Uterine Fibroids: Symptoms and Treatment Options

Fibroids are non-cancerous growths in or around the womb. They are very common, and many women who have them never know, because small fibroids often cause no symptoms at all.

If you have been told you have a fibroid, the first thing to know is that it usually does not need urgent treatment. This guide explains the types, the symptoms to watch for, how they are found, and the choices ahead.

What Are Fibroids?

Fibroids grow from the muscle wall of the womb. The NHS describes them as growths that mostly affect women who have not yet reached menopause. You can have one or many, and they can be as small as a seed or large enough to enlarge the womb. According to Cleveland Clinic, they can grow, shrink or stay the same size over time.

The exact cause is not known. The NHS lists these as raising the chance of fibroids: not having gone through menopause yet, never having had a full-term pregnancy, being overweight, having high blood pressure or diabetes, being of Black or Asian background, and having a close relative with fibroids.

Types of Fibroids

The type depends on where the fibroid grows, and this strongly affects symptoms:

• Intramural: inside the muscle wall of the womb; the most common type
• Submucosal: just under the womb lining, bulging into the cavity; often linked to heavier bleeding
• Subserosal: on the outer surface of the womb; can press on nearby organs
• Pedunculated: attached by a thin stalk; the least common type

Symptoms to Watch For

Many women have no symptoms. When symptoms do occur, they can include:

• Heavy or painful periods, or bleeding between periods
• A feeling of fullness or pressure in the lower tummy, or a swollen tummy
• Passing urine more often, or a sudden urge to pass it
• Constipation or bloating
• Lower back pain
• Pain or discomfort during sex
• Difficulty getting pregnant in some women

Heavy bleeding can slowly cause anaemia, which brings tiredness, breathlessness and a pale look. Tell your doctor if you feel unusually tired during or after periods.

How Fibroids Are Diagnosed

Your doctor will ask about your periods and examine your tummy and pelvis. According to the NHS, an ultrasound scan is the usual next step, and it shows how many fibroids there are, their size and where they sit. Sometimes fibroids are discovered by chance on a scan done for another reason, including a pregnancy scan.

Cleveland Clinic lists other tools for special situations, such as MRI, a hysteroscopy (a thin camera passed through the cervix to see inside the womb) and a saline ultrasound. Our article on laparoscopy and hysteroscopy explains these procedures.

Watchful Waiting: Often the First Choice

If your fibroids are small and cause no trouble, treatment is not needed. Your doctor may simply recheck them with a pelvic examination or an ultrasound from time to time. Fibroids often shrink after menopause, which can relieve symptoms.

Tip: Keep a note of how many pads you use on heavy days, and how long your period lasts. It helps your doctor judge whether treatment is needed.

Medicines

If symptoms bother you, your doctor may prescribe medicines. Sources describe these groups:

• Pain relievers for cramps or discomfort
• Medicine that reduces heavy bleeding
• Hormonal treatments, including some that can shrink fibroids for a while, though they may regrow after stopping
• Iron treatment if bleeding has caused anaemia

Which medicine is suitable, and for how long, depends on your age, health and plans for pregnancy. Do not start hormonal tablets on your own.

Procedures and Surgery

If medicines do not help, or the fibroids are large or growing, other options may be discussed:

• Myomectomy: removal of the fibroids while keeping the womb. It can be done through a hysteroscope, by keyhole surgery or by open surgery, depending on the fibroid.
• Uterine artery embolisation: a non-surgical procedure that blocks the blood supply so fibroids shrink
• Hysterectomy: removal of the womb. It is the only treatment that prevents fibroids from coming back, but pregnancy is no longer possible. See our guide to hysterectomy reasons, types and recovery.
• Endometrial ablation: destroying the womb lining with heat to reduce bleeding, mentioned by the NHS for some women

When to be cautious: Some treatments can affect future pregnancy. If you want children, say so clearly before choosing a procedure, and ask how each option affects fertility.

Fibroids, Pregnancy and Fertility

Many women with fibroids have healthy pregnancies. Still, fibroids that bulge into the womb cavity can make it harder to conceive in some women, and your pregnancy care may need closer follow-up. If you are pregnant and know you have fibroids, mention it at your first visit to an antenatal check-up. If you are struggling to conceive, the infertility and reproductive care team can look at the whole picture.

Questions to Ask Your Doctor

A short list can make a busy appointment far more useful. Consider asking:

• How many fibroids do I have, how big are they and where are they?
• Are they likely to be causing my symptoms?
• Do I need treatment now, or can we monitor them and when should I come back?
• How will each option affect my chance of pregnancy?
• Could my heavy bleeding be causing anaemia, and should I be tested?
• What warning signs mean I should come in sooner?

Fibroids are a common condition and not your fault. The exact cause is not known, so there is no need for guilt or fear. Most women find a plan that suits them once symptoms and goals are clear.

When to See a Doctor

• Heavy periods that soak through pads quickly or last longer than usual
• Pelvic pain or pressure that does not go away
• Trouble passing urine, or needing to go very often
• Tiredness, dizziness or breathlessness that may signal anaemia
• Trouble getting pregnant, or repeated miscarriages
• Bleeding after menopause

Sudden, severe pelvic pain, very heavy bleeding with dizziness or fainting need urgent care. Go to the nearest hospital or see our emergency information. For other period problems, read about menstrual disorders.

Talk to a doctor

Book an appointment at Chaitanya Hospital, Kadapa (near RTC Bus Stand, Simhapuri Colony), or call +91 944 103 0587. Teleconsultation is also available if you would like to start with a conversation from home. This article is for general awareness and is not a substitute for a doctor's advice.