Fibroids
Fibroids are non-cancerous growths in or around the uterus. They’re common, often influenced by hormones, and can cause symptoms like heavy periods, pelvic pressure, or pain - though many people have none. With proper assessment, there are effective ways to manage symptoms and support your wellbeing.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
What are Fibroids?
Fibroids are non-cancerous growths that develop within the uterus (womb), an organ made of smooth muscle and lined by the endometrium. In a healthy uterus, this muscular wall is normally uniform and flexible. Fibroids form when some of these muscle cells grow more than usual, creating firm, rubbery lumps within the wall, on the outer surface, or inside the cavity.
They are very common, especially during the reproductive years, and can range from tiny nodules to large growths that change the size or shape of the uterus. Many fibroids cause no symptoms, while others may contribute to heavy periods, pelvic pressure, pain, or fertility issues depending on their number, size, and location.
Understanding Fibroids
Fibroids can affect people in different ways. Many cause no symptoms at all and are found incidentally during a scan or routine examination. When symptoms do occur, they usually relate to the size, number, or location of the fibroids and how they affect the normal function of the uterus.
Common symptoms include:
- Heavy or prolonged periods, sometimes with blood clots
- Pelvic pressure or a feeling of fullness, especially if fibroids are large
- Lower abdominal or pelvic pain, which may be constant or cyclical
- Pain during sex, depending on fibroid position
- Frequent urination if a fibroid presses on the bladder
- Constipation if the bowel is compressed
- Back or leg pain from pressure on nearby nerves
- Bloating or visible enlargement of the abdomen
- Difficulty conceiving or pregnancy-related issues, in some cases
Causes and Risk Factors
Fibroids develop when muscle cells in the uterine wall begin to grow abnormally, forming a firm, rubbery lump. The exact reason this happens is not fully understood, but hormones and genetic changes appear to play the biggest roles. Fibroids are hormone-responsive, meaning they tend to grow when oestrogen and progesterone levels are higher (such as during reproductive years) and often shrink after menopause.
Several factors can increase the likelihood of developing fibroids
| Hormones | Oestrogen and progesterone stimulate the growth of the uterine lining and can also encourage fibroid growth. |
| Genetics | Fibroids often run in families. Specific genetic changes are also found within fibroid tissue itself. |
| Age | Most fibroids develop between ages 30 and 50, when hormone levels are highest. |
| Family history | Having a close relative (mother or sister) with fibroids increases your risk. |
| Ethnicity | Fibroids are more common, tend to grow larger, and appear earlier in people of African or Caribbean descent. |
| Weight | Being overweight is associated with higher oestrogen levels, which may increase the risk of fibroids. |
| Pregnancy | People who have been pregnant, especially more than once, appear to have a lower risk of developing fibroids. Pregnancy can also influence the size of existing fibroids, causing them to grow or shrink. |
Diagnosing Fibroids
Fibroids are often suspected based on symptoms or during a routine pelvic examination, but imaging is needed to confirm the diagnosis and understand their size, number, and location. The first step is often a pelvic examination, during which a clinician may feel an enlarged, irregular, or firm uterus. This can suggest the presence of fibroids and guide the need for further imaging.
| Ultrasound | This is the most common way to diagnose fibroids. An ultrasound can show the number of fibroids, their size, and where they sit within the uterus. It may be done through the tummy (transabdominal) or using a small probe placed in the vagina (transvaginal). |
| MRI Scan | An MRI provides more detailed images and is usually recommended when fibroids are large, numerous, or when planning specific treatments such as surgery or uterine artery embolisation. It helps map fibroids accurately. |
| Hysteroscopy (in select cases) | If symptoms suggest fibroids inside the uterine cavity, such as heavy bleeding or fertility issues, a hysteroscopy may be recommended. This involves passing a thin camera through the vagina and cervix to look directly inside the womb. |
Treatment Options
Treatment for fibroids depends on your symptoms, the size and location of the fibroids, your age, and whether you wish to become pregnant in the future. Some people need no treatment at all, while others benefit from medicines or procedures to reduce symptoms.
Conservative Management
If your fibroids are small, not causing symptoms, or discovered incidentally, no immediate treatment may be needed. Your clinician may recommend periodic monitoring with ultrasound to check for any changes.
Medicines can help manage symptoms such as heavy bleeding or pain but do not permanently remove fibroids. Options may include:
| Hormonal treatments | Such as the contraceptive pill, hormonal coils (IUS), or tablets that help regulate bleeding. |
| Non-hormonal medicines | Such as tranexamic acid or NSAIDs for heavy or painful periods. |
| Gonadotrophin-releasing hormone (GnRH) analogues or antagonists | Temporarily shrink fibroids by reducing estrogen levels. These are usually used short-term, for example before surgery. |
Minimally Invasive Procedures
For moderate symptoms or when medicines are not effective, procedures may be recommended.
| Uterine artery embolisation (UAE) | A radiologist blocks the blood supply to the fibroids, causing them to shrink over time. |
| MRI-guided focused ultrasound | High-intensity ultrasound waves are used to heat and destroy fibroid tissue without incisions (available only in certain centres). |
Surgical Treatments
Surgery is sometimes recommended for larger fibroids, severe symptoms, or when fertility is a priority. Options include:
| Myomectomy | Removal of fibroids while preserving the uterus. This can be done through keyhole surgery, open surgery, or hysteroscopic surgery (through the cervix), depending on fibroid size and location. |
| Hysterectomy | Removal of the uterus, which completely resolves fibroids and bleeding. This is usually considered when other treatments haven’t worked and when you do not wish to retain fertility. |
Your clinician will help you understand the benefits and limitations of each approach, and guide you toward the option most suited to your symptoms, goals, and overall health.
How can Lanthorn help?
Ultrasound Uterus & Ovaries - From £300
A pelvic ultrasound is often the first-line test for identifying fibroids. It can confirm their presence and assess their size, number, and location. We provide prompt, high-quality ultrasound scans with clear explanations of the findings.
Pelvic MRI - £550
MRI provides a more detailed picture of the uterus, which can be helpful for complex cases, surgical planning, or when ultrasound results are unclear. We can arrange advanced pelvic MRI scanning to give a comprehensive assessment.
Referral to specialists
If further treatment is needed, such as gynaecology review, surgical assessment, or interventional radiology (e.g., for uterine artery embolisation), we can refer you directly to the appropriate specialist.
