Fibroids are non-cancerous growths or lumps of muscle tissue that form within the walls of the uterus (womb). Causes, signs and symptoms of fibroids along with how they are diagnosed and treated are discussed.
What are fibroids?
What causes fibroids?
Symptoms
Diagnosis
Impact on fertility
Fibroids & pregnancy
Management & treatment
Who to see for help
ABC Health Report on fibroids
Fibroids (also known as uterine fibromyomas, leiomyomas or myomas) are non-cancerous growths or lumps of muscle tissue that form within the walls of the uterus (womb).
Fibroids can vary in size ranging from the size of a pea to the size of a rockmelon or larger.
It is not known exactly why fibroids occur. However, we do know the female hormones, oestrogen and progesterone play a significant role in stimulating the growth of fibroids.
Fibroids occur in women of reproductive age, growing at varying rates until the onset of menopause. After menopause, they tend to decrease in size and may slowly disappear. This is because at this time, the levels of oestrogen and progesterone decrease.
Some things increase your risk of getting fibroids, while others lower your risk including:
| Higher risk | Early onset of periods Obesity A family history of fibroids Never having given birth Being of Afro-Caribbean descent Age (risk increases in your late reproductive years) Having polycystic ovary syndrome (PCOS) High blood pressure (hypertension) |
| Lower risk | Smoking Having more than 2 children Having had a multiple birth Use of Depo-Provera (a contraceptive) Use of the oral contraceptive pill |
Fibroids occur in up to 70% of women by the time they are 50. Many women will not know they have fibroids because for the majority they do not cause symptoms.
Symptoms will depend on the size, number and location of the fibroids and may include the following:
In very rare instances, a fibroid may become cancerous and is called a sarcoma.
Fibroids are usually found during a gynaecological examination, pelvic ultrasound or during surgery for other conditions.
Fibroids may be found during a hysteroscopy which is an internal examination, usually under general anaesthesia, performed using a hysteroscope (a thin telescope). This is inserted along the vagina into a woman's uterus to examine the inside cavity.
Fibroids can also be found during a laparoscopy (keyhole surgery). This is an examination, using a thin telescope performed under general anaesthesia, through a small cut in the navel (umbilicus) to look at or operate on the pelvic organs, such as the uterus, ovaries and uterine (fallopian) tubes.
Infertility is not a common problem for women with fibroids, less than three per cent of women may have fertility problems as a result of fibroids.
Sometimes fibroids cause problems in pregnancy or they interfere with labour and delivery. The number and position of the fibroids will determine if there is a problem.
Fibroids can increase the risk of:
A pregnancy following surgery to remove fibroids may increase the risk of the scar in the uterus rupturing during the pregnancy.
Most fibroids will not require treatment unless they are causing problems such as:
Treatment will depend on:
Treatments may include:
| Treatment | How it works |
|---|---|
| GnRH agonist (an artificial hormone used to prevent natural ovulation) | It causes a temporary chemical menopause which shrinks the fibroids. |
| Intrauterine device (IUD) such as Mirena | Placed in the uterus, it can reduce heavy periods. |
| Uterine artery embolisation | A fine substance or coil is injected into the uterine artery to reduce the blood supply to the fibroid causing the fibroid to shrink by 30-50%. The procedure is performed by a specialist radiologist using X-ray control, under sedation or anaesthesia. |
| Endometrial resection | A hysteroscope is used under general anaesthesia to cut out a fibroid that is partially or completely inside the cavity of the uterus, and partially in the wall of the uterus. These are called 'sub mucosal' fibroids and they usually cause heavy periods. |
| Myomectomy | Complete removal of a fibroid using:
|
| MRI-directed ultrasound technique | Guided by an MRI, high intensity focused ultrasound waves cause a localised increase in temperature to destroy the fibroid. |
| Hysterectomy | Removal of some or all of the uterus particularly for multiple fibroids causing major symptoms |
If you are experiencing any of the symptoms of fibroids, see your doctor. Your doctor may refer you to a gynaecologist.
Jean Hailes gynaecologist Dr Elizabeth Farrell featured on ABC Radio's Health Report in a special report on fibroids.
You can hear the full interview here.