Fibroids are benign knots of muscle that affect the uterus. They are not cancerous, but they can grow to be quite large, and they can develop inside the tissues of the uterus or as attachments on the outside wall. Their growth is generally oestrogen-dependent, so they tend to affect women before the menopause or women taking hormone replacement therapy (HRT).

What symptoms do fibroids cause?

Some women have fibroids but never realise because they have no symptoms. Other women may notice one or more of the following signs:

  • A dull aching pain in the abdomen, back or legs
  • Periods that are heavy and painful, sometimes so heavy that you develop iron-deficiency anaemia
  • Constipation
  • The need to pass urine more frequently
  • Sexual difficulties

Types of fibroid

The most common are intramural fibroids that develop inside the muscle of the uterus. Other less usual types include:

  • Fibroids that grow inside the muscle in the cervix: cervical fibroids.
  • Those that develop in the inner uterine lining and then extend into the space inside the uterus: submucosal fibroids.
  • Fibroids that develop on the outer wall of the uterus in the abdominal cavity: subserosal fibroids.
  • Fibroids that grow outside the uterus but are attached by a stalk: pedunculated fibroids.

Treating fibroids

Conservative management of fibroids

Some fibroids do not need treatment. If they start to cause problems as a woman is approaching the menopause it may still be possible to manage them conservatively. This may mean taking medication to help cope with heavy periods and waiting for the menopause to occur. Fibroids start to shrink once the levels of oestrogen in the body start to fall.

It is still important to have regular check-ups with your consultant gynaecologist, as you need to be monitored regularly and it is important to be tested for iron-deficiency anaemia if your periods are very heavy.

Surgical treatment for fibroids

We offer various forms of surgery that can treat fibroids; the type of surgery you have will depend on the size and position of your fibroids:

  • Hysteroscopic resection: removal of fibroids that are on the inner surface of the uterus using a hysteroscope inserted through the vagina.
  • Laparoscopic myomectomy: this involves keyhole surgery performed in our minimally invasive therapy centre (MITU) to remove fibroids on the outside of the uterus. No part of the uterus, ovary or fallopian tube is taken away.
  • Open myomectomy: the same procedure as above but done through a larger incision in the abdomen.
  • Endometrial ablation: this involves using a laser or a heated wire to remove the entire lining of the uterus and any internal fibroids. It cannot be used for fibroids outside the uterus or those that have developed deep within the muscle.

Fibroids can also be treated by having a hysterectomy and this is generally recommended for women who have completed their family and who are experiencing very heavy and painful periods due to their benign fibroid growths.

Interventional radiology to treat fibroids

We also offer interventional radiology to shrink fibroids. Uterine artery embolisation: this can be used to treat large fibroids and involves injecting a chemical into the arteries that supply each fibroid with blood. This chemical seals up the artery, preventing fresh blood flowing in and, over the next few weeks and months, the fibroids gradually shrink.