SEXUAL HEALTH CONCERN

Fibroids

Also called: fibroids, fibroid, uterine fibroids

Fibroids are non-cancerous growths that develop in or around the womb (uterus). They vary considerably in size, number and location and may cause heavy periods, pelvic pressure, pain or reproductive problems.

TYPICALLY OCCURS

Hormones, genetics, age and reproductive factors

TREATED BY

Myomectomy, hysterectomy, embolisation and medication

ALSO LINKED TO

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Why it happens?

Fibroids, medically known as uterine leiomyomas, develop from the smooth muscle and connective tissue of the uterus. The exact reason why an individual fibroid begins to grow is not fully understood, but the hormones oestrogen and progesterone play an important role in stimulating their growth. This helps explain why fibroids mainly develop during the reproductive years, may increase in size during periods of greater hormonal activity and often shrink after the menopause as hormone levels fall. Fibroids can develop within the muscular wall of the uterus, project into the uterine cavity or grow towards the outside of the womb.

Genetics also appear to have a significant influence. Fibroids can run in families, and changes within the cells of fibroids distinguish them from normal uterine muscle. Several other factors are associated with a greater likelihood of developing them, including increasing reproductive age and certain reproductive or metabolic factors. However, having one or more risk factors does not mean someone will necessarily develop fibroids. Likewise, fibroids can occur without any obvious risk factor or family history.

The symptoms caused by fibroids depend not only on their size but also on their number and location. Fibroids that distort the uterine cavity can contribute to heavy or prolonged menstrual bleeding, while larger fibroids may create pelvic pressure, abdominal fullness, urinary frequency, constipation or discomfort. Some fibroids can be associated with fertility difficulties or pregnancy complications, although many people with fibroids conceive and have pregnancies without significant problems. Because fibroids are usually benign and many cause no symptoms, simply discovering a fibroid does not automatically mean treatment is required.

How far along is it?

Early

One or more fibroids are present but cause few or no noticeable symptoms. They may be discovered incidentally during an examination, ultrasound or investigation for another reason.

Moderate

Fibroids begin causing noticeable symptoms such as heavier or longer periods, pelvic discomfort, pressure, bloating or increased urinary frequency.

Advanced

Symptoms become more substantial, potentially including very heavy bleeding, anaemia, significant pelvic pressure or pain, or reproductive concerns. Larger or multiple fibroids may significantly affect everyday life.

What addresses it?

Treatments that address this

Fibroid removal→Hysterectomy→

Medical assessment is worthwhile when periods become unusually heavy or prolonged, pelvic pain or pressure persists, the abdomen appears increasingly enlarged or symptoms begin interfering with everyday life. Heavy menstrual bleeding can sometimes lead to iron-deficiency anaemia, which may cause tiredness, weakness, shortness of breath or palpitations.

Assessment may also be appropriate when fibroids are suspected alongside difficulty conceiving or when planning a pregnancy, although fibroids do not necessarily cause fertility problems.

Seek urgent medical attention for very heavy vaginal bleeding, particularly if accompanied by dizziness, fainting, severe weakness or shortness of breath. Sudden severe pelvic or abdominal pain also warrants prompt assessment rather than automatically being attributed to known fibroids.

Quick Questions:

What are the main symptoms of fibroids?

Many fibroids cause no symptoms. When symptoms occur, they can include heavy or prolonged periods, pelvic pressure or pain, abdominal fullness, frequent urination, constipation and sometimes reproductive difficulties.

What causes fibroids to grow?

The exact cause is not completely understood. Oestrogen and progesterone influence fibroid growth, while genetics and other biological factors also appear to contribute.

Can fibroids affect fertility?

Some fibroids can affect fertility, particularly when their size or location changes the shape of the uterine cavity or interferes with reproductive function. However, many people with fibroids become pregnant naturally.

Do fibroids always need to be removed?

No. Fibroids that are small and do not cause significant symptoms may simply be monitored. Whether treatment is appropriate depends on symptoms, fibroid size and location, age, general health and future pregnancy plans.