Uterine Fibroids

Uterine fibroids are common, non-cancerous growths that develop in or around the uterus. They vary greatly in size and number, and while many cause no symptoms, others can cause heavy periods, pain, or fertility problems.

• Many fibroids cause no symptoms and are found incidentally
• Heavy or prolonged menstrual bleeding
• Pelvic pain or pressure, and a feeling of fullness in the lower abdomen
• Frequent urination if a fibroid presses on the bladder
• In some cases, fibroids can contribute to difficulty conceiving or complications during pregnancy

• The exact cause is not fully understood, but fibroid growth is influenced by the hormones oestrogen and progesterone.
• Risk is increased by family history of fibroids, and fibroids are more common as women approach and pass through their late reproductive years, tending to shrink after menopause.
• Risk may also be influenced by certain dietary and other lifestyle factors, though the evidence for specific modifiable causes is limited.

• Often diagnosed through pelvic examination, where an enlarged or irregularly shaped uterus may be felt.
• Pelvic ultrasound is the standard test to confirm the diagnosis, determine the size, number, and location of fibroids.
• Further imaging may occasionally be used for complex cases or before certain treatments.

Fibroids causing no symptoms generally require no treatment beyond routine monitoring.

For heavy menstrual bleeding, treatment options include medicines to reduce bleeding and, in some cases, hormonal treatments that can also help shrink fibroids.

Iron supplementation may be needed if heavy bleeding has caused anaemia.

For larger or more symptomatic fibroids, particularly if affecting fertility or causing significant symptoms, a procedure or surgery to remove the fibroids (or, in some cases, the uterus) may be considered at specialist level, depending on the woman's symptoms, fibroid characteristics, and future fertility wishes.

• Attend regular gynaecological check-ups, which may detect fibroids before symptoms develop.
• Seek assessment for heavy or prolonged menstrual bleeding rather than assuming it is normal.
• Discuss fertility plans with a health worker if fibroids are diagnosed and pregnancy is desired, as this affects treatment choice.
• Maintain a healthy weight, as this may help reduce the risk or severity of fibroid-related symptoms.