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Fibroids

What are fibroids?

Fibroids are benign growths of the muscle that makes up the womb. They are very common and may be present in up to 40% of women in the UK. In at least half of these women fibroids will not cause any symptoms and do not require treatment.

It is still not known what causes fibroids to form but it is likely to be a combination of genetic and environmental factors.

Symptoms typically include heavy periods and pressure symptoms. In some cases fibroids may be implicated in pregnancy or fertility problems.

Symptoms and treatment options depend on the position, number and size of fibroids.

Different types of fibroids

Submucosal fibroids: these are fibroids that project into the cavity of the womb and are particularly associated with heavy periods and miscarriage or difficulty conceiving.

Intramural fibroids: these fibroids are deep in the muscular wall of the womb and may be associated with heavy bleeding or pressure symptoms.

Subserosal and serosal fibroids: the serosa is the surface of the womb and these types of fibroids are just below or on the surface respectively and are most likely to cause pressure symptoms.

Pedunculated fibroids: these fibroids are attached to the surface of the womb by a stalk and can cause pain (if they twist on their stalk) and/or pressure symptoms.

Extra-uterine fibroids: this is extremely rare but fibroids may be in other sites within the pelvis without any attachment to the womb

Diagnosing and treating fibroids

Diagnosis

Fibroids may be diagnosed when you are examined by a doctor or typically visualised by ultrasound scan. In some cases it may be helpful to arrange an MRI scan which can give additional information when trying to decide the most appropriate treatment option.

Treatment options

Small fibroids that are not causing symptoms should not be treated but can be monitored by ultrasound scan or change in symptoms to ensure that they are not growing rapidly. In women with heavy periods simple drug treatments such as the contraceptive pill or a UTI may improve symptoms but will not influence the size of the fibroids. Although there are drugs that can shrink fibroids, this is only a temporary effect as treatment is limited by significant side-effects and following therapy the fibroids rapidly return to pre-treatment size.

A surgical approach can be advised, and this ensures that the fibroids are physically removed.