What are fibroids?
Fibroids (also called myomas or leiomyomas) are growths made of muscle and fibrous tissue in the wall of the womb. They are not cancer. They are very common in women in their thirties and forties, and they usually shrink after the menopause, when oestrogen levels fall.
Fibroids are described by where they grow: inside the cavity of the womb (submucosal), within the wall (intramural) or on the outer surface (subserosal). Their position affects the symptoms they cause.
What symptoms can fibroids cause?
- Heavy or long periods, sometimes with clots
- A feeling of pressure or fullness in the lower tummy
- Needing to pass urine often, or constipation
- Back pain or pain during sex
- Difficulty getting pregnant, or problems in pregnancy, mainly with fibroids that bulge into the womb cavity
Many fibroids cause no symptoms at all and are found by chance on a scan.
How are fibroids diagnosed?
A pelvic ultrasound is usually the first test and shows the size, number and position of fibroids. An MRI scan is sometimes used to plan surgery. A blood test checks for anaemia if your periods are heavy.
What are the treatment options?
Fibroids that cause no problems usually only need monitoring. When treatment is needed, the choice depends on your symptoms, the fibroids' size and position, and whether you want to keep your fertility.
- Medicines for heavy bleeding: non-hormonal medicines taken during your period, a hormonal intrauterine system or the pill.
- Medicines that shrink fibroids for a time: sometimes used before surgery.
- Hysteroscopic removal: for fibroids inside the womb cavity, removed through the cervix with no cuts on the tummy.
- Myomectomy: removing the fibroids while keeping the womb, often by keyhole surgery.
- Hysterectomy: removing the womb, for women who have completed their families and when other options have not helped.
Some women are also suitable for treatments carried out by interventional radiologists, which reduce the blood supply to fibroids. Your doctor can explain whether this is an option for you.
When should I see a doctor?
This article is general information and does not replace a consultation with a doctor. If you are worried about your health, please book a visit or, in an emergency, call +65 6535 8833.
