Fibroids living in children

Overview

Uterine fibroids are non-cancerous growths that develop in the muscle wall of the uterus (womb). They are made of muscle and fibrous tissue and can vary in size from very small to large. Fibroids are very common in women during their childbearing years, but they are extremely rare in children. When they do occur in children, they are usually found in teenage girls after they start having periods, and they are almost always benign (not cancer).

Fibroids are very common in adult women, but they are extremely rare in children. Less than 1% of children or adolescents are affected. Most cases in girls are found after they have started menstruating.

Fibroids almost always affect women of reproductive age. In children, they are most often seen in teenage girls who have already begun their menstrual periods. They can also occur in infants or young children, but that is exceptionally rare and often linked to genetic conditions.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding
• Pelvic pain or pressure
• Feeling of fullness or bloating in the lower belly
• Frequent urination or difficulty emptying the bladder
• Constipation or rectal pressure
• Pain during sex (in sexually active young women)

Symptoms in children

• Heavy periods (menorrhagia) in teenage girls
• Lower abdominal pain or cramping
• A noticeable lump or swelling in the lower abdomen
• Anemia due to heavy bleeding (tiredness, pale skin)
• Painful periods (dysmenorrhea)

Symptoms in older adults

• Fibroids often shrink after menopause, so symptoms may lessen or disappear.
• If symptoms do occur, they may include pelvic pressure or bleeding (postmenopausal bleeding requires immediate medical evaluation).

Causes

Main causes

• The exact cause of fibroids is not known.
• They are influenced by hormones, especially estrogen and progesterone, which is why they are rare before a girl starts her periods.
• Genetics may play a role; if your mother or sister had fibroids, you may be more likely to develop them.

Risk factors

• Being of African-Caribbean or African-American descent (higher risk and more severe fibroids)
• Early onset of menstruation (before age 12)
• Family history of fibroids
• Obesity
• High blood pressure (hypertension)
• Vitamin D deficiency

When to see a doctor

See a doctor urgently if:

• Very heavy vaginal bleeding (soaking through pads/tampons quickly)
• Severe pelvic pain that does not go away
• Fever with pelvic pain
• Inability to urinate or pass stool

Book a routine appointment if:

• If you notice heavy, painful, or irregular periods that affect daily life
• If you feel a lump or fullness in your lower belly
• If you have bloating, pressure, or frequent urination
• If you have a family history of fibroids and are concerned

Diagnosis

Fibroids are usually diagnosed during a pelvic exam or with imaging tests. In children, a doctor will ask about symptoms, menstrual history, and do a physical exam (including an abdominal exam). An ultrasound (using sound waves) is the most common test to see the uterus and fibroids.

Tests that may be done

• Pelvic ultrasound (transabdominal or transvaginal in sexually active teens)
• Magnetic resonance imaging (MRI) for detailed images if needed
• Blood tests to check for anemia (low iron) from heavy bleeding
• Hysteroscopy or laparoscopy in rare cases (a thin camera to look inside the uterus or pelvis)

What to expect at your appointment

The doctor will first talk with you and the child about symptoms and health history. Then they will do a gentle exam of the abdomen. An ultrasound is painless and uses a small wand on the belly. If needed, a vaginal ultrasound (for older teens) uses a slim probe. Results are usually available right away. The whole appointment may take about an hour.

Treatment

Treatment for fibroids in children and teenagers focuses on managing symptoms. Many cases need no treatment at all. Options include medication to control heavy bleeding or pain, hormonal treatments to shrink fibroids, and rarely surgery. The goal is to protect future fertility and minimize side effects.

Self-care at home

• Use over-the-counter pain relief (like ibuprofen or paracetamol) for cramps, following the dose on the packet or as advised by a pharmacist
• Apply a heating pad or hot water bottle to the lower belly for comfort
• Rest during heavy bleeding days and stay hydrated
• Keep a symptom diary to share with the doctor

Medical treatments

For heavy periods, doctors may prescribe non-hormonal medicines that reduce bleeding (such as tranexamic acid) or anti-inflammatory pain relievers, but never specific brand names. Hormonal treatments like the combined contraceptive pill or a progestogen-releasing intrauterine system (IUD) can help control bleeding and shrink fibroids. These are used only after a girl has started her periods and with careful discussion of risks and benefits. Other medications that lower hormone levels (GnRH agonists) may be used for a short time to shrink fibroids before surgery.

When is surgery considered?

Surgery for fibroids in children is very rare. It may be considered if the fibroid is very large, causing severe pain or bleeding, or pressing on other organs. Options include myomectomy (removing only the fibroid) to preserve the uterus, or hysterectomy (removing the whole uterus) as a last resort. Hysterectomy is almost never done in children because it ends future pregnancy.

Living with this condition

Most young people with fibroids have a normal life. Heavy periods may cause some disruption, but symptoms can be managed with medication and lifestyle changes. It helps to plan ahead: keep spare pads/tampons at school or in your bag, and take pain relief when needed. Talk to a school nurse or teacher if you need to see the bathroom more often.

Lifestyle tips

• Stay active with gentle exercise like walking, swimming, or yoga – this can reduce pain and improve mood
• Get enough sleep and manage stress with relaxation techniques or hobbies
• Wear comfortable clothing during flare-ups
• Track your cycle and symptoms to help your doctor adjust treatment

Diet and exercise

A healthy diet rich in fruits, vegetables, whole grains, and lean protein can help manage weight and reduce inflammation. Iron-rich foods (like spinach, beans, red meat) or an iron supplement (as recommended by a doctor) can prevent anemia. Regular exercise, even light activity, improves blood flow and may reduce discomfort.

Mental health and emotional wellbeing

Living with fibroids during the teenage years can be stressful – heavy periods, pain, and worry about future fertility may affect mood. It is normal to feel anxious or frustrated. Talk to a parent, school counselor, or doctor. If you feel very down or helpless, reach out for mental health support. You are not alone.

Prevention

There is no known way to prevent fibroids. Maintaining a healthy weight, eating a balanced diet, and avoiding high blood pressure may lower the risk. Early detection through routine check-ups can help manage symptoms before they become severe.

Screening programmes

Fibroids are not routinely screened for in children or teenagers. If a girl has symptoms like heavy periods or pelvic pain, a doctor may perform an ultrasound. Routine pelvic exams are not recommended before age 21 unless there are symptoms.

Complications

If left untreated

• Anemia (low red blood cells) from heavy bleeding, causing fatigue, weakness, and pale skin
• Severe pain that disrupts daily life
• Pressure on the bladder or bowel, causing difficulty urinating or constipation
• Rarely, a fibroid may twist (torsion) and cause sudden severe pain, requiring emergency care

Long-term outlook

The outlook for young people with fibroids is very good. Most fibroids do not cause serious problems. Symptoms often improve with age and after menopause. Many treatment options are available to manage symptoms without affecting future fertility. With proper care, most people can lead a full and active life.

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