Fibroids

If you’re seeking private treatment for fibroids, we provide detailed consultations with Consultant Gynaecologists who are highly experienced in diagnosing and treating fibroids. They will discuss your symptoms with you, carry out a gentle examination of your abdomen and an internal examination, to assess the condition, size and shape of your womb. They will also carry out: 

• An ultrasound scan: an advanced pelvic ultrasound provides us with a detailed picture of the internal structures of your uterus as well the size and location of any fibroids
• A blood test: This can help diagnose fibroids by checking for anaemia, thyroid issues, and other conditions

Our experts use highly accurate diagnostic tools, including 3D pelvic ultrasounds, to assess your womb and any fibroids. This can help to give us a clear understanding of what’s going on, and whether you require treatment or further monitoring.

Fibroids are non-cancerous growths that are made up of muscle and fibrous tissue that form a hard, round ‘knot’ in and around the womb (uterus). They vary in size and typically develop during the reproductive years, most frequently between the ages of 30 and 50. Fibroids tend to develop slowly until the menopause, when they usually shrink.

It’s not completely clear what causes fibroids, but we know that several factors can increase the likelihood of developing them:  

• Hormones: Fibroids form during a woman’s reproductive years when oestrogen levels are at their highest, typically shrinking post-menopause, when levels drop and periods stop
• Family history: If your mother, sister, or grandmother has a history of fibroids, you have an increased chance of developing them, suggesting a possible genetic predisposition 
• Ethnicity: Fibroids are thought to be more common if you are of African-Caribbean heritage
• Lifestyle: A higher body weight can increase the risk of fibroids

It’s important to know that taking the combined oral contraceptive pill does not appear to increase the risk of fibroids, while using a progestogen-only method of contraception may reduce the risk.

Many women with fibroids experience no symptoms, and you may only discover you have them during a routine examination or scan. However, if symptoms do occur, it’s important to discuss them with your doctor. Symptoms may include: 

• Heavy periods, sometimes with clots and cramping
• Discomfort or pain during sex
• Swelling in your tummy
• Pelvic pressure or discomfort
• Difficulties conceiving
• Urinary symptoms (frequency, urgency or occasionally incontinence if a large fibroid is pressing against your bladder)
• Bowel problems (bloating, constipation or abdominal cramps, if the fibroid is pressing against your bowel)

Treatment depends on whether you have symptoms and how severe they are. We would also consider the size and location of the fibroids, and your individual needs, especially if you are thinking of starting a family. Options include:

• Monitoring: If you have mild or no symptoms, we may recommend simply monitoring your fibroids over time
• Medication: Certain medications can reduce bleeding or manage pain. Fitting a progestogen-releasing intrauterine system (IUS) can help to control bleeding and provide contraception. Special hormone blockers can shrink fibroids by mimicking the menopause.
• Minimally invasive procedures: We may refer you for cutting-edge techniques such as uterine artery embolisation or MRI guided focused ultrasound. These are less invasive than surgery, but their long-term effects on fertility are still being researched. 
• Surgery: In some cases, we may recommend surgery to remove the fibroids

Fortunately, many women with fibroids have healthy pregnancies. However, depending on their size and location, fibroids can sometimes affect the chances of conceiving. In some cases they can also increase the risk of miscarriage and premature birth. 

If you’re trying for a baby and are worried you may have fibroids, it’s important to seek specialist advice. Our Consultant Gynaecologists – many of whom specialise in fertility – can offer guidance and personalised care to support you, advising on any potential risks and how to manage them.