If you have been told you have fibroids, or if you have very heavy periods, pelvic pressure, or trouble getting pregnant, this guide is for you. We explain what fibroids actually are, when they cause problems, and all the treatment options available. For related content on heavy or painful periods, see our main condition page.

What are uterine fibroids?

Fibroids (also called myomas or leiomyomas) are growths made of the same type of muscle that forms the wall of your uterus. They are not cancer and they do not turn into cancer in most instances. They range from the size of a pea to larger than a rockmelon. A woman can have one fibroid or many at the same time.

Fibroids are grouped by where in the uterus they grow:

1. Submucosal: inside the cavity of the uterus. These are most likely to cause heavy bleeding and fertility problems, even when small.

2. Intramural: within the muscle wall of the uterus. The most common type.

3. Subserosal: on the outside of the uterus. These can press on other organs if they grow large.

4. Pedunculated: attached by a stalk, either inside or outside the uterus.

Where a fibroid sits matters as much as how big it is when deciding on treatment.

How common are fibroids?

Fibroids are very common. Up to 70 percent of women can have at least one fibroid by the age of 50. Many of these women will never know, because the fibroid causes no symptoms. Fibroids are more common in women of African heritage and in families where other women have had fibroids.

Signs and symptoms of fibroids

Many fibroids cause no symptoms at all. When they do, the most common signs include:

1. Heavy or long periods. This is the most common symptom. Soaking through a pad or tampon in less than an hour, passing large clots, or periods lasting more than 7 days may all suggest fibroids.

2. Pelvic pressure or a feeling of fullness in the lower abdomen.

3. A visibly bigger tummy, especially with large fibroids.

4. Pain during sex, especially in certain positions.

5. Needing to pee often, or trouble emptying the bladder, when fibroids press on the bladder.

6. Constipation or lower back pain, when fibroids press on the bowel.

7. Trouble getting pregnant or recurrent miscarriage, in some cases.

How are fibroids diagnosed?

Fibroids are usually diagnosed with a pelvic ultrasound, which can show the number, size, and location of the fibroids. In some cases an MRI gives more detail, especially before planning surgery. A hysteroscopy (a small camera inside the uterus) is useful when a fibroid is inside the uterine cavity.

Your specialist will also want to rule out other causes of the same symptoms. A heavy or long period can be due to fibroids, but it can also be due to adenomyosis, polyps, a thickened lining, or hormonal issues. Treatment depends on getting the diagnosis right first.

Do all fibroids need treatment?

No. Many fibroids are found by chance on scans done for other reasons, and the woman has no symptoms at all. In this case, watchful monitoring is a reasonable option. Your specialist will suggest a plan for repeat scans so you know whether the fibroid is growing or staying stable.

Treatment is usually recommended when fibroids cause heavy bleeding that affects your life, pressure or pain, fertility problems, or when they are growing quickly.

Treatment options for fibroids

Medications

Tranexamic acid and anti-inflammatories (like mefenamic acid) can reduce heavy bleeding during periods. The combined contraceptive pill can also help. These do not shrink the fibroid, but they can make life more comfortable while you decide on next steps.

Mirena IUD

A Mirena IUD releases a small amount of progesterone directly into the uterus. It is very effective for heavy periods caused by small to moderate fibroids. It avoids surgery and can last up to 5 years.

Endometrial ablation

Endometrial ablation destroys the lining of the uterus. It can be a good option for women who have finished having children and whose fibroids are small and causing heavy bleeding. It is a day procedure done under light anaesthetic.

Myomectomy (fibroid removal)

Myomectomy is a surgery that removes the fibroid while leaving the uterus in place. This is the option for women who want to keep the possibility of pregnancy. Depending on the size and location, myomectomy can be done with a hysteroscopy (through the vagina for fibroids inside the uterus) or with laparoscopy (keyhole surgery through the tummy).

Uterine artery embolisation

This is a procedure done by an interventional radiologist. Small particles are injected into the arteries that feed the fibroid, cutting off its blood supply and causing it to shrink. It is useful for some women who want to avoid open surgery. Our blog on non-invasive fibroid treatment covers this option in more detail.

Hysterectomy

Hysterectomy is the complete removal of the uterus. It is a definitive solution and the only one that guarantees no fibroid will ever come back. It is usually only recommended for women who have severe symptoms, do not want more children, and have tried or ruled out other options. In most cases a hysterectomy for fibroids can be done as keyhole surgery with a quick recovery.

Fibroids and fertility

Most women with fibroids have healthy pregnancies. Whether a fibroid is likely to affect fertility depends mostly on where it sits. Fibroids inside the uterine cavity (submucosal) are the ones most likely to cause problems and are usually worth removing before trying to conceive. Fibroids in the muscle wall or on the outside of the uterus may or may not need treatment, depending on size and other factors.

If you are planning pregnancy and you have fibroids, a specialist assessment is very useful. We can tell you whether treatment before pregnancy would help your chances.

Fibroids and menopause

Fibroids are sensitive to oestrogen. After menopause, oestrogen drops and fibroids usually shrink. For many women this means symptoms settle without any treatment. For women close to menopause, your specialist may suggest a less aggressive approach knowing that nature will do some of the work.

About Northside Gynaecology and fibroid care

Northside Gynaecology is a specialist gynaecology practice in Brisbane. Our team, led by Dr Archna Saraswat, FRANZCOG, has been caring for women with fibroids since 2011. We offer all the modern treatment options including keyhole fibroid removal. We consult from Kedron, North Lakes, and Caboolture Private Hospital.

Frequently asked questions

Are fibroids cancer?

No. Uterine fibroids are benign (non-cancerous) growths. The chance of a fibroid being cancerous is very low. However, any new growth that behaves unusually should be assessed by a specialist to rule out other possibilities.

Do all fibroids need to be removed?

No. Many fibroids cause no symptoms and can simply be monitored. Treatment is usually recommended when fibroids cause heavy bleeding, pain, pressure, fertility problems, or when they are growing quickly.

Can I get pregnant with fibroids?

Yes, many women with fibroids have healthy pregnancies. Whether fibroids affect fertility depends on their size and location. A specialist can assess your fibroids and let you know if treatment before pregnancy would be helpful.

Do fibroids shrink after menopause?

Yes, in most cases. Because fibroids are sensitive to oestrogen, they usually shrink after menopause when oestrogen levels drop. For some women this means symptoms settle without any treatment.

Is a hysterectomy the only treatment for fibroids?

No. There are many treatment options including medications, a Mirena IUD, endometrial ablation for reducing bleeding and myomectomy, and uterine artery embolization for the fibroid itself. Hysterectomy is only one of the options and may not be the first choice for most women.

How long does fibroid surgery take to recover from?

Recovery depends on the type of surgery. A hysteroscopic fibroid removal usually means 1 to 2 days of rest. A laparoscopic (keyhole) myomectomy or hysterectomy usually means 2 to 4 weeks before full activity returns. Your specialist will give you a tailored plan.

Can fibroids come back after treatment?

New fibroids can grow after a myomectomy or ablation because the uterus remains. The chance of this varies. The only treatment that guarantees no fibroids will return is a hysterectomy.

Book a fibroid consultation in Brisbane

If your periods are affecting your life or you have been told you have fibroids, a specialist consultation can help you decide what to do next.

You can book at Kedron, North Lakes, or Caboolture Private Hospital. Call 07 3054 4687 or use our contact page. Bring your GP referral so you can claim your Medicare rebate, and any ultrasound or MRI reports you have.