What Are Uterine Fibroids?
Uterine fibroids (leiomyomas) are noncancerous growths that develop in or around the uterus. They are the most common benign tumour in women of reproductive age, affecting up to 70–80% of women by age 50. While many fibroids cause no symptoms, others can lead to heavy menstrual bleeding, pelvic pain, and other complications that significantly affect quality of life.
How Common Are Fibroids?
Uterine fibroids are remarkably common. Population-based studies suggest that up to 70–80% of women will develop at least one fibroid by the age of 50. Despite this high prevalence, many women are unaware they have fibroids because the growths often cause no symptoms and are discovered incidentally during routine imaging or gynaecological examinations.
The incidence of fibroids varies significantly across different demographic groups. Black women are two to three times more likely to develop fibroids than white women, and they tend to develop them at a younger age, with larger and more numerous growths. Studies have also shown that fibroids are more common in women who have never given birth, those who are overweight, and those with a family history of the condition.
In the United Kingdom, fibroids account for a significant proportion of gynaecological consultations and are one of the most common reasons for hysterectomy. According to the NHS, around one in three women will develop fibroids at some point in their lives, with the condition most frequently diagnosed between the ages of 30 and 50.
What Causes Fibroids?
The exact cause of uterine fibroids remains incompletely understood, but research points to a combination of hormonal, genetic, and environmental factors. Oestrogen and progesterone — the hormones responsible for the development of the uterine lining during each menstrual cycle — are known to stimulate fibroid growth. This is why fibroids typically develop during the reproductive years and tend to shrink after the menopause.
Genetic factors also play a significant role. Women with a first-degree relative (mother or sister) who has fibroids are at considerably higher risk of developing them. Researchers have identified specific genetic mutations in fibroid cells that differ from those in normal uterine muscle cells.
Other factors that may contribute to fibroid development include obesity, vitamin D deficiency, early onset of menstruation, and dietary habits. For a comprehensive overview of all known risk factors, see our dedicated page on fibroid causes and risk factors.
Types of Fibroids
Fibroids are classified according to their location within or around the uterus. The four main types are intramural fibroids (within the muscular wall of the uterus), submucosal fibroids (projecting into the uterine cavity), subserosal fibroids (growing outward from the outer surface of the uterus), and pedunculated fibroids (attached to the uterus by a stalk).
The location of a fibroid is a key factor in determining which symptoms it causes and which treatment options are most appropriate. For example, submucosal fibroids are most likely to cause heavy menstrual bleeding, while large subserosal fibroids may cause pressure symptoms such as urinary frequency or constipation.
Understanding the different types of fibroids is essential for making informed treatment decisions. Learn more about each type on our types of fibroids page.
Symptoms of Fibroids
Many women with fibroids experience no symptoms at all. When symptoms do occur, the most common include heavy or prolonged menstrual bleeding (menorrhagia), pelvic pain or pressure, frequent urination, constipation, and abdominal bloating. Some women also experience pain during sexual intercourse, lower back pain, or reproductive difficulties.
The severity of symptoms depends largely on the size, number, and location of the fibroids. A single small fibroid may cause no problems, while multiple large fibroids can have a profound impact on daily life. Heavy menstrual bleeding is particularly common and can lead to iron-deficiency anaemia, fatigue, and reduced quality of life.
If you are experiencing any of these symptoms, it is important to seek medical advice. For a detailed guide to recognising fibroid symptoms, visit our fibroid symptoms page, which includes an interactive symptom checker.
How Are Fibroids Diagnosed?
Fibroids are typically diagnosed through a combination of clinical examination and imaging. A GP or gynaecologist may suspect fibroids based on your symptoms and a pelvic examination. The diagnosis is then confirmed using imaging techniques, most commonly pelvic ultrasound or MRI.
MRI is considered the gold standard for fibroid assessment as it provides detailed information about the number, size, position, and blood supply of each fibroid. This level of detail is particularly important for treatment planning, especially if uterine fibroid embolisation (UFE) is being considered.
Early and accurate diagnosis is important for effective treatment planning. Find out more about the diagnostic process on our fibroid diagnosis page.
Treatment Options
Treatment for uterine fibroids depends on the severity of symptoms, the size and location of the fibroids, and the patient’s individual circumstances, including whether she wishes to preserve her fertility. Options range from watchful waiting for small, asymptomatic fibroids to medical therapy, minimally invasive procedures, and surgery.
Uterine fibroid embolisation (UFE) is a highly effective, minimally invasive treatment that blocks the blood supply to fibroids, causing them to shrink. It is performed by an interventional radiologist and offers a shorter recovery time compared to surgery, with no need for general anaesthesia. Other options include medications to manage symptoms, myomectomy (surgical removal of fibroids), and hysterectomy.
At the North London Fibroid Clinic, we offer the full range of treatment options and work with each patient to develop a personalised treatment plan. To explore your options in detail, visit our treatments page.
When to See a Specialist
You should consider seeing a fibroid specialist if you are experiencing heavy or prolonged menstrual bleeding, pelvic pain or pressure that affects your daily activities, urinary symptoms such as frequency or urgency, or if you have been diagnosed with fibroids and want to understand your treatment options.
It is particularly important to seek specialist advice if your symptoms are worsening, if you are planning a pregnancy, or if previous treatments have not been effective. Our team at the North London Fibroid Clinic can provide a thorough assessment and discuss the full range of treatment options available to you.
You do not need a GP referral to see us privately. Book a consultation with our specialist team today.
Frequently Asked Questions
References
- NHS — Fibroids. Available at: https://www.nhs.uk/conditions/fibroids/
- NICE Clinical Knowledge Summaries — Fibroids. Available at: https://cks.nice.org.uk/topics/fibroids/
- Stewart EA. Uterine Fibroids. New England Journal of Medicine. 2015;372(17):1646–1655.
- Baird DD, Dunson DB, Hill MC, Cousins D, Schectman JM. High cumulative incidence of uterine leiomyoma in black and white women. American Journal of Obstetrics and Gynecology. 2003;188(1):100–107.
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