Fibroids, Explained

Fibroids are one of the most common reasons women are referred to a gynaecologist. Most fibroids never need treatment. This is what they are, and how we decide what, if anything, to do about yours.

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What a fibroid is

A fibroid is a non-cancerous growth of the muscle wall of the uterus. Fibroids can be a single growth or several, and they range from the size of a seed to much larger. Where a fibroid sits matters more than how many you have: some sit inside the uterine cavity, some in the muscle wall, and some on the outer surface.

Many fibroids cause no symptoms at all and are found only on a scan done for another reason.

Signs that may point to fibroids

• Heavy or prolonged periods
• Pelvic pressure or a feeling of fullness
• Pain during sex
• Needing to pass urine more often
• Lower back discomfort
• Difficulty falling pregnant, in some cases

Any of these can also have other causes, which is why an assessment looks at the whole picture, not just the finding of a fibroid.

How fibroids are found and assessed

• A clinical history and pelvic examination
• A pelvic ultrasound, which usually confirms the diagnosis and shows size and position
• Blood tests if bleeding has been heavy, to check for anaemia
• Occasionally, further imaging (MRI) or a hysteroscopy if the picture is unclear

Your options

Treatment depends on your symptoms, the size and position of the fibroid, your age, and whether you want to have children in future. There is rarely one right answer, so this is a decision made together, not handed down.

Watching and waiting. If a fibroid is small and not causing symptoms, the most common plan is to monitor it and act only if that changes.

Medical treatment. Hormonal treatment or medication to reduce bleeding and pain can control symptoms without surgery, sometimes for years.

Fibroid-specific procedures. Depending on the fibroid, options can include removing it alone (myomectomy) or shrinking its blood supply. These aim to relieve symptoms while preserving the uterus.

Hysterectomy. Removing the uterus is sometimes the right answer, usually once other options have been tried or when family is complete. It is never the automatic first step.

Your next step

If you have symptoms that sound like this guide, the next step is a proper assessment, not a guess. Bring a note of your symptoms, how long you have had them, and whether you are hoping to fall pregnant in future. That last detail changes the conversation more than any other.

Fibroids are common, well understood, and manageable. Talk to your care team about what fits your situation.