|  health information  |  health factsheets

Print-friendly version

Fibroids

Published by BUPA's health information team, healthinfo@bupa.com, October 2005.

This factsheet is for women who have fibroids, or who would like information about them.

Fibroids are non-cancerous (benign) growths of the womb (uterus). They are sometimes called uterine myomas, fibromyomas or leiomyomas.

• About fibroids
• Symptoms of fibroids
• Causes of fibroids
• Diagnosis of fibroids
• Treatment of fibroids
• Fibroids and cancer
• Further information
• Sources
• Related topcs

About fibroids

Your womb is a pear-shaped organ which responds to hormones (oestrogen and progesterone) during your monthly cycle.

Fibroids grow in your womb. Occasionally they are almost free of the wall of your womb and are only attached by a narrow stalk.

You can have one or many fibroids in your womb, and the average number is six. They are enclosed in fibrous capsules and do not spread to other parts of your body.

Fibroids are named according to where they are found in your womb.

• Intramural fibroids are found within the muscular wall of the womb.
• Subserosal fibroids grow outwards (into the pelvic cavity) from the outside wall of the womb. They can become very large.
• Submucosal fibroids grow from the inner wall of the womb and can take up space inside the womb.

Fibroids can range from the size of a pinhead to up to 20cm (8 inches) across. The average size is around 2cm (two-thirds of an inch).

Fibroids usually grow, but very slowly. The growth is stimulated by hormones, especially oestrogen. The ovaries, which are small organs inside your body where the egg cells are produced and stored, release oestrogen during your reproductive years. Fibroids tend to become smaller when oestrogen levels fall, such as after the menopause.

Around one in three women have fibroids in their womb, but less than half of these women ever get any symptoms. It's not clear what causes fibroids.

Illustration showing the different types of fibroid

Symptoms of fibroids

Fibroids don't usually cause symptoms.

However, you may get one or more of the symptoms listed below, often depending on where the fibroid is within your womb.

• Heavy periods can occur in up to a third of all women with fibroids. In some cases, this can lead to anaemia.
• Large fibroids can lead you to feel some discomfort in your lower abdomen (tummy).
• If the fibroid(s) is pressing on your bladder, you may need to pass urine more often than normal.
• If the fibroid(s) is pressing on your rectum, it can cause constipation.
• If the fibroid(s) is growing in the womb near to the vagina (the cervix area) you may have pain or discomfort during sexual intercourse (dyspareunia).
• You can get severe pain if a fibroid growing on a stalk twists or if a fibroid outgrows its blood supply causing it to break down (red degeneration), but this is rare.
• The submucosal type of fibroids can affect the shape and internal environment of the womb, which can make it more difficult to conceive. However, only around 3 in every 100 women have problems getting pregnant because of fibroids. It is unclear whether the intramural type of fibroids affect fertility.

Fibroids and pregnancy

Most women with fibroids have a normal pregnancy and delivery. Fibroids do not necessarily cause any problems and, for around two-thirds of women, the fibroids stay at a constant size or shrink.

Problems such as miscarriage, premature labour and bleeding can happen but they are rare. If you are pregnant and have fibroids, you should consider seeking specialist pregnancy care from an obstetrician.

Causes of fibroids

The reason why women get fibroids is not known.

Although oestrogen seems to make the fibroids grow, it is not thought to be responsible for them appearing in the beginning.

Who gets fibroids?

You are more likely to get fibroids if:

• you are in your 30s or 40s
• you are overweight
• you are black - black women are three times more likely than white women to get fibroids
• you have no children or had your last child at a young age

Diagnosis of fibroids

There are a number of tests that your doctor may do to see if you have fibroids.

He or she may do an internal examination to check the size of the womb. If your womb is enlarged, it indicates that you may have fibroids.

An ultrasound scan is a useful way to confirm if you have fibroids. For more information, please see Related topics.

Large fibroids can make it difficult to see the womb using ultrasound. Magnetic resonance imaging (MRI) can produce detailed pictures to help your doctor to judge the exact size and location of fibroids. For more information, please Related topics.

Treatment of fibroids

If you are not getting any symptoms, or if they are only mild, you do not need to treat or remove fibroids. Your doctor may suggest however, that you have a repeat ultrasound scan in the future if your symptoms worsen.

If you are getting symptoms then there is a range of treatments available. Your doctor will explain which is most suitable for you.

Medicines

There is no drug treatment that cures fibroids. However, hormone-based treatments can help relieve the symptoms.

Gonadotrophin releasing hormone analogues (GnRH analogues) such as goserelin (eg Zoladex) or ileuprorelin (eg Prostap SR) can lower the level of oestrogen in your body. This usually shrinks the fibroids. GnRH analogues are often used for two to three months prior to surgery (see below) to make it easier to remove fibroids.

GnRH analogues can cause side-effects such as menopausal symptoms. You may get hot flushes and, long-term, osteoporosis (thinning of the bones). Therefore, you can only take GnRH analogues for a maximum of six months. Taking progestogen hormone replacement therapy or tibolone (Livial) at the same time reduces the chances that you'll get side-effects.

Other medical treatments such as anti-inflammatory medicines may help to relieve the pain of fibroids and some types of contraceptive pill may help. Ask your doctor for advice.

Uterine artery embolisation (UAE)

This is a non-surgical treatment whereby the blood supply to a fibroid is blocked, causing it to shrink. It is performed under a local anaesthetic. This means that the area will be numb but you will still be awake.

UAE gives relief from symptoms such as bleeding and pain for at least two-thirds of women treated.

As there is no surgical scar and a general anaesthetic is not required, side-effects and complications are lower than with open surgery.

The National Institute of Clinical Excellence (NICE) states that women having this treatment should understand that it is a relatively new treatment with uncertain long-term results. If you are considering a UAE, please consult the NICE advice. See Further information.

Surgery

There are a number of surgical options including those outlined below.

• A myomectomy is an operation to remove fibroids from the womb. The womb is left in place. It may be done through cuts in the abdomen (tummy) or through your vagina using keyhole surgery. A myomectomy is usually only offered to women who still wish to be able to have the option to be pregnant in the future.
• A hysterectomy is a major operation to remove the entire womb, usually via a "bikini-line" cut on the abdomen (tummy) or, if the fibroids are not too large, via the vagina. It is not possible to get pregnant after a hysterectomy.
• An endometrial ablation is an operation to remove the lining of your womb. This can be done in various ways, including using laser energy or microwave. It is still possible to get pregnant after an endometrial ablation. The National Institute of Clinical Excellence (NICE) states that women having this treatment should understand that it is a relatively new treatment with uncertain long-term results. If you are considering a UAE, please consult the NICE advice. See Further information.

Fibroids and cancer

Fibroids very rarely become cancerous. However, your doctor may still recommend that you have fibroids removed by surgery, especially if you have gone through the menopause.

Further information

• Women's Health Concern
  0845 123 2319
  www.womens-health-concern.org
• National Institute of Clinical Excellence
  www.nice.org.uk

Sources

• Fibroids. UK Department of Health. Prodigy. www.prodigy.nhs.uk, accessed 6 June 2005
• British National Formulary 49, March 2005
• National Institute of Clinical Excellence. Uterine artery embolisation for the treatment of fibroids. Interventional Procedure Guidance 94. October 2004. www.nice.org.uk
• National Institute of Clinical Excellence. MR image-guided percutaneous laser ablation for uterine fibroids. Interventional Procedure Guidance 30. December 2003. www.nice.org.uk

Related topics

• MRI scan
• Abdominal ultrasound

This information was published by BUPA's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by BUPA doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

		Feedback on this factsheet Rate this factsheet Have you found the information in this factsheet helpful? Do take a couple of moments to give us your feedback. We’re also currently conducting some research to help us continuously improve our health factsheets. If you live in the UK, we invite you to provide your feedback and telephone contact details. If we contact you to discuss your thoughts, it will be at a convenient time for you. For each completed telephone interview we will donate £2 to Marie Curie Cancer Care. Click here to give us your feedback

		Information you can trust We use expert sources of medical information to research all our health information and it is checked and approved by medical professionals. Find out more about how we produce our health information

email a friend

bupa.com  | website legal notices  |  cookie policy  |  © BUPA 1996-2007  |  accessibility  |  contact us

back to top