelvic pressure or bloating
• Frequent urination or difficulty emptying the bladder
• Pain during sex
• Lower back or leg pain
• Difficulty conceiving or maintaining pregnancy

If you’re experiencing heavy periods or pelvic pressure, a gynaecology consultation and ultrasound scan can identify whether fibroids are the cause.

How Fibroids are Diagnosed

Your gynaecologist may recommend several tests to confirm the presence and type of fibroids:

• Pelvic or trans-vaginal ultrasound: The most common and effective way to detect fibroids.
• MRI scan: Provides more detail, especially for larger or multiple fibroids.
• Hysteroscopy: A small camera is inserted into the womb to view submucosal fibroids.
• Blood tests: To check for anaemia caused by heavy bleeding.

Early diagnosis helps determine the best treatment plan based on your symptoms and reproductive goals.

Treatment Options

Treatment depends on your symptoms, the size and location of the fibroids, and whether you plan to have children.

1. Watchful Waiting

If fibroids are small and not causing symptoms, no immediate treatment may be needed. Regular monitoring ensures they aren’t growing.

2. Medication

• Hormonal therapy: Contraceptive pills, coils, or injections can help control bleeding.
• GnRH analogues: Temporarily shrink fibroids by lowering hormone levels.
• Tranexamic acid or anti-inflammatory drugs: Help reduce heavy bleeding and pain.

3. Non-Surgical Procedures

• Uterine fibroid embolisation (UFE): Blocks blood flow to the fibroid, causing it to shrink.
• MRI-guided focused ultrasound: Uses heat to destroy fibroid tissue.

4. Surgery

• Myomectomy: Removes fibroids while preserving the uterus — suitable for women wishing to have children.
• Hysterectomy: Complete removal of the womb, considered for severe symptoms or when other treatments fail.

Your gynaecologist will discuss which approach best fits your needs and fertility plans.

Can Fibroids Affect Fertility?

In some cases, fibroids can interfere with conception or pregnancy, especially if they distort the uterine cavity or block the fallopian tubes. Removing or reducing fibroids can often improve fertility outcomes. Many women go on to have healthy pregnancies after treatment.

Lifestyle and Self-Care Tips

While you can’t always prevent fibroids, healthy habits may help reduce growth:

• Maintain a healthy weight
• Eat a diet rich in fruit, vegetables, and whole grains
• Limit red meat and processed foods
• Manage stress and get regular exercise
• Attend routine gynaecology check-ups

Final Thoughts

Fibroids are common, benign, and highly treatable. If heavy periods, pain, or fertility problems are affecting your quality of life, it’s important not to ignore them. Early assessment ensures you get the right diagnosis and treatment.

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