Around one in three women have fibroids. These non-cancerous growths only develop during the reproductive years, usually between ages 16 and 50. They are also called uterine fibroids, leiomyomas or myomas.
Learning that you have fibroids can be worrying. However, they almost never develop into cancer and do not increase your risk of womb cancer.
Sometimes fibroids are so small that they can only be seen under a microscope. However, they can also grow to be so large that they change the shape of your womb and push against your organs. You can have one or several and may not even know that you have them as fibroids are often symptomless.
You may be diagnosed with fibroids incidentally during a prenatal ultrasound or a pelvic examination. There are different types of fibroids based on their location:
But what causes fibroids? The cause isn’t currently known but the sex hormone oestrogen is involved — oestrogen causes fibroids to grow. This is why fibroids occur when your oestrogen levels are high during your reproductive years and shrink after menopause when your oestrogen levels drop off.
If you have fibroids, you may not have any symptoms. However, around one in three women with fibroids do have symptoms. Symptoms will depend on the size, number and location of your fibroids and sometimes, where you are in your menstrual cycle.
Here are 10 uterine fibroid symptoms to look out for:
Heavy periods (dysmenorrhoea) include periods that last for seven days or more and/or bleeding that soaks through your sanitary product in an hour, or means you need to use two sanitary products at the same time. You may also notice large blood clots in your menstrual blood.
Heavy bleeding during your periods may cause you to lose too much iron, which is carried by your blood cells — this is called iron-deficiency anaemia and can be treated by taking prescription iron tablets. Anaemia can make you feel extremely tired (fatigued) and breathless, as well as cause headaches.
Large uterine fibroid symptoms often include discomfort or pain in your lower tummy. You may notice that your tummy is bloated or swollen too.
In rare cases, fibroids can push against muscles and nerves in your lower back, causing pain. This is a more common symptom of large uterine fibroids, particularly on the back of your womb. However, back pain is very common and may not be caused by fibroids but by another condition.
A large fibroid can push against your pelvic nerve or sciatic nerve — in both cases, this can cause pain to radiate down your legs. If your sciatic nerve is compressed, you may also find it difficult to stand up for long periods of time.
Large fibroids can cause a feeling of heaviness or pressure in your pelvis or lower tummy. This usually causes discomfort, particularly if you are lying on your front, bending down or exercising. For some women, this discomfort can become painful and persistent.
In rare cases, pain may suddenly become severe. This occurs when a fibroid outgrows its blood supply and starts to degenerate. The pain usually goes away on its own after two to four weeks. Over-the-counter painkillers can help you manage your pain.
Your bladder sits below and in front of your womb. If your fibroids push against your bladder, you may need to urinate more often, which can disturb your sleep at night. Depending on exactly where your fibroids are pushing against your bladder, they may also prevent you from completely emptying your bladder or make it difficult to control the flow of urine.
The lower part of your bowel sits behind your womb and if your fibroids push against it, this can make it difficult to have a bowel movement, causing constipation — although this is not common. Constipation can mean you strain more when trying to pass a stool, which can cause haemorrhoids, more commonly known as piles.
Fibroids pushing against your vagina or the neck of your womb (cervix) can make sex uncomfortable or painful. This may only occur when you are in certain positions or during certain times of your menstrual cycle.
For most women, fibroids don’t cause any problems during pregnancy. However, some women may feel discomfort or pain — this may be caused by the fibroid outgrowing its blood supply or its blood supply becoming twisted and therefore suddenly cut off. In very rare cases, fibroids can cause a miscarriage.
However, fibroids do increase your risk of early labour, needing to deliver your baby via caesarean section and your baby lying with its bottom down (breech) instead of its head.
If your fibroids grow into your womb they may block your fallopian tubes or make it harder for a fertilised egg to implant into your womb lining. This can make it harder to get pregnant or cause infertility.
If you notice a lump or mass in your tummy or have persistent pain in your pelvis, make sure you see your GP. You may not have fibroids, however, your symptoms need to be investigated so you can get appropriate treatment.
If you have already been diagnosed with fibroids and are pregnant, make sure you tell your midwife or doctor that you have fibroids. They can then make plans in case your fibroids cause any problems during your pregnancy or labour.
What does fibroid pain feel like?
Fibroid pain varies according to where your fibroids are located. Pain can be dull and persistent or sudden and severe. You may have pain in your tummy, pelvis, lower back and/or legs.
How do you check for fibroids?
If you have very large fibroids, you may notice a lump or mass in your tummy. However, in most cases, you can’t check for fibroids yourself. You will need to see your GP for a diagnosis. Depending on your symptoms they may suggest an ultrasound scan to check for fibroids.
What happens if fibroids go untreated?
For most women, fibroids do not cause any symptoms and so don’t need any treatment. However, if you do have symptoms and don’t get treatment, your fibroids may grow. As they get bigger, they may cause further symptoms, such as pain during sex, pain in your tummy, lower back, pelvis and/or legs, constipation, needing to urinate more often and heavy periods. In rare cases, fibroids can make it more difficult to get pregnant.
Do fibroids go away on their own?
Fibroids usually shrink and go away after menopause. However, if you are not nearing menopause, your fibroids may grow.
Can fibroids come out as clots?
No, fibroids can’t pass out of your body as clots. However, they can cause heavy periods, which can, in turn, cause large clots in your menstrual blood.
Do fibroids make you smell bad?
No, fibroids don’t make you smell bad.
How do I know if I have fibroids or cysts?
Fibroids and ovarian cysts can share similar symptoms. However ovarian cysts form on your ovaries and therefore are more likely to cause pain on the right or left side of your tummy. Fibroids are more likely to cause pain centrally. You will need to see your GP to get a diagnosis — this may involve having an ultrasound scan.
What to avoid if you have fibroids?
Being overweight can increase your oestrogen levels, which can cause your fibroids to grow. So try to avoid high-fat, high-sugar foods — instead, eat a diet rich in fresh fruits and vegetables and low in red and processed meats. Alcohol may also increase your oestrogen levels, so try to decrease how much alcohol you drink — it is recommended that adults drink no more than 14 units of alcohol per week and have two to three alcohol-free days.
Who is at risk of fibroids?
One in three women have fibroids, however, you are more at risk of developing fibroids if you are of African or Afro-Caribbean descent, are overweight, have a diet low in fruit and vegetables, have a family history of fibroids and/or use the contraceptive pill. If you have a child, your risk is lower and decreases the more children you have.
When should fibroids be removed?
If your fibroids are causing severe symptoms, such as severe pain or bladder or bowel problems, your doctor may recommend surgery. However, in most cases, other non-surgical treatments will be recommended first.
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Lux Fatimathas, Editor and Project Manager
Lux has a BSc(Hons) in Neuroscience from UCL, a PhD in Cellular and Molecular Biology from the UCL Institute of Ophthalmology and experience as a postdoctoral researcher in developmental biology. She has a clear and extensive understanding of the biological and medical sciences.Having worked in scientific publishing for BioMed Central and as a writer for the UK’s Medical Research Council and the National University of Singapore, she is able to clearly communicate complex concepts.
Alfie Jones, Director — Cahoot Care Marketing
Alfie has a creative writing degree from UCF and initially worked as a carer before supporting his family’s care training business with copywriting and general marketing.He has worked in content marketing and the care sector for over 10 years and overseen a diverse range of care content projects, building a strong team of specialist writers and marketing creatives after founding Cahoot in 2016.