Uterine fibroids are incredibly common, yet they remain one of the most debated topics in women’s health.
Because they are so frequent—affecting up to 80% of women by age 50—doctors often struggle to decide whether a fibroid is a “disease” or simply a normal part of a woman’s anatomy.
Understanding the symptoms and the challenges of diagnosis is key to making the right decision for your body.
Uterine fibroids (also called leiomyomas) are non-cancerous growths made of muscle and fibrous tissue that develop in or around the womb. They can range in size from a tiny seed to the size of a large melon.
One of the most unique things about fibroids is their natural history: they often grow and shrink on their own. They frequently regress (disappear) after a pregnancy or after the menopause when hormone levels drop.
Most women with fibroids have no symptoms at all. However, when they do cause issues, these are the most common signs:
1. Heavy Menstrual Bleeding (Menorrhagia)
This is the most frequent symptom. You may find you need to change your pad or tampon every hour, or you may pass large blood clots. This can lead to anaemia, making you feel tired and weak.
2. Pelvic Pressure and Pain
Large fibroids can put physical pressure on the pelvis. This often feels like a constant “heaviness” or a dull ache in the lower abdomen or back.
3. Urinary Frequency or Constipation
Depending on where the fibroid is growing, it can press against nearby organs.
Bladder pressure: Causes a frequent need to urinate or difficulty emptying the bladder.
Bowel pressure: Can lead to persistent constipation.
4. Pain During Intercourse (Dyspareunia)
Fibroids that grow near the cervix or at the bottom of the uterus can make sexual intercourse uncomfortable or painful.
5. Abdominal Swelling
In severe cases, fibroids can grow so large that they cause the abdomen to enlarge, sometimes making a woman look as though she is in the early stages of pregnancy.
Because fibroids are so common, you don’t always need treatment. However, you should book an appointment with your GP if:
Your periods have become significantly heavier or more painful.
You feel a hard lump or “mass” in your lower tummy.
You are struggling with “pressure” symptoms, like needing the toilet constantly.
You are experiencing shortness of breath or extreme fatigue (signs of anaemia from blood loss).
When to seek urgent care: Seek medical attention immediately if you have sudden, sharp pelvic pain that does not go away.
Even though they are easy to see on an ultrasound or MRI scan, managing them is complicated for several reasons:
The “Co-incidence” Problem: Because 80% of women have fibroids, finding one on a scan doesn’t always mean it is the cause of your pain. It might just be an “innocent bystander” while something else, like adenomyosis or endometriosis, is the real culprit.
Treatment Uncertainty: There is no single “best” treatment. Options range from doing nothing (watchful waiting) to medication, uterine artery embolisation, or surgery (myomectomy or hysterectomy).
Unknown Causes: We still don’t know exactly why they start growing or why they suddenly shrink in some women and not others.
Are they cancer? No, they are benign growths.
How common are they? They affect 70–80% of women over 50.
Is there a higher risk for some? Yes, Black women are more likely to develop fibroids at a younger age.
Do they go away? Yes, they often shrink after menopause.
Do they cause infertility? Sometimes, depending on their size and location.
Is surgery the only option? No, many medical and minimally invasive treatments exist.
Can they be misdiagnosed? Yes, they are often confused with adenomyosis.
Is “Doing Nothing” an option? Yes, if there are no symptoms, monitoring is often best.
Why the delay in care? Cultural taboos around talking about heavy periods often delay diagnosis.
Is more research needed? Absolutely—specifically into what triggers their growth and non-surgical cures.
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