What Are Uterine Fibroids?
Fibroids (uterine leiomyomas) are non-cancerous growths made of muscle and fibrous tissue that develop in or around the uterus. They are the most common gynaecological tumour. Most women are asymptomatic but some experience significant symptoms.
Symptoms
- Heavy, prolonged periods (menorrhagia) — leading to anaemia
- Pelvic pressure or heaviness
- Abdominal swelling
- Urinary frequency (large fibroids pressing on bladder)
- Constipation or backache
- Pain during sex
- Difficulty conceiving (depending on fibroid location)
Blood Tests
| Test | Purpose |
|---|---|
| Full Blood Count | Checks for iron deficiency anaemia from heavy bleeding |
| Iron studies + ferritin | Assesses iron store depletion |
| FSH + oestradiol | Rules out premature menopause as an alternative cause |
| Thyroid (TSH) | Hypothyroidism can cause heavy periods independently |
Treatment Options
| Option | Type | Notes |
|---|---|---|
| No treatment (watchful waiting) | Non-surgical | For asymptomatic or small fibroids |
| Tranexamic acid / NSAIDs | Medication | Reduces bleeding volume per cycle |
| Combined pill / progestins | Hormonal | Controls bleeding but doesn't shrink fibroids |
| Mirena coil | Hormonal | Effective for heavy bleeding, minimal systemic effect |
| GnRH analogues | Hormonal | Shrinks fibroids short-term; used pre-surgery |
| Uterine artery embolisation | Minimally invasive | Blocks fibroid blood supply — preserves uterus |
| Myomectomy | Surgery | Removes fibroids; preserves uterus |
| Hysterectomy | Surgery | Definitive cure — appropriate if no future pregnancy planned |
FAQs
Do fibroids become cancerous?
Extremely rarely — uterine sarcoma (cancer) can mimic a fibroid, but less than 1 in 1,000 fibroids are malignant.
Do fibroids affect pregnancy?
Most don't. Large or submucosal fibroids may affect implantation, increase miscarriage risk, or cause pregnancy complications.
Do fibroids shrink after menopause?
Yes — oestrogen drives fibroid growth. Most shrink significantly after menopause.
Medical Disclaimer: Fibroids should be evaluated by a gynaecologist. The best treatment depends on fibroid size, location, symptoms and future pregnancy plans.