Uterine fibroids are non cancerous growths in or around the womb (uterus). They are extremely common, and studies show women of African descent develop them more often, at a younger age and with more symptoms. Many women live with fibroids without knowing, while others experience heavy bleeding, pain and fertility challenges. The good news is that fibroids are treatable.
What are fibroids?
Fibroids (also called myomas or leiomyomas) are growths made of muscle and fibrous tissue. They can be as small as a seed or as large as a melon, and a woman can have one or many. They are described by location:
- Intramural: within the muscle wall of the uterus (most common)
- Submucosal: bulging into the uterine cavity, often causing heavy bleeding and fertility problems
- Subserosal: on the outer surface of the uterus, sometimes causing pressure symptoms
- Pedunculated: attached by a stalk
Common symptoms
- Heavy or prolonged menstrual periods, sometimes with clots
- Bleeding between periods
- Tiredness, dizziness or shortness of breath due to anaemia from blood loss
- Lower abdominal swelling or a feeling of fullness
- Pelvic pain or pressure, and lower back pain
- Frequent urination or difficulty emptying the bladder
- Constipation
- Pain during sex
- Difficulty getting pregnant or repeated miscarriages in some cases
Some women have no symptoms at all, and fibroids are found during a routine scan.
Causes and risk factors
The exact cause is not fully understood, but fibroids grow in response to the hormones oestrogen and progesterone. Risk factors include:
- Being of African descent
- Family history of fibroids
- Age, particularly from the 30s until menopause
- Early onset of periods
- Obesity
- Low vitamin D levels (suggested by some studies)
Fibroids usually shrink after menopause when hormone levels fall.
How fibroids are diagnosed
- Pelvic examination by a doctor
- Ultrasound scan (abdominal or transvaginal), the most common test
- MRI for detailed mapping before some treatments
- Blood tests to check for anaemia
- Hysteroscopy to look inside the uterus
Treatment options
Treatment depends on symptoms, size and location of fibroids, age and whether you want to have children.
Watchful waiting
Small fibroids without symptoms may only need monitoring with periodic scans.
Medicines
- Pain relief and medicines that reduce bleeding
- Iron supplements to treat anaemia
- Hormonal treatments, including some contraceptive methods, to control bleeding
- Medicines that temporarily shrink fibroids, often used before surgery
Procedures and surgery
- Myomectomy: removal of fibroids while keeping the uterus, suitable for women who want children
- Hysteroscopic resection: removing submucosal fibroids through the vagina without abdominal cuts
- Uterine artery embolisation: blocking blood supply to fibroids, available in some specialised centres
- Hysterectomy: removal of the uterus, a permanent solution for women who do not plan more children
Fibroids and fertility
Many women with fibroids conceive and have healthy pregnancies. Submucosal fibroids and large fibroids that distort the uterine cavity are more likely to affect fertility. A gynaecologist can advise whether treatment before pregnancy is helpful.
Beware of "miracle cures"
Many products in Uganda claim to "flush out" fibroids. There is no reliable evidence that herbs or detox products dissolve fibroids. Some can be harmful or delay proper treatment. Discuss any supplements with your doctor.
When to see a doctor urgently
- Very heavy bleeding soaking a pad every hour
- Severe sudden abdominal pain
- Fainting, extreme weakness or shortness of breath
- Rapidly growing abdominal swelling
Questions to ask your doctor
- How many fibroids do I have, how big, and where are they?
- Are they likely causing my symptoms?
- What are my treatment options, and how do they affect fertility?
- What are the risks and recovery time of surgery?
- How often should I have follow up scans?
Talk to a health professional
If you have heavy periods or pelvic symptoms, book a quick video consultation with a verified doctor on The Quick Consult to understand your next steps. This article is general information and not a substitute for medical care.