Fibroids

Overview

Fibroids are non-cancerous growths that develop in or around the womb (uterus). They are made of muscle and fibrous tissue and can range in size from very small to large.

Yes, fibroids are very common. Up to 8 in 10 women may develop them by age 50.

Fibroids most often affect women of reproductive age, especially those in their 30s and 40s. They are more common in women of African-Caribbean heritage.

Symptoms

Common symptoms

• Heavy or prolonged menstrual periods
• Pain or pressure in the lower abdomen
• Frequent urination or difficulty emptying the bladder
• Constipation or bloating
• Pain during sex
• Lower back pain

Symptoms in children

• Fibroids are extremely rare in children; if they occur, symptoms would be similar to adults but should be checked by a doctor.

Symptoms in older adults

• After menopause, fibroids often shrink and symptoms may improve. However, new bleeding after menopause should always be checked by a doctor.

Causes

Main causes

• The exact cause is unknown, but fibroids are linked to hormones like estrogen and progesterone.
• Genetic changes may also play a role.

Risk factors

• Age (more common in reproductive years)
• Family history of fibroids
• Obesity
• High blood pressure
• Not having had children
• African-Caribbean ethnicity

When to see a doctor

See a doctor urgently if:

• If you have very heavy bleeding that soaks through protection quickly
• If you have sudden, severe pelvic pain
• If you feel faint, dizzy, or short of breath from heavy bleeding

Book a routine appointment if:

• If you have heavy periods that are affecting your daily life
• If you have pelvic pain or pressure that bothers you
• If you have trouble getting pregnant

Diagnosis

Fibroids are often found during a routine pelvic exam. Your doctor may feel an irregularity in the shape of your womb.

Tests that may be done

• Ultrasound (most common test)
• MRI scan for more detail
• Hysteroscopy (camera inside the womb)
• Laparoscopy (camera through small cut in abdomen)

What to expect at your appointment

Diagnosis usually involves an ultrasound, which is painless and uses sound waves to create an image of your uterus. You may need a full bladder for the test.

Treatment

Treatment depends on your symptoms, the size and location of the fibroids, your age, and whether you want to become pregnant. Options range from monitoring to medication or procedures.

Self-care at home

• Use over-the-counter pain relief like ibuprofen for pain (ask your pharmacist if it's safe for you)
• Apply a heating pad or hot water bottle on your lower belly for pain
• Rest during heavy bleeding days
• Keep a symptom diary to discuss with your doctor

Medical treatments

Medications may help reduce symptoms. Hormonal treatments such as contraceptives or hormone-releasing devices can lighten periods and reduce pain. Other medicines, like those that block estrogen or progesterone, can shrink fibroids. Your doctor will discuss which options suit you.

When is surgery considered?

If fibroids cause severe symptoms or you want to preserve fertility, procedures like myomectomy (removing fibroids while leaving the womb) may be considered. For women who do not want more children, hysterectomy (removing the womb) is an option. Non-surgical treatments like uterine artery embolization (blocking blood flow to fibroids) are also available.

Living with this condition

Many women with fibroids live normal lives. You may need to plan around heavy bleeding days. Keep track of your symptoms and talk to your doctor if they change.

Lifestyle tips

• Maintain a healthy weight to reduce estrogen levels
• Exercise regularly to improve circulation and reduce stress
• Avoid excessive alcohol and caffeine, which may worsen symptoms

Diet and exercise

A balanced diet rich in fruits, vegetables, and whole grains may help reduce inflammation. Regular exercise like walking or swimming can help with pain and heavy bleeding.

Mental health and emotional wellbeing

Heavy bleeding and pain can cause anxiety, stress, or low mood. It's important to talk to your healthcare provider or a mental health professional if you feel overwhelmed. You are not alone.

Prevention

There is no proven way to prevent fibroids, but maintaining a healthy weight and eating a balanced diet may lower your risk.

Screening programmes

Routine screening for fibroids is not recommended unless you have symptoms. Regular well-woman exams can help detect them early.

Complications

If left untreated

• Anemia (low red blood cells) from heavy bleeding
• Severe pain or pressure on the bladder or bowels
• Difficulty getting pregnant or complications in pregnancy

Long-term outlook

Fibroids are not cancer and rarely turn into cancer. Most women with fibroids have no serious complications. With proper care, symptoms can be managed, and many treatment options are available to improve quality of life.

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