Fibroids

A fibroid (leiomyoma) is a benign growth of muscle in the uterus (womb).

Fibroids may occur on the outside (sub serosal), within the wall (intra mural) or in the cavity (sub mucousal) of the uterus.

While the exact cause of fibroids is uncertain it is likely that a number of factors contribute to the formation of fibroids, including genetic or familial predisposition, environmental and immunological factors, and in particular, hormonal factors. Generally, the hormone Oestrogen causes fibroids to grow.

Fibroids affect up to two in every five women over the age of 40. Fibroids are more common in women with infertility, and in those with few or no children.

Under the influence of female hormones, fibroids usually continue to grow until menopause. In most patients, fibroids do not cause any problems and do not require any treatment. Fibroids usually shrink after menopause however do not tend to disappear.

Most women have small fibroids which do not produce any symptoms. If however, due to size or position they may and symptoms can include:

  • Pain with periods, pain when passing urine or opening bowels and chronic pelvic and lower back pain

  • Difficulty falling pregnant

  • Abnormal bleeding: irregular or heavy periods; bleeding between your periods

  • Rarely, fibroids may become cancerous. This risk does increase in women after menopause, but probably occurs in less than 1:1000 cases

A doctor or gynaecologist can diagnose fibroids at the time of a pelvic examination or they can be seen by ultrasound, CT or MRI. The diagnosis can be further confirmed by hysteroscopy or laparoscopy.

There are several treatments for fibroids and this depends on age, symptoms and size. If the fibroid does not cause any problems then it can be treated by observation (conservative management).

If surgery is required, there are three main surgical options.

  1. Surgical Myomectomy can be performed to remove the fibroids if there are only a small number of them in a favourable location in the uterus. This can be performed laparoscopically (key hole surgery) or hysteroscopically.

  2. Hysterectomy to remove the uterus and fibroids altogether.

  3. Uterine Artery Embolization in specialist centres.