Fibroids

What are fibroids?

Fibroids are benign growths (non-cancerous) found in and around the uterus and are made up of muscle and fibrous tissue. They are also known as uterine fibroids or myomas. Although only one uterine fibroid may develop, in most cases there will be several. Symptoms are uncommon, but some women may experience pain or heavy periods.

There are different types of fibroid, including:

  • Intramural fibroids: located in the muscle wall of the uterus.
  • Submucosal fibroids: located in the muscle layer found beneath the uterine lining.
  • Subserosal fibroids: located outside the wall of the uterus, developing into the pelvis. This type can be quite large.
  • Pedunculated fibroids: subserosal or submucosal fibroids that are attached to the uterus by a narrow stem of tissue.

What are the symptoms of fibroids?

In general, women with fibroids will not have any symptoms. Therefore, they are usually detected during a routine gynaecological examination. However, around 1 in 3 women with fibroids will experience symptoms, including:

  • Heavy and/or painful periods
  • Lower back pain
  • Abdominal pain
  • Constipation
  • Pain during sex
  • Increased need to urinate

What causes uterine fibroid?

The exact cause of uterine fibroids is unknown, but it is believed that they may be caused by the hormone oestrogen. Oestrogen is the female reproductive hormone produced by the ovaries, and fibroids tend to develop during a woman’s reproductive years. Interestingly, fibroids will often shrink when oestrogen levels are low, such as after the menopause.

Fibroids are fairly common, with 1 in 3 women having them. They are thought to be more common in African-Caribbean women, as well as obese or overweight women.

Can fibroids be prevented?

Uterine fibroids cannot be prevented.

How are fibroids treated?

If fibroids are not causing symptoms, then treatment will not be required. Generally, over time fibroids will shrink and disappear. Fibroid treatment or surgery can range from oral contraceptives to help control heavy menstrual periods; even nonsteroidal anti-inflammatory drugs, for colic or pain. In severe cases, treatment requires removal of the fibroid, which is done with surgery. Each type can have an affect on the ability to have children afterwards, so this will need to be a discussion with the specialist.

  • Uterine artery embolization (UAE): the blood supply to the fibroids is blocked, causing them to shrink.
  • Endometrial ablation: lasers or heat are used to remove the womb lining (endometrium), and it can be used to remove smaller fibroids, however, the option of pregnancy after this can be affected.
  • Myomectomy: fibroids are removed from the uterus, but the uterus is left in place. Fibroids can return after this procedure.
  • Hysterectomy: the uterus is removed. Fibroids will not return after this procedure, but you will no longer be able to become pregnant.

The type of treatment will depend on several factors, including the patient's age, her general health, the symptoms she has, the type of uterine fibroid she has, and if she wants to have children in the future.

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