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Understanding Uterine Fibroids

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in or around the womb (uterus). Made up of muscle and fibrous tissue, these growths can vary in size—from as small as a pea to as large as a melon. Fibroids are very common, particularly in women aged 30–50, and often cause no symptoms. However, when symptoms do occur, they can affect quality of life.

Where do fibroids grow?

Fibroids can grow in different parts of the uterus:

  • Intramural: Within the muscular wall of the womb (most common type).
  • Submucosal: Just beneath the lining of the womb; these can affect bleeding and sometimes fertility.
  • Subserosal: On the outer wall of the womb; may press on surrounding organs.
  • Pedunculated: Attached to the womb by a stalk, which can sometimes twist and cause pain.

What Are the Symptoms of Fibroids?

Many women with fibroids have no symptoms at all, but when symptoms do occur, they may include:

  • Heavy or prolonged periods (menorrhagia)
  • Pelvic pain or pressure
  • Bloating or swelling in the lower abdomen
  • Frequent urination if the fibroid presses on the bladder
  • Pain during sex
  • Back or leg pain
  • Constipation
  • Difficulty getting pregnant (in some cases)

What causes fibroids?

The exact cause of fibroids is not fully understood, but several factors are known to increase risk:

  • Hormones: Fibroids are sensitive to oestrogen and progesterone, which help them grow.
  • Genetics: A family history of fibroids increases your risk.
  • Age: More common during the reproductive years.
  • Ethnicity: Women of African-Caribbean descent are more likely to develop fibroids, and they tend to be larger and more numerous.
  • Obesity: Higher body weight can elevate the risk of developing fibroids.

How are fibroids diagnosed?

At WWWW, we believe in accurate diagnosis and clear understanding of your condition. We use
internationally recognised FIGO classification to categorise fibroids, which helps guide the most effective
treatment options.

Diagnostic Tools We Use:

  • Pelvic Ultrasound: Both abdominal and transvaginal scans to visualise fibroids and their location.
  • 3D Ultrasound: For more complex cases, 3D imaging provides a clearer picture of fibroid size and position.
  • Hysteroscopy: A small camera is passed into the womb to inspect the lining and check for submucosal fibroids.

Should we recommend the following investigations:

  • MRI Scan: If more detailed imaging is required, MRI offers high-resolution insights.
  • Laparoscopy: Keyhole surgery for more detailed assessment

WWWW can support you with a referral letter to complete them.

We prioritise up-to-date, evidence-based approaches to ensure that our assessments are precise and our treatment recommendations are the most effective available.

Non-Surgical Management Options at WWWW:

At WWWW, we focus on evidence-based, non-surgical treatments for managing fibroids effectively, minimising disruption to your life and avoiding unnecessary procedures. Our commitment to staying current with the latest medical advances allows us to deliver fast, effective solutions tailored to your needs.

Watchful Waiting:

  • If fibroids are small and not causing symptoms, regular monitoring may be all that’s required.
  • Many fibroids do not grow significantly, especially after menopause.

Hormonal Treatments:

We stay informed on the latest guidelines for hormonal management, offering:

  • Hormone-releasing IUD (e.g., Mirena): Helps reduce heavy periods and may shrink fibroids.
  • GnRH Analogues: These medications can temporarily shrink fibroids by reducing hormone levels.
  • Selective Progesterone Receptor Modulators (SPRMs): Newer treatments like Ulipristal acetate that target fibroid growth while preserving the uterus.
  • Combined Oral Contraceptives: Can help regulate bleeding.

Non-Hormonal Medications:

  • Tranexamic Acid: Reduces heavy menstrual bleeding.
  • NSAIDs (e.g., ibuprofen): Helps relieve pain and reduce menstrual flow.
  • Newer Non-Hormonal Agents: We are committed to exploring innovative treatments that emerge, ensuring you have access to the best care available.

While we focus on non-surgical options, there are minimally invasive treatments available for those with persistent symptoms and WWWW can support you with referral letters should you wish to consider the following:

  • Uterine Artery Embolisation (UAE): Blocks blood supply to fibroids, causing them to shrink.
  • Endometrial Ablation: Destroys the lining of the womb to reduce heavy bleeding.

We continuously assess emerging technologies and minimally invasive techniques to offer you the safest and most effective options.

Do fibroids affect fertility or pregnancy?

Some fibroids can:

  • Interfere with implantation or embryo growth
  • Increase the risk of miscarriage, preterm birth, or breech position
  • Lead to heavier bleeding after childbirth

Not all fibroids cause fertility problems, and many women conceive naturally. At WWWW, we provide thorough assessments and practical guidance if you are planning a pregnancy.

When should I see a doctor?

We recommend booking an assessment if you experience:

  • Heavy or painful periods that impact daily life
  • A feeling of pressure or fullness in the lower abdomen
  • Difficulty emptying your bladder or frequent urination
  • Constipation or bloating
  • Fertility concerns or difficulty conceiving

Why Choose WWWW for Your Care?

At WWWW, we prioritise:

  • Accurate diagnosis using the latest imaging technology, including 3D ultrasound
  • Up-to-date medical management that aligns with current evidence and best practice
  • Non-surgical solutions wherever possible to avoid unnecessary procedures
  • Rapid intervention to manage symptoms effectively and improve your quality of life

Living Well with fibroids

At WWWW, our goal is to help you manage fibroids effectively without unnecessary surgery. With the right support, many women live comfortably with fibroids, enjoying a high quality of life. Our expert team is dedicated to providing clear diagnosis, effective non-surgical treatments, and compassionate care every step of the way.
Book your consultation today and take control of your health with confidence.