Uterine Fibroids

Overview

Uterine fibroids are non-cancerous growths that develop in the wall of the uterus (womb). They are made of muscle and fibrous tissue and can range in size from very small to large enough to change the shape of the uterus.

Yes, uterine fibroids are very common. About 2 in 3 women will develop at least one fibroid during their reproductive years.

Fibroids most often affect women of childbearing age, especially those in their 30s and 40s. They are more common in Black women and women with a family history of fibroids.

Symptoms

Common symptoms

• Heavy or prolonged menstrual bleeding
• Pain or pressure in the lower belly or back
• Frequent urination or difficulty emptying the bladder
• Constipation or bloating
• Pain during sex
• A feeling of fullness or swelling in the lower abdomen

Symptoms in children

• Uterine fibroids are rare before puberty. If they occur, symptoms may include pelvic pain or changes in menstrual cycles after periods start.

Symptoms in older adults

• After menopause, fibroids usually shrink, but some women may still have symptoms like pressure or bleeding if fibroids are large.

Causes

Main causes

• The exact cause is unknown, but fibroids are linked to the hormones estrogen and progesterone, which stimulate their growth.

Risk factors

• Being of reproductive age
• Being of Black ethnicity
• Having a family history of fibroids
• Starting periods at an early age
• Having a high body weight (obesity)
• Never having been pregnant

When to see a doctor

See a doctor urgently if:

• If you have very heavy bleeding with dizziness or weakness
• If you have sudden, severe pelvic pain
• If you have trouble urinating or passing stool

Book a routine appointment if:

• If your periods are heavy, long, or painful and affect your quality of life
• If you feel a lump or pressure in your lower belly
• If you have pain during sex

Diagnosis

Fibroids are often found during a routine pelvic exam. If your doctor suspects fibroids, they will usually suggest an imaging test to confirm the diagnosis.

Tests that may be done

• Pelvic ultrasound (uses sound waves to create images of the uterus)
• MRI (magnetic resonance imaging) for more detail if needed
• Hysteroscopy (a tiny camera inserted through the cervix to look inside the uterus)
• Sonohysterography (ultrasound with fluid to better see the uterine cavity)

What to expect at your appointment

Most tests are done in a clinic or radiology department and are not painful. You may be asked to have a full bladder for an ultrasound. Your doctor will explain the results and discuss options if fibroids are found.

Treatment

Treatment depends on your symptoms, age, whether you want to have children, and the size and location of the fibroids. Many women with no symptoms need no treatment. For those with symptoms, options range from medications to procedures.

Self-care at home

• Apply a heating pad to your lower belly to ease pain
• Take over-the-counter pain relief (like ibuprofen or paracetamol) as directed on the label
• Rest during heavy bleeding
• Keep a symptom diary to share with your doctor

Medical treatments

Your doctor may suggest medications to help control symptoms. These can include hormonal treatments (such as birth control pills or a hormone-releasing coil) to reduce bleeding, or non-hormonal medicines to relieve pain and heavy periods. There are also medications that temporarily shrink fibroids by lowering hormone levels. Always discuss the benefits and side effects with your healthcare provider.

When is surgery considered?

Surgery may be considered if symptoms are severe, medications do not help, or you want to remove fibroids. Procedures include myomectomy (removing only the fibroids) for women who want to keep their uterus, or hysterectomy (removing the whole uterus) for women who do not want more children. There are also less invasive options like uterine artery embolisation or focused ultrasound. Your doctor will help you choose the best approach.

Living with this condition

For many women, fibroids are manageable with lifestyle changes and regular check-ups. If you have symptoms, plan ahead for heavy days during your period and carry supplies. Communicate with your doctor about any changes.

Lifestyle tips

• Maintain a healthy weight to help balance hormones
• Manage stress with relaxation techniques like deep breathing or yoga
• Get regular exercise to improve overall health and reduce pelvic pressure
• Stay hydrated and eat a balanced diet

Diet and exercise

There is no special diet proven to cure fibroids, but eating plenty of fruits, vegetables, and whole grains and limiting red meat and alcohol may help. Regular physical activity can help with weight management and reduce symptoms like bloating.

Mental health and emotional wellbeing

Living with fibroids can be stressful, especially if symptoms affect your daily life, relationships, or plans to have children. Many women feel anxious or frustrated. It is important to talk to your doctor about how you feel. If you are feeling overwhelmed, seek support from a counsellor or a mental health hotline.

Prevention

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

Complications

If left untreated

• Severe anaemia from heavy bleeding, causing fatigue and weakness
• Chronic pain or pressure that affects quality of life
• Problems with fertility or pregnancy complications (such as miscarriage or premature labour)
• Rarely, a twisted fibroid (torsion) causing sudden severe pain

Long-term outlook

For most women, fibroids are not life-threatening and can be managed effectively. Many women have no symptoms and need no treatment. With the right care, symptoms can be controlled, and fertility can often be preserved. After menopause, fibroids usually shrink. There is always hope for improvement.

Find support

International organisations

• The Fibroid Foundation ↗

Local organisations

• NHS ↗ · UK

Helplines

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