Fibroids

Fibroids are benign (non-cancerous) tumours that grow in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and can vary in size. Fibroids are sometimes known as uterine myomas or fibromyomas.
Fibroids usually develop during a woman’s reproductive years (from approximately 16 to 50 years of age). They are linked to the production of oestrogen, which is the female reproductive hormone.
Types of fibroids
Fibroids can grow anywhere in the womb. The five main types of fibroids are described below.

• Intramural fibroids develop in the muscle wall of the womb and they are the most common type of fibroids found in women.
• Subserosal fibroids grow outside the wall of the womb into the pelvis and can become very large.
• Submucosal fibroids develop in the muscle beneath the inner lining of the womb wall and they grow into the middle of the womb.
• Pedunculated fibroids grow from the outside wall of the womb and are attached to the womb wall by a narrow stalk.
• Cervical fibroids develop in the wall of the cervix (the neck of the womb).

Fibroids are common, with at least one in four women developing them at some stage in their life. They most often occur in women who are from 30 to 50 years old.
Symptoms of fibroids
Fibroids tend to develop more frequently in women who are of Afro-Caribbean origin and in women who are overweight. It is thought that they occur in heavier women as a result of higher oestrogen levels.
In many cases, fibroids do not cause symptoms and treatment is not required. Over time, fibroids will often shrink and disappear without any treatment. However, sometimes fibroids can cause symptoms, such as pain or heavy bleeding. In such cases, medication may be prescribed. If this proves ineffective, surgical or non-surgical techniques may be recommended.
Fibroids are growths of smooth muscle and fibrous tissue in the womb. Many women are unaware they have fibroids because they do not have any symptoms. If your fibroids do cause symptoms, you may experience one or more of the following:
Heavy or painful periods
Fibroids do not disrupt the normal menstrual cycle (periods) but they can cause heavy or painful bleeding. Heavy bleeding can some-times cause anaemia (a reduction of oxygen-carrying red blood cells).
Abdominal pain
If you have fibroids, particularly if you have large ones, you may experience discomfort or bloating (swelling) in your stomach. You may also experience pain in your back and legs.
Frequent urination and constipation
If your fibroids press on your bladder, you may need to urinate frequently. Fibroids can also press on your rectum (large intestine), which can cause constipation.
Pain or discomfort during sex
If you have fibroids growing near to your vagina, or cervix (neck of the womb), you may experience pain or discomfort during sexual intercourse (dyspareunia).

Causes of fibroids 
The exact cause of fibroids is unknown. However, fibroids are linked to the female hormone, oestrogen. Oestrogen is the female reproductive hormone produced by the ovaries (the female reproductive organs).
Fibroids tend to increase in size when oestrogen levels are at their highest, such as during pregnancy. They are also known to shrink when oestrogen levels are low, such as after the menopause (when a woman’s monthly periods stop at around 50 years of age).
Diagnosing fibroids
As fibroids do not often cause symptoms, they are sometimes discovered during a routine gynaecological (vaginal) examination or during a diagnostic test or scan. A diagnostic test is any test that is carried out to help confirm or rule out a health condition that may be causing your symptoms.
If your doctor suspects fibroids, they may recommend that you have some tests to confirm a diagnosis, or to rule out other possible causes of your symptoms. These tests are listed below.
Ultrasound scan: An ultrasound scan of the womb is often used to confirm a diagnosis of fibroids. It can also be used to rule out any other possible causes of your symptoms. Depending on the results of your ultrasound scan, your doctor may refer you to a gynaecologist (a specialist in the female reproductive system). The gynaecologist will be able to investigate the problem further using a number of specialised techniques, such as those outlined below.
Trans-vaginal scan: A trans-vaginal scan is sometimes used to diagnose fibroids. It involves inserting a small scanner into your vagina to take a close-up image of your womb.
Hysteroscope: It may be possible to see fibroids that are near your inner lining (intramural fibroids), and those within the cavity of your womb (submucosal fibroids) using a hysteroscope. A hysteroscope is a small telescope used to examine the inside of your womb.
Laparoscope: A laparoscope is a thin, flexible microscope with a light on the end that is used to look inside the stomach. It can also be used to examine the size and shape of the outside of your womb.
Biopsy: A laparoscopy can also be used to take a biopsy (a tissue sample) of the inside lining or the outer layer of your womb. The sample can then be sent to a laboratory for closer examination under a microscope.