A fibroid is a common, non-cancerous growth of muscle and fibrous tissue in or around the womb. Fibroids are very common: they can be found in up to 80% of women by the age of 50, and many women never know they have them. When fibroids cause symptoms, the most common is heavy menstrual bleeding, which can lead to iron deficiency anaemia; others include painful periods, pelvic pressure, needing to pee often, constipation and pain during sex. Fibroids that cause no problems usually do not need treatment. Medicines can ease heavy bleeding and pain, and larger or troublesome fibroids can be treated with procedures such as myomectomy or uterine artery embolisation. The risk of cancer is very low. This guide explains the types, symptoms, causes, how fibroids differ from cysts, treatment options, fibroids in pregnancy, and when to see a doctor.
What is a fibroid?
Fibroids (also called uterine fibroids, myomas or leiomyomas, and sometimes "ketumbuhan dalam rahim" in Malay) are growths that develop in or around the womb. The NHS describes them as common and non-cancerous, mainly affecting women who have not been through the menopause.
- They are very common. A review in American Family Physician notes that fibroids can be detected in up to 80% of women by age 50. In a US ultrasound study, the estimated cumulative incidence by age 50 was more than 80% for Black women and nearly 70% for White women.
- Many cause no symptoms, and some are only found during a scan for something else, such as a pregnancy scan.
- The cancer risk is very low. A rare cancer called leiomyosarcoma is estimated in about 1 in 400 (0.25%) women having surgery for fibroids.
- They usually shrink after menopause; most decrease in size at menopause.
Types of fibroids
Fibroids are described by where they grow. Symptoms and treatment depend on their size, number and location.
Simptom fibroid: what are the symptoms?
Fibroids do not always cause symptoms. When they do, the NHS lists:
- heavy periods or painful periods; heavy bleeding is the most common symptom;
- stomach pain or lower back pain;
- peeing more often than usual, needing to pee suddenly, or leaking urine;
- problems pooing, such as bloating, constipation or pain when you poo;
- pain or discomfort during sex;
- difficulty getting pregnant.
Heavy bleeding over months can cause iron deficiency anaemia, with tiredness and breathlessness; see our guide to kurang darah (anaemia). Large fibroids pressing on the bladder can also lead to urinary infections or problems peeing (see our guide to UTI symptoms).
Punca fibroid: who gets fibroids?
The exact cause of fibroids is unknown, but according to the NHS you are more likely to get them if you:
- have not reached the menopause;
- have never had a full-term pregnancy;
- are overweight or obese;
- have high blood pressure or diabetes;
- are from a Black or Asian background;
- have a close relative who has fibroids.
Fibroid vs cyst: what is the difference?
Both are usually found on an ultrasound scan. The NHS advises getting urgent help for sudden, severe pelvic pain, or tummy pain with feeling or being sick, which can happen if an ovarian cyst splits or twists.
How are fibroids treated?
Diagnosis. A doctor will ask about your symptoms and examine your tummy and pelvis, and usually arrange an ultrasound scan to see how many fibroids there are, where they are and how big they are.
No symptoms: treatment is usually not needed.
Medicines for painful or heavy periods, according to the NHS:
- painkillers such as ibuprofen, naproxen or diclofenac (our period pain guide explains how to use them safely);
- tranexamic acid, or a hormone medicine such as the combined pill, to help with heavy bleeding.
Procedures and surgery, if medicines do not help, the fibroids are large, or symptoms are getting worse:
- myomectomy, removing the fibroids while keeping the womb;
- uterine artery embolisation (UAE), a non-surgical procedure that blocks the blood supply to the fibroids so they shrink;
- endometrial ablation, using heat to remove the lining of the womb;
- hysterectomy, removing the womb.
The best option depends on the size, number and location of your fibroids, your symptoms, and whether you want children in the future. The NHS notes that some treatments can stop you having children or increase the risk of problems in pregnancy, so discuss your plans with your doctor.
Fibroids and pregnancy
According to the NHS, fibroids can sometimes make it harder to get pregnant and, rarely, are linked with miscarriage. Fibroids are sometimes first found on a pregnancy scan. A large study reviewed in American Family Physician found a higher rate of caesarean delivery in women with fibroids (33.1% vs 24.2%), so extra monitoring during pregnancy is advised. If you are trying to conceive, see our guide to early signs of pregnancy.
When to see a doctor
According to the NHS, see a doctor if:
- you have symptoms of fibroids, such as heavy or painful periods;
- your symptoms are affecting your everyday life, work or relationships;
- painkillers are not helping.
Also see a doctor if your periods change, you bleed between periods or after sex, or you feel tired and breathless, which can be a sign of anaemia. Our guides to irregular periods and Pap smear and HPV screening cover other causes worth checking.
Frequently asked questions (FAQ)
What is a fibroid (fibroid maksud)?
A fibroid is a common, non-cancerous growth that develops in or around the womb (uterus). Fibroids are made of muscle and fibrous tissue and can range from tiny to large. They mainly affect women who have not yet reached the menopause, and many women have them without knowing.
What are the symptoms of fibroids?
Many fibroids cause no symptoms. When they do, symptoms can include heavy or painful periods, stomach or lower back pain, peeing more often or urgently, constipation or bloating, pain during sex, and difficulty getting pregnant.
Are fibroids cancer?
No. Fibroids are non-cancerous. The risk of a cancer called leiomyosarcoma is very low, estimated at about 1 in 400 women having surgery for fibroids, according to a review in American Family Physician.
What is the difference between a fibroid and a cyst?
A fibroid is a solid growth of muscle and fibrous tissue in or around the womb. An ovarian cyst is a fluid-filled sac on an ovary. Both are common and often cause no symptoms, and both are usually found on an ultrasound scan.
Do fibroids need to be removed?
Not always. Fibroids that cause no symptoms usually do not need treatment. If they cause heavy bleeding or pain, medicines may help; if not, options include surgery to remove the fibroids (myomectomy), uterine artery embolisation, or removing the womb (hysterectomy).
Can I get pregnant if I have fibroids?
Fibroids can sometimes make it harder to get pregnant, and rarely cause miscarriage. In pregnancy, fibroids are linked with a higher chance of caesarean delivery, so extra monitoring is advised. If you plan to have children, discuss treatment options with your doctor, as some treatments affect fertility.
Do fibroids shrink after menopause?
Usually, yes. Most fibroids decrease in size at menopause, which is why symptoms often improve afterwards.
Disclaimer
This article is for general information only and is not a substitute for advice, diagnosis or treatment from a doctor. Health supplements are not intended to diagnose, treat, cure or prevent any disease.
References
- Fibroids — NHS
- Ovarian cyst — NHS
- De La Cruz MS, Buchanan EM. Uterine fibroids: diagnosis and treatment. Am Fam Physician. 2017;95(2):100-107.
- Baird DD, et al. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence. Am J Obstet Gynecol. 2003;188(1):100-107.
