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Fibroids: What They Are, Common Symptoms and When They Need Treatment
Updated: 2 days ago
Fibroids can affect women from all backgrounds, although they are more common and can develop at younger ages in Black women. At HerCare, we recognise the importance of providing inclusive, personalised care that reflects the diverse women we support.
At HerCare, we provide compassionate, consultant-led assessment and personalised treatment for women experiencing fibroid-related symptoms. Understanding what fibroids are and recognising when they require medical attention is the first step towards effective treatment and improved wellbeing.
What Are Uterine Fibroids?
Uterine fibroids (also called leiomyomas or myomas) are benign growths that develop from the muscle tissue of the uterus (womb). They are not cancerous, and the vast majority will never become cancerous.
Fibroids can vary considerably in size, ranging from tiny growths that are only visible under a microscope to large masses capable of enlarging the uterus significantly. Some women develop just one fibroid, while others may have several.
Fibroids commonly develop during a woman's reproductive years and often shrink naturally after the menopause as hormone levels decline.
If you are experiencing symptoms that could be linked to fibroids, our dedicated Gynaecology Services can provide a comprehensive assessment and personalised treatment plan.
What Causes Fibroids?
Although the exact cause of fibroids remains unknown, several factors are believed to contribute to their development, including:
Oestrogen and progesterone hormone activity
Family history of fibroids
Increasing age during the reproductive years
Ethnic background, with fibroids occurring more frequently and often at a younger age in Black women
Obesity
Other genetic and lifestyle factors
Having one or more risk factors does not necessarily mean you will develop fibroids, but understanding these factors can help identify women who may benefit from earlier assessment.
Common Symptoms of Fibroids
Many women experience no symptoms whatsoever, with fibroids often being discovered during a routine pelvic examination or ultrasound scan.
However, larger fibroids or those located in certain areas of the uterus can cause symptoms including:
Heavy Menstrual Bleeding
One of the most common symptoms is unusually heavy or prolonged periods. Some women may experience:
Passing large blood clots
Needing to change sanitary protection very frequently
Periods lasting longer than seven days
Iron deficiency anaemia caused by excessive blood loss
Women experiencing heavy periods should also read our article on Heavy Menstrual Bleeding, which explains when bleeding may require medical investigation.
Pelvic Pain and Pressure
Fibroids can create a sensation of:
Pelvic discomfort
Lower abdominal pain
Pressure within the pelvis
Lower back pain
Pain during sexual intercourse
Large fibroids may also press on nearby organs.
Bloating and Abdominal Swelling
Some women notice that their lower abdomen appears swollen or enlarged, sometimes resembling early pregnancy. This may be accompanied by a feeling of fullness or increased abdominal pressure.
Bladder and Bowel Symptoms
Depending on their location, fibroids may press against the bladder or bowel, causing:
Frequent urination
Difficulty emptying the bladder completely
Constipation
Discomfort during bowel movements
Fertility and Pregnancy Problems
Although many women with fibroids conceive naturally, some fibroids may affect fertility depending on their size and location.
Possible complications include:
Difficulty becoming pregnant
Recurrent miscarriage
Pregnancy complications
Increased likelihood of Caesarean delivery
If you are concerned about fertility, our Fertility Assessments can help identify potential causes and treatment options.
How Are Fibroids Diagnosed?
Accurate diagnosis is essential to determine whether fibroids are responsible for your symptoms and whether treatment is required.
Your consultant gynaecologist may recommend:
Medical History
A detailed discussion about:
Menstrual patterns
Pain symptoms
Fertility history
Family history
General health
Pelvic Examination
A clinical examination may identify an enlarged or irregular uterus suggestive of fibroids.
Ultrasound Scan
A pelvic ultrasound is usually the first imaging investigation and is highly effective at identifying fibroids, including:
Their size
Number
Position
Growth pattern
MRI Scan
For larger or more complex fibroids, an MRI scan may provide additional information before treatment planning.
Hysteroscopy
Where fibroids are suspected inside the uterine cavity, a hysteroscopy allows the consultant to examine the inside of the womb using a small camera.
Learn more about our comprehensive Diagnostic Gynaecology Services and how we investigate women's health concerns.
Do All Fibroids Need Treatment?
Not necessarily.
Many fibroids are small, cause no symptoms and require no immediate treatment.
In these cases, your consultant may recommend:
Regular monitoring
Periodic ultrasound scans
Symptom review appointments
This "watchful waiting" approach allows any changes in size or symptoms to be monitored without unnecessary intervention.
Treatment is generally considered when fibroids:
Cause heavy bleeding
Lead to anaemia
Cause significant pain
Affect bladder or bowel function
Interfere with fertility
Continue growing or cause significant enlargement
Affect your quality of life
The most appropriate treatment depends on factors such as the size and position of the fibroids, the severity of symptoms, your age, general health and whether you wish to become pregnant in the future.
Non-Surgical Treatment Options
Many women can successfully manage fibroids without surgery.
Treatment may include:
Medication
Several types of medication may be considered depending on the symptoms and individual circumstances.
These can include:
Anti-inflammatory medication for pain
Hormonal contraception
Treatments designed to reduce heavy menstrual bleeding
GnRH-based medicines that can temporarily suppress ovarian hormone production and reduce fibroid-related symptoms
Ryeqo
Ryeqo is a newer treatment option for moderate to severe symptoms associated with uterine fibroids. It contains three active ingredients: relugolix, estradiol and norethisterone acetate.
Relugolix reduces ovarian hormone production, while the addition of estradiol and norethisterone acetate helps to maintain a lower hormonal environment while reducing some of the effects associated with reduced oestrogen levels.
For appropriate patients, Ryeqo can reduce heavy menstrual bleeding and other symptoms associated with fibroids. It is not suitable for everyone, so your consultant will consider your medical history, symptoms, other medications and individual circumstances before recommending treatment.
Ryeqo is also licensed in the UK for the treatment of symptoms associated with endometriosis in appropriate adult women with a history of previous medical or surgical treatment.
Intrauterine Hormonal System (IUS)
A hormonal intrauterine system may help reduce heavy menstrual bleeding associated with smaller fibroids where the uterine cavity is not significantly distorted.
Uterine Artery Embolisation (UAE)
This minimally invasive procedure blocks the blood supply to fibroids, causing them to shrink over time.
For many women, UAE provides an effective alternative to major surgery.
Surgical Treatment Options
Where symptoms are severe or fertility is affected, surgery may offer the most effective long-term solution.
Myomectomy
A myomectomy removes fibroids while preserving the uterus, making it an important option for women wishing to have children.
The procedure may be performed:
Hysteroscopically
Laparoscopically (keyhole surgery)
Via open surgery for larger fibroids
Hysterectomy
For women who have completed their family or whose symptoms are particularly severe, hysterectomy provides a permanent solution to uterine fibroids by removing the uterus.
Your consultant will discuss whether this option is appropriate based on your circumstances.
Fibroids, Endometriosis and New Developments in Women's Health
Fibroids and endometriosis are different conditions, although some women may experience symptoms associated with both.
Endometriosis is a chronic condition in which tissue similar to the lining of the womb grows outside the uterus. It can cause pelvic pain, painful periods, pain during sex and fertility difficulties.
Treatment for endometriosis is developing, with greater emphasis on personalised care and newer medical options. Ryeqo, for example, is now licensed in the UK for the treatment of symptoms associated with endometriosis in appropriate adult women.
Another medicine used in the management of endometriosis is dienogest, a progestogen that can be prescribed to help manage endometriosis-associated symptoms. As with all medicines, its suitability depends on the individual and should be discussed with an appropriately qualified healthcare professional.
Could Biomarkers Improve Endometriosis Diagnosis?
One of the most exciting areas of current endometriosis research is the search for reliable biomarkers.
Endometriosis can be difficult to diagnose, and researchers are investigating whether measurable biological markers could eventually help identify the condition earlier and reduce delays in diagnosis.
Research is currently exploring a wide range of potential biomarkers, including:
Inflammatory markers
Genetic and epigenetic markers
Hormonal and molecular markers
MicroRNAs and other non-coding RNAs
Metabolic markers
Markers found in blood and other biological samples
Combinations of multiple biomarkers rather than relying on a single test
Recent research has also explored techniques such as blood-based metabolic profiling and molecular analysis as possible routes towards more accurate, non-invasive diagnosis.
However, it is important to understand that these approaches remain an area of research. There is currently no single biomarker that can reliably diagnose endometriosis in routine clinical practice, and further research is needed before these tests can become established diagnostic tools.
The continued development of biomarkers could eventually provide clinicians with additional tools to identify endometriosis earlier, understand different forms of the disease and potentially develop more personalised approaches to treatment.
When Should You Seek Medical Advice?
You should also seek medical advice if your symptoms are affecting your ability to work, exercise, sleep or enjoy your normal daily activities.
Very heavy periods
Persistent pelvic pain
Pain during intercourse
Increasing abdominal swelling
Difficulty becoming pregnant
Frequent urination caused by pelvic pressure
Symptoms of anaemia such as fatigue or breathlessness
Early assessment can help establish whether fibroids are responsible for your symptoms and identify the most appropriate treatment options. You may also find our articles on Endometriosis, Ovarian Cysts and Abnormal Vaginal Bleeding helpful.
Expert Fibroid Care at Her Care
Every woman's experience with fibroids is different. At Her Care, we take a personalised approach, carefully assessing your symptoms, future fertility plans and overall health before recommending the most appropriate treatment.
Our experienced consultant-led team offers comprehensive investigations, advanced imaging and evidence-based treatment options designed to relieve symptoms while supporting your long-term health.
We understand that women's experiences of gynaecological conditions can vary considerably and we are committed to providing inclusive, individualised care for women from all backgrounds.
Whether your fibroids simply require monitoring or more specialised treatment, we're here to help you make informed decisions with confidence.
Book a Consultation
If you're experiencing heavy periods, pelvic pain, bloating or fertility concerns, don't ignore the symptoms.
Book a consultation with Her Care today for expert diagnosis, personalised advice and access to appropriate, evidence-based treatment options for uterine fibroids.
