Uterine Fibroids: What They Are and How to Treat Them
Uterine fibroids are non-cancerous growths that form in or around the uterus. They’re incredibly common, especially in women in their 30s and 40s. While many fibroids cause no symptoms, others can lead to heavy periods, pelvic pain, or fertility problems. The good news is, fibroids are treatable, and understanding your options helps you take control of your health.
What Are Fibroids?
Fibroids, also called leiomyomas or myomas, are made of muscle and fibrous tissue. They vary in size from tiny seeds to bulky masses that can distort and enlarge the uterus. A woman may have one or several fibroids at a time.
These growths can form in different parts of the uterus:
• Intramural: Within the muscular wall of the uterus
• Submucosal: Just beneath the lining of the uterus, projecting into the cavity
• Subserosal: On the outer surface of the uterus
• Pedunculated: Attached to the uterus by a stalk
No one knows exactly why fibroids form, but they seem to be linked to:
• Hormones, especially oestrogen and progesterone
• Genetics (family history of fibroids)
• Lifestyle factors like obesity or early onset of menstruation
Symptoms of Uterine Fibroids
Many fibroids are small and cause no symptoms. But larger or strategically located fibroids can result in a variety of symptoms, including:
• Heavy or prolonged menstrual bleeding
• Pelvic pressure or pain
• Frequent urination due to bladder pressure
• Constipation or bloating
• Pain during intercourse
• Back or leg pain
• Difficulty getting pregnant or maintaining a pregnancy
The type, size, and number of fibroids influence the severity of symptoms. Submucosal fibroids are most commonly linked with heavy bleeding and fertility issues.
How Are Fibroids Diagnosed?
If your doctor suspects fibroids, they may recommend one or more of the following tests:
• Pelvic ultrasound: The most common method to detect fibroids and evaluate their size and location
• MRI (Magnetic Resonance Imaging): Provides a more detailed view of fibroids and surrounding tissues, especially useful before surgery
• Saline infusion sonography: Enhances ultrasound imaging of the uterus to detect submucosal fibroids
• Hysteroscopy: A thin scope inserted into the uterus to directly view the inside and potentially treat small fibroids
Blood tests may also be done to check for anaemia caused by excessive bleeding.
Treatment Options
The best treatment depends on your symptoms, age, the number and size of fibroids, and whether you want to preserve fertility.
Medication
• Hormonal birth control: Pills, patches, or IUDs can help reduce heavy bleeding and pain but do not shrink fibroids
• GnRH agonists: Temporarily shrink fibroids by putting the body in a menopause-like state
• Tranexamic acid: Reduces menstrual bleeding without affecting hormones
• Pain relievers: Non-steroidal anti-inflammatory drugs (NSAIDs) for cramping and discomfort
Minimally Invasive Procedures
• Uterine fibroid embolisation (UFE): Blocks blood flow to fibroids, causing them to shrink
• MRI-guided focused ultrasound: Uses sound waves to destroy fibroid tissue, with no incisions
These treatments are typically outpatient and offer quicker recovery times, though they may not be suitable for all fibroid types.
Surgery
• Myomectomy: Surgical removal of fibroids while preserving the uterus. Ideal for women who want to maintain fertility. It can be done via:
- Hysteroscopy (for submucosal fibroids)
- Laparoscopy (minimally invasive)
- Laparotomy (open surgery)
• Hysterectomy: Complete removal of the uterus, which eliminates fibroids entirely and is a permanent solution. This is recommended when other treatments fail or if the fibroids are very large or numerous.
Recovery from surgery varies depending on the method used, and your doctor will guide you on the best approach.
Fibroids are incredibly common and often don’t need treatment. But if they’re affecting your quality of life or fertility, you don’t have to suffer in silence.
Book a gynaecology consultation if you have heavy periods, pelvic pain, or fertility concerns that may be related to uterine fibroids.
FAQs
Can fibroids become cancerous?
Uterine fibroids are almost always benign (non-cancerous). In rare cases, a cancerous tumour called a leiomyosarcoma may develop, but it is not thought to arise from an existing fibroid. Your gynaecologist may recommend further assessment if a fibroid grows rapidly or has unusual features.
Can fibroids return after treatment?
Yes, especially if the uterus is left intact. Recurrence is possible after myomectomy, which is why regular monitoring and follow-up care are important.
Can fibroids shrink on their own?
Fibroids may shrink naturally after menopause because hormone levels fall. Before menopause, they usually remain the same size or grow slowly, although growth patterns vary between individuals.