Fibroids living in adults

Overview

Fibroids are noncancerous growths that develop in or around the womb (uterus). They are made of muscle and fibrous tissue. They are sometimes called uterine myomas or leiomyomas.

Fibroids are very common. Up to 80 out of 100 people with a uterus will have them by age 50.

Anyone who has a uterus can develop fibroids. They are most common in people aged 30 to 50. They are less common in people under 20 and after menopause.

Symptoms

Common symptoms

• Heavy or long periods that may interfere with daily life
• Bleeding between periods
• Pelvic pain or pressure
• Frequent need to urinate
• Difficulty emptying the bladder
• Constipation or bloating
• Pain during sex
• Lower back pain or leg pain

Symptoms in older adults

• Fibroids often shrink after menopause, so symptoms may lessen or stop.
• If fibroids persist after menopause, they may still cause bleeding, pain, or pressure. Any new bleeding after menopause should be checked by a doctor.

Causes

Main causes

• The exact cause of fibroids is not known. They are thought to be linked to hormone levels, especially oestrogen and progesterone, which stimulate their growth.
• Genetics may play a role: fibroids sometimes run in families.

Risk factors

• Age: most common in the 30s and 40s
• Family history: having a close relative with fibroids
• Being of African or Caribbean heritage
• Obesity (having a body mass index over 30)
• Starting periods at a young age
• Not having had children
• High blood pressure (hypertension)
• Diet high in red meat and low in green vegetables, fruit, and dairy

When to see a doctor

See a doctor urgently if:

• Any of the emergency symptoms listed above
• Heavy bleeding that makes you feel weak or dizzy
• Sudden severe pelvic pain

Book a routine appointment if:

• Heavy or painful periods that affect your quality of life
• Pelvic pain, pressure, or bloating that does not go away
• Difficulty urinating or emptying your bladder
• Constipation that is new and not explained by other causes
• Pain during sex

Diagnosis

Your doctor will ask about your symptoms and medical history, and may do a pelvic exam. If fibroids are suspected, imaging tests are used to confirm.

Tests that may be done

• Pelvic ultrasound: uses sound waves to create images of the uterus and fibroids.
• MRI scan: provides detailed images to see the size, number, and location of fibroids.
• Hysteroscopy: a thin camera is inserted through the vagina into the womb to look at the cavity.
• Sonohysterography: an ultrasound with saline (salt water) injected into the uterus to get a clearer view.

What to expect at your appointment

Most tests are done as an outpatient and are not painful. Your doctor will explain the results and discuss options based on your symptoms, fibroid size and location, and your plans for pregnancy.

Treatment

Treatment depends on whether you have symptoms, how severe they are, your age, and whether you want to become pregnant in the future. Many people with no symptoms do not need treatment. Options include watchful waiting, medication, non-surgical procedures, and surgery.

Self-care at home

• Use over-the-counter pain relief (such as ibuprofen or paracetamol) for mild pain – ask your pharmacist for advice.
• Apply a hot water bottle or heating pad to your lower belly for comfort.
• Rest when you need to during your period.
• Keep a symptom diary to share with your doctor.

Medical treatments

Medication can help manage symptoms but does not make fibroids go away. Options include hormonal treatments (like birth control pills or intrauterine systems) that reduce heavy bleeding, and other medicines that shrink fibroids temporarily. Always talk to your doctor about which approach might work for you. Do not take any medication without medical advice.

When is surgery considered?

Surgery may be recommended if fibroids cause severe symptoms, do not respond to other treatments, or if you have very large fibroids. Options include myomectomy (removing just the fibroids, often preserving fertility) and hysterectomy (removing the whole uterus, which ends fertility). Your doctor will explain the risks and benefits of each.

Living with this condition

Most people with fibroids live normally, especially if symptoms are mild. If you have heavy periods, plan ahead with extra supplies and consider wearing dark clothes. Track your cycle so you can anticipate heavy days.

Lifestyle tips

• Stay at a healthy weight – being overweight can increase hormone levels that make fibroids grow.
• Exercise regularly to help manage pain and stress.
• Reduce stress through relaxation techniques like deep breathing, meditation, or gentle yoga.

Diet and exercise

Eating a balanced diet with plenty of fruits, vegetables, and whole grains may help. Some studies suggest a diet low in red meat and high in green leafy vegetables may lower the risk of fibroids. Regular exercise (walking, swimming, cycling) can improve circulation and help with pain.

Mental health and emotional wellbeing

Living with fibroids can be frustrating and stressful, especially if symptoms disrupt your work, relationships, or sleep. Heavy bleeding may cause anxiety about leaks or shame. Pelvic pain can affect your mood. It is normal to feel upset or worried. Talking to a counsellor or joining a support group can help.

Prevention

There is no proven way to prevent fibroids. However, maintaining a healthy weight, eating a balanced diet, and exercising may reduce your risk. Regular check-ups can help detect fibroids early.

Screening programmes

There is no routine screening for fibroids. They are often found during a pelvic exam or ultrasound for other reasons. If you have symptoms, see your doctor.

Complications

If left untreated

• Untreated fibroids can cause heavy bleeding leading to anaemia (low red blood cells), which can make you feel tired, weak, or short of breath.
• Large fibroids may press on the bladder or bowel, causing urinary problems or constipation.
• Fibroids can cause infertility or pregnancy complications, such as miscarriage or preterm labour, depending on their size and location.

Long-term outlook

For most people, fibroids are manageable. They are not cancer and rarely become cancer. Symptoms often improve with treatment or after menopause. Many people with fibroids live full, healthy lives.

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