Fibroids

Also known as myomas or leiomyomas, fibroids are firm, round lumps that develop in women of all ages and races. As many as 40 per cent of women over the age of 35 have them. In fact, some research suggests that if you looked hard enough for tiny fibroids, you’d find them in every woman.

In most cases, fibroids are no trouble at all. Although a type of tumour – thought to form from muscle cells in the walls of the womb’s blood vessels – they are benign (they don’t spread around the body). Many women aren’t even aware they have them.

Possible Problems

For a number of women, however, fibroids cause significant problems. This is usually because of their size or position in the womb. Click here for animated diagrams.

Possible complications include:

  • Heavy periods (menorrhagia) and anaemia – the most common symptoms. For a review of treatments for heavy periods, see the website of the Royal College of Obstetricians & Gynaecologists.
  • Abdominal pain.
  • Bloating – large fibroids can even cause a visible tummy bulge.
  • Urinary problems – pressure from large fibroids on the bladder can make you feel like you need to go to the toilet more often.
  • Painful bowel movements – pressure on the bowel can cause problems such as constipation.
  • Miscarriage and premature birth – fibroids are stimulated by high levels of oestrogen and can increase to as much as five times their normal size during pregnancy, getting in the way of a growing baby.
  • Infertility – more common among women with large fibroids, possibly because the fibroids interfere with the way the fertilised egg implants into the lining of the womb.

Very rarely – in about one in 1,000 cases – a cancer called a leiomyosarcoma may form in the fibroid. However, some research suggests that these tumours are actually very different from fibroids.

Treatment

There are a number of treatment options for women with fibroids:

    • Hormone treatments – drugs, such as progesterone, can decrease bleeding or shrink the fibroids, but the effects may be temporary. Another group of drugs known as LHRH analogues, which suppress oestrogen production and induce an artificial menopause, may be more effective. However, there may be risks such as osteoporosis and they obviously aren’t suitable for women who are trying to conceive.

 

    • Myomectomy – this is an operation to ‘shell’ the fibroids out of the wall of the womb. As the womb itself is preserved, this is an option for women still wanting children. It’s often recommended to women with infertility that may be due to fibroids, although there may be scarring that can aggravate infertility problems. Other complications include serious haemorrhage that can only be stopped by a hysterectomy and recurrence of the fibroids.

 

    • Uterine artery embolisation (sometimes referred to as UAE or UFE) – this involves blocking the blood supply to the fibroids by injecting tiny particles through a small tube guided by x-ray scans. This can shrink tumours by up to 60 per cent. For more information and to read women’s experiences of embolisation go to the Fibroid Treatment Collective. You may also want to visit FEmISA, an information and support site set up by women whose fibroids were successfully treated by embolisation.

 

  • Hysterectomy – for many women, hysterectomy is the best option because it removes all chance of the fibroids recurring. But it is a final step that carries significant risks and may cause an early menopause. Some women find it liberating, while others have problems with depression or lost libido.

Which treatment best suits you depends on the size of the fibroids, the problems they’re causing and your individual needs. For example, older women with large fibroids who’ve completed their family may choose a hysterectomy. In younger women still trying to have children, other treatments may be more suitable.

Top Tips

  • If fibroids are diagnosed, don’t fret unnecessarily. They may cause you no problems at all.
  • Think carefully before surgery and make sure you choose the right option for you.
  • Always report abnormal vaginal bleeding to your doctor, who can rule out sinister causes.

 

This article was last medically reviewed by Dr Trisha Macnair in August 2005.
First published in November 1997.