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FibroidsPublished by Bupa's health information team, June 2008. This factsheet is for women who have fibroids, or who would like information about them. Fibroids are non-cancerous growths of the womb (uterus). They are also known as uterine myomas, fibromyomas or leiomyomas.
About fibroidsMore than one in three women have fibroids, but most of these women don't ever get any symptoms. Fibroids are enclosed in fibrous capsules attached to the wall of your womb and don't spread to other parts of your body. You can have one fibroid or many - the average number is between four and seven depending on your age. Fibroids are named according to where they are found in your womb.
Fibroids range from the size of a pinhead to up to 20cm across. Fibroid growth is very slow and can be stimulated by hormones, especially oestrogen. A hormone is a chemical found naturally in your body. Fibroids tend to become smaller and reduce in number when oestrogen levels fall, such as after the menopause.
SymptomsFibroids 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.
ComplicationsFibroids and pregnancyMost women with fibroids have a normal pregnancy and delivery. In around two-thirds of women, the fibroids stay at a constant size or shrink. Submucosal fibroids can affect the shape and internal environment of the womb, which can make it more difficult to become pregnant. 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 (a doctor specialising in pregnancy and childbirth). Fibroids and cancerFibroids very rarely become cancerous. CausesThe reason why women get fibroids isn't known. Although oestrogen seems to make the fibroids grow, it's not thought to be responsible for their initial development. You are more likely to get fibroids if you:
DiagnosisAs fibroids rarely have symptoms, they are often found during routine gynaecological (vaginal) examination. Your doctor may do the following tests to see if you have fibroids.
TreatmentIf you don't have any symptoms, or if they are only mild, you don't need treatment. If you are getting symptoms, there is a range of treatments available. Your doctor will explain which is most suitable for you. MedicinesThere is no medicine that cures fibroids. However, hormone-based treatments can help relieve the symptoms. Treatment with gonadotrophin releasing hormone analogues (GnRH analogues) can lower your oestrogen level. This usually shrinks the fibroids. GnRH analogues such as goserelin (eg Zoladex) or leuprolin acetate (eg Prostap SR) are often prescribed for three to four months before surgery (see Surgery) to make it easier to remove fibroids. GnRH analogues can cause side-effects such as 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 will get side-effects. Non-surgical treatmentsUterine artery embolisation (UAE)This treatment blocks the blood supply to a fibroid, causing it to shrink. It's performed under a local anaesthetic, meaning that the feeling in the area will be completely blocked but you will stay awake during the operation. UAE gives relief from symptoms such as bleeding and pain for at least two-thirds of women treated. Side-effects and complications with UAE are lower than with open surgery. The National Institute for Health and Clinical Excellence (NICE) states that UAE is a relatively new treatment with uncertain long-term results. If you are considering UAE, please talk to your gynaecologist (a doctor specialising in identifying and treating conditions of the female organs). Endometrial ablationAn endometrial ablation is a procedure to remove the lining of your womb or an individual fibroid using laser energy or ultrasound. You can still get pregnant after an endometrial ablation. SurgeryThere are a number of surgical options including those outlined below.
Sometimes it's possible for these operations to be performed by keyhole surgery. Further information
Sources
Related topics
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 Thomas Ind MBBS, MD, MRCOG; Royal Marsden Hospital, Fulham, London and by Bupa doctors. It has also been reviewed by Women's Health Concern. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional. Publication date: June 2008. Expected review date: June 2010
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