Fibroids living in pregnancy

Overview

Fibroids are non-cancerous growths that develop in or around the womb (uterus). When a woman with fibroids becomes pregnant, the fibroids can sometimes cause symptoms or affect the pregnancy, but most women with fibroids have a healthy pregnancy and baby.

Yes, fibroids are common in women of childbearing age. Up to 70% of women in this age group have fibroids, but only a minority experience symptoms during pregnancy.

Fibroids mostly affect women between 30 and 50 years old. They are more common in Black women and those with a family history of fibroids.

Symptoms

Common symptoms

• Heavy or painful periods (before pregnancy)
• Lower back pain or pelvic pressure
• Frequent urination or constipation
• A feeling of fullness in the lower belly

Symptoms in children

• Fibroids are extremely rare in children. If a child has pelvic pain or unusual bleeding, it is likely due to another cause and they should see a doctor.

Symptoms in older adults

• After menopause, fibroids usually shrink and symptoms often go away. In older women, new or worsening pelvic symptoms should still be checked by a doctor.

Causes

Main causes

• The exact cause is unknown, but fibroids are linked to the hormones oestrogen and progesterone, which can make them grow.
• Changes in your genes may also play a role.

Risk factors

• Being of African-Caribbean or Black African descent
• Having a close family member with fibroids (mother, sister)
• Starting your periods at an early age
• Being overweight or obese
• Not having given birth (nulliparity)

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If you are pregnant and have sudden severe pain or heavy bleeding – call your hospital maternity unit or emergency services immediately

Book a routine appointment if:

• If you have symptoms like heavy periods, pelvic pressure, or frequent urination that bother you
• If you are planning a pregnancy and know you have fibroids – talk to your GP or gynaecologist about how they might affect your pregnancy

Diagnosis

Fibroids are often diagnosed during a pelvic exam or with an ultrasound scan. If you are pregnant, an ultrasound can show the size, number, and location of any fibroids.

Tests that may be done

• Pelvic ultrasound (most common and safe during pregnancy)
• MRI scan (if more detail is needed – also safe in pregnancy)
• Sometimes a small sample of tissue (biopsy) is taken to confirm it is not cancer

What to expect at your appointment

If you have fibroids during pregnancy, your doctor will monitor the growth and position of the fibroids with regular scans. They will also check your baby's growth and position. Most women do not need any special treatment.

Treatment

Treatment during pregnancy focuses on managing symptoms and reducing risks to you and your baby. In most cases, no treatment is needed. If symptoms occur, simple measures and careful monitoring are usually enough.

Self-care at home

• Rest when you feel tired or have mild pain
• Use a warm heat pack (on your belly, not too hot) for mild pain
• Drink plenty of water and eat foods with fibre to prevent constipation
• Keep moving gently – walking and stretching can help ease discomfort

Medical treatments

If you have pain or bleeding, your doctor may suggest pain relief that is safe in pregnancy (such as paracetamol). In some cases, medicines that help reduce heavy bleeding or prevent preterm contractions may be used. Your healthcare team will choose options that are safe for you and your baby. Avoid any over-the-counter or herbal remedies without checking first.

When is surgery considered?

Surgery (myomectomy – removal of fibroids) is rarely done during pregnancy because it increases risks. It may be considered after the baby is born if fibroids cause ongoing symptoms. In very rare cases, if a fibroid twists or causes severe problems during pregnancy, emergency surgery could be needed.

Living with this condition

Living with fibroids during pregnancy means paying attention to your body and knowing when to rest. Most women continue normal daily activities. If your fibroids cause symptoms, you may need to adjust your schedule and avoid heavy lifting.

Lifestyle tips

• Get plenty of rest and sleep
• Stay active with gentle exercise (walking, swimming, prenatal yoga – ask your doctor first)
• Manage stress with relaxation techniques like deep breathing or meditation
• Drink enough water to help prevent urinary infections
• Avoid smoking and alcohol

Diet and exercise

Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein. Include foods with iron (like spinach, beans) to prevent anaemia. Gentle exercise like walking can improve blood flow and reduce pain. Avoid high-impact exercise that may cause strain.

Mental health and emotional wellbeing

Worrying about your health and your baby's health is normal. Fibroids can cause anxiety, especially if you have had problems before. Talk to your midwife or doctor about your feelings – they can offer advice and support. Remember, most pregnancies with fibroids are successful.

Prevention

There is no guaranteed way to prevent fibroids, but a healthy lifestyle (maintaining a healthy weight, eating well, and exercising) may reduce your risk. Once you have fibroids, you cannot always prevent them from growing, but careful monitoring during pregnancy helps manage any issues.

Vaccines

There is no vaccine for fibroids.

Screening programmes

There is no routine screening for fibroids. They are often found during routine pelvic exams or scans. If you have symptoms, your doctor can arrange tests.

Complications

If left untreated

• If fibroids cause heavy bleeding, you may develop anaemia (low blood count)
• In pregnancy, untended fibroids can increase the risk of preterm labour, placenta problems, or the baby being in a breech position
• Rarely, a fibroid may twist (torsion) causing severe pain that requires emergency care

Long-term outlook

Most women with fibroids have a normal pregnancy and deliver a healthy baby. Even when symptoms occur, they can usually be managed with simple care and close monitoring. After childbirth, fibroids often shrink. With the support of your healthcare team, you can have a positive pregnancy experience.

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