Uterine fibroids: your questions answered

Uterine fibroids, also known as leiomyomas or simply myomas, are non-cancerous growths that develop in the uterus, which is the organ where a baby grows during pregnancy. These growths are made up of muscle and fibrous tissue and can vary in size, ranging from as small as a pea to as large as a melon. Many women may not even know they have fibroids as they can be present without causing any symptoms. However, for others, fibroids can lead to noticeable and sometimes severe symptoms that interfere with daily life.

We speak to a leading gynaecologist about this health issue.

Who is at risk of developing uterine fibroids?

Fibroids are very common and are particularly likely to occur in women of childbearing age, typically between 30 and 50 years old. While the exact cause of fibroids remains unclear, several factors appear to influence their development. Genetics can play a role; women with a family history of fibroids are more likely to develop them. Additionally, hormone levels, particularly oestrogen and progesterone, have been linked to fibroid growth, as these hormones stimulate the uterine lining during each menstrual cycle and can also encourage fibroids to grow. Other risk factors include obesity, a diet high in red meat, and African-Caribbean heritage, as women of African descent are statistically more likely to develop fibroids than women of other ethnic backgrounds.

What are the symptoms of uterine fibroids?

Many women with fibroids do not experience any symptoms, and their fibroids are only discovered during a routine pelvic examination or an ultrasound scan. For others, fibroids can lead to symptoms such as heavy menstrual bleeding, often causing prolonged periods that can last more than a week. Some women experience menorrhagia—the medical term for heavy menstrual bleeding—which can lead to anaemia (a deficiency of red blood cells), fatigue, and overall weakness.

Other common symptoms include pelvic pain or pressure, pain during sexual intercourse, frequent urination due to pressure on the bladder, and even constipation if the fibroids press against the intestines. In some cases, fibroids may cause difficulties with fertility, either by blocking the fallopian tubes or by changing the shape of the uterus, making it harder for a fertilised egg to implant and grow.

How are uterine fibroids diagnosed?

To diagnose fibroids, your doctor will typically perform a pelvic examination, where they may feel the presence of any lumps or abnormalities. If fibroids are suspected, an ultrasound scan is often the next step. This non-invasive imaging technique uses sound waves to create an image of the uterus, allowing the doctor to see the fibroids and determine their size and location. In some cases, additional imaging, such as an MRI, may be recommended to get a more detailed view of the fibroids, particularly if surgery is being considered.

What treatment options are available for uterine fibroids?

The choice of treatment for fibroids depends on various factors, including the size, number, and location of the fibroids, as well as the severity of symptoms and the patient’s plans for future pregnancies. For women who have mild symptoms, a “watch-and-wait” approach may be appropriate. Many fibroids shrink after menopause due to the decrease in hormone levels, so if a woman is close to menopause, treatment may not be necessary.

For those with moderate to severe symptoms, medication can be prescribed to help manage symptoms. These may include hormonal treatments that regulate menstrual cycles and reduce bleeding. Additionally, non-hormonal pain relievers can help with pelvic pain. For women who do not respond to medication, surgical options are available. A procedure called myomectomy removes fibroids while leaving the uterus intact, making it a preferred option for women who wish to preserve their fertility. Another option is a hysterectomy, which is the complete removal of the uterus and is often considered when other treatments have failed or if the woman does not plan to have children. Less invasive treatments, like uterine artery embolisation, which cuts off blood supply to the fibroids, causing them to shrink, are also available.

In summary, if you are experiencing symptoms that may be related to fibroids, it is essential to speak to your doctor, as there are many effective treatments available that can help manage or eliminate symptoms.