Understanding Uterine Fibroids
Fibroids are non-cancerous growths of the muscular wall of the uterus, and they are extremely common. Many women have them without ever knowing. Others experience heavy periods, prolonged bleeding, pelvic pressure, frequent urination, back pain, or difficulty conceiving.
What matters is not the presence of a fibroid but its size, its position and the symptoms it causes. A small fibroid sitting inside the cavity of the uterus can cause far more trouble than a large one on the outer wall. Treatment is decided on that basis, and on whether you wish to have children.
Your Treatment Options
Not every fibroid needs treatment. Where treatment is required, we favour the option that preserves the uterus wherever that is appropriate.
- Watchful monitoring - for small, symptom-free fibroids, with periodic ultrasound.
- Medical management - tranexamic acid, hormonal treatment or a hormonal intrauterine system to control heavy bleeding.
- Correcting anaemia - iron replacement, and intravenous iron where haemoglobin is very low.
- Hysteroscopic myomectomy - removal of fibroids inside the uterine cavity with no external incision at all.
- Laparoscopic myomectomy - keyhole removal of fibroids with the uterus preserved, and a shorter recovery than open surgery.
- Open myomectomy - for very large or multiple fibroids where it remains the safer approach.
- Hysterectomy - offered only where fibroids are severe and the family is complete, and always discussed fully first.
- Fertility planning - advice on the interval between myomectomy and attempting pregnancy, and on delivery afterwards.
A hysterectomy is not the automatic answer to fibroids. For most women who still wish to conceive, uterus-preserving surgery is possible, and it is always worth a second opinion before agreeing to removal.
