Overview
Uterine fibroids are non-cancerous growths that can develop in the uterus during your reproductive years. Hormones, genetics and lifestyle all play a role in their formation and not everyone experiences symptoms. This article explains what causes uterine fibroids, the signs to watch for and how doctors diagnose and manage them.
Understanding Uterine Fibroids
Uterine fibroids are very common, and you may develop them without realising it. Some remain small and silent, while others can affect your periods, daily comfort or fertility. Understanding the causes also helps you recognise common uterine fibroid symptoms and know when to discuss them with your doctor.
What Are Uterine Fibroids?
Uterine fibroids are non-cancerous (benign) growths that develop in or around the uterus. Research shows that up to 70-80% of women may develop fibroids by age 50, though many experience no symptoms.These tumours form from the muscle and connective tissue of the uterus. They can remain very small or grow large enough to stretch the uterus or press on nearby organs. Fibroids may occur as a single growth or multiple ones, and they can develop inside the uterine cavity, within the muscle wall or on the outer surface.
What Causes Uterine Fibroids?
Uterine fibroids develop due to a combination of hormonal, genetic and biological factors. While the exact cause isn’t fully understood, researchers have identified several key influences:
- Hormonal Influence Oestrogen and progesterone support fibroid growth. Fibroids tend to grow when these hormones are active and often stabilise or shrink after menopause, when hormone levels drop. Fibroids also contain more hormone receptors than normal uterine muscle, making them more responsive.
- Genetics and Family History Fibroid tissue often carries gene variations not found in the surrounding muscle. Having close family members with fibroids increases your likelihood of developing them.
- Growth-Related Factors Substances such as insulin-like growth factor (IGF) may affect how fibroid cells multiply, contributing to their development.
- Changes in the Extracellular Matrix (ECM) Fibroids contain ECM, which makes them firmer and may promote their growth.
- Stem Cell Activity Some research suggests fibroids may originate from a single smooth muscle cell that begins to grow abnormally, forming a fibroid.
What Types of Fibroids Can You Develop?
Uterine fibroids are classified based on their location in the uterus and how they affect it. Each type can cause different symptoms depending on its size and position.
What Types of Fibroids Can You Develop?
Uterine fibroids are classified based on their location in the uterus and how they affect it. Each type can cause different symptoms depending on its size and position.
| Type | Location | Possible Effects |
|---|---|---|
| Intramural | Within the uterine wall | Heavy periods, pelvic pressure |
| Submucosal | Under the uterine lining | Heavy bleeding, fertility issues |
| Subserosal | Outside the uterus | Pressure or pelvic discomfort |
| Pedunculated | Attached by a stalk | Pain if twisted |
What Symptoms Might You Notice?
Symptoms of uterine fibroids can vary widely. Some people experience noticeable changes, while others may have no symptoms at all.
Common symptoms include:
- Heavy or prolonged menstrual bleeding
- Pelvic pressure or a feeling of fullness
- Frequent urination
- Constipation
- Pain during intercourse
- Back or leg discomfort
- Difficulty conceiving, depending on the size and type of fibroid
What Factors Can Raise Your Chances of Developing Fibroids?
Several personal, hormonal and lifestyle factors can increase the likelihood of developing uterine fibroids. Key risk factors include:
- Age: Fibroids are more common in women in their 30s and 40s, when hormone levels naturally fluctuate.
- Family Background: Having close family members with fibroids increases your risk, likely due to shared genetic patterns.
- Hormonal Patterns: Oestrogen and progesterone influence fibroid growth. Early onset of menstruation or changing menstrual cycles may contribute to their development.
- Weight: Higher body weight can affect hormone activity, raising the chances of fibroids forming or growing.
- Vitamin D Levels: Lower vitamin D levels have been linked to a higher likelihood of developing fibroids, though the exact connection is not fully understood.
- Lifestyle Habits: Diets low in fruits and vegetables or high in red meat and alcohol may contribute to fibroid risk. Conditions such as obesity and high blood pressure are also associated with an increased chance of developing fibroids.
How Are Fibroids Diagnosed?
Doctors diagnose fibroids using a combination of physical examinations and imaging tests. Understanding these methods helps you know what to expect.
- Pelvic Examination Your doctor may start by feeling your uterus for any changes in size, shape or firmness that could indicate fibroids.
- Ultrasound Scan A standard ultrasound provides a clear view of the uterus, showing the number, size and location of fibroids.
- Transvaginal Ultrasound This internal ultrasound allows your doctor to see the uterus in greater detail, making it easier to detect smaller fibroids not visible on a standard scan.
- MRI Scan MRI offers a highly detailed image of the uterus. It is particularly useful when precise information about fibroid size, number or position is needed, such as before surgery.
- Hysteroscopy During hysteroscopy, a thin camera is passed through the cervix into the uterus, allowing direct visualisation of fibroids near or inside the uterine lining.
- Saline Infusion Sonography In this procedure, a small amount of saline expands the uterine cavity during an ultrasound, helping doctors see whether fibroids are affecting its shape or size.
What Treatment Options Can Help?
Treatment for uterine fibroids depends on your symptoms, the type and size of fibroids and your plans for pregnancy.
- Watchful Waiting: If fibroids cause no symptoms, you may not need immediate treatment. Regular monitoring can help track any changes.
- Medications: Hormonal treatments, NSAIDs and GnRH agonists can help manage heavy bleeding, pain or other symptoms associated with fibroids.
-
Non-Surgical Procedures
- Uterine Artery Embolisation (UAE): Shrinks fibroids by reducing their blood supply.
- MRI–Guided Ultrasound: Uses focused energy to reduce fibroid size without surgery.
- Surgical Options
- Myomectomy: Removes fibroids while preserving the uterus, suitable for women who wish to maintain fertility.
- Hysterectomy: Complete removal of the uterus, generally reserved for severe cases or when other treatments are not effective or appropriate.
Can Fibroids Affect Fertility or Pregnancy?
Fibroids can affect fertility and pregnancy depending on their size and location.
- Submucosal Fibroids: These fibroids may interfere with implantation.
- Large Fibroids: They can distort the uterus.
- Many Fibroids Cause No Issues: Most fibroids do not affect fertility.
- Pregnancy and Fibroids: Pregnancy may temporarily change fibroid size due to hormones.
Final Thoughts
Uterine fibroids are common and often harmless, but they can affect your fertility, comfort or daily life. While some fibroids cause no symptoms, others may lead to changes in bleeding, pelvic pressure or urinary habits. By understanding the causes, symptoms and risk factors, you can take a proactive role in your reproductive health; monitor changes, seek timely medical advice and explore treatment options that suit your needs and lifestyle.
Table of Contents
- Understanding Uterine Fibroids
- What Are Uterine Fibroids?
- What Causes Uterine Fibroids?
- What Types of Fibroids Can You Develop?
- What Symptoms Might You Notice?
- What Factors Can Raise Your Chances of Developing Fibroids?
- How Are Fibroids Diagnosed?
- What Treatment Options Can Help?
- Can Fibroids Affect Fertility or Pregnancy?
- Final Thoughts
Common Questions Asked
Do all fibroids affect fertility?
Most fibroids do not cause infertility. Fertility issues usually arise when fibroids change the shape of the uterine cavity, block fallopian tubes or interfere with implantation. Early detection and tailored treatment can help preserve fertility.
Will fibroids go away after menopause?
Fibroids often shrink after menopause due to lower hormone levels. However, any new growth or persistent fibroids should be evaluated to rule out other conditions, as they rarely signal cancer.
Can uterine fibroids turn into cancer?
Fibroids are almost always benign. Uterine leiomyosarcoma is a rare, separate cancer that does not develop from typical fibroids. Rapidly growing fibroids in postmenopausal women should be assessed by a clinician.
Do uterine fibroids always cause symptoms?
No, many fibroids remain symptom-free. Symptomatic fibroids may cause issues depending on their size, location and effect on surrounding organs. Monitoring symptom changes is key for timely intervention.
Can lifestyle habits influence fibroid growth?
Lifestyle cannot remove fibroids, but maintaining a healthy weight, balanced diet and regular exercise may help manage hormone levels and support overall uterine health.
How quickly can fibroids grow?
Fibroid growth varies individually. Some remain stable for years, while others grow faster due to hormonal changes. Tracking growth with regular check-ups helps guide treatment decisions.