Commonality
Fibroids are extremely common. Research suggests that up to 70% of women develop fibroids during their lifetime, although many never experience symptoms. Fibroids are most commonly diagnosed between the ages of 30 and 50.
Causes
The exact cause of fibroids is not fully understood, but several factors are believed to contribute.
Factors associated with fibroid development include:
Hormonal influences such as oestrogen and progesterone
Genetic predisposition or family history
Ethnicity, with higher prevalence in women of African or Caribbean background
Increased body weight
Diet and lifestyle factors
Fibroids tend to grow during the reproductive years and may shrink after menopause.
Symptoms
Many fibroids cause no symptoms and are found during routine scans or examinations.
When symptoms occur, they may include:
Heavy or prolonged menstrual bleeding
Pelvic pressure or pain
Abdominal swelling or bloating
Pain during intercourse
Frequent urination
Constipation
Lower back discomfort
Difficulty conceiving
Recurrent miscarriage in some cases
Symptoms often depend on the size, number and location of the fibroids.
Effects on Fertility
Many women with fibroids are able to conceive naturally and have healthy pregnancies. However, some fibroids - particularly those growing inside the uterine cavity - may interfere with embryo implantation or increase the risk of miscarriage.
Specialist assessment can help determine whether fibroids may be affecting fertility and whether treatment could improve reproductive outcomes.
Diagnosis
Fibroids are usually diagnosed following a specialist consultation, pelvic examination and imaging tests.
Investigations may include:
Pelvic ultrasound
Transvaginal ultrasound
MRI scanning in more complex cases
Saline sonohysterography to assess fibroids within the uterine cavity
Accurate imaging helps guide treatment decisions and fertility planning.
Treatments
Treatment depends on symptoms, fibroid size and future fertility plans. Some fibroids only require monitoring, while others may need medical or surgical treatment.
Medical treatments may include:
Hormonal therapies such as GnRH analogues
Mirena coil to reduce heavy bleeding
Non-hormonal medication for pain and bleeding control
Minimally invasive surgical options may include:
Laparoscopic (keyhole) myomectomy
Robotic-assisted myomectomy
Hysteroscopic fibroid removal
Other treatment options may include:
Uterine artery embolisation (UAE)
Hysterectomy in selected cases
Where possible, fertility-preserving approaches are prioritised.
Ongoing Care
Living with the Condition
Fibroids can affect many aspects of daily life, including physical comfort, energy levels and emotional wellbeing. Heavy bleeding, pelvic pressure and fertility concerns may interfere with work, relationships and everyday activities.
With appropriate treatment and monitoring, many women experience significant improvement in symptoms and quality of life.
When to See a Specialist
You may benefit from specialist assessment if you experience:
Heavy or prolonged periods
Pelvic pain or pressure
Abdominal swelling or bloating
Frequent urination or bowel symptoms
Difficulty conceiving
Rapidly worsening symptoms
Specialist evaluation can help confirm the diagnosis and identify the most appropriate treatment options.