🟤 Men's Health

Uterine Fibroids — Long-Term Management

Living with fibroids — monitoring, treatment, and fertility.

Uterine fibroids are non-cancerous muscle growths in the uterus that affect up to 80% of Black African women by age 50 — the highest rate of any ethnic group globally. Most fibroids cause no symptoms. When they do, the impact on quality of life can be significant — but effective management options exist.

Signs and Symptoms

✓ Heavy, prolonged periods (the most common symptom)

✓ Pelvic pressure or fullness

✓ Frequent urination — fibroids pressing on the bladder

✓ Constipation — fibroids pressing on the bowel

✓ Pain during periods

✓ Pain during sex

✓ Abdominal enlargement (larger fibroids)

✓ Anaemia from blood loss — fatigue, breathlessness, pallor

✓ Difficulty conceiving or recurrent miscarriage

✓ Many fibroids cause NO symptoms — found incidentally on scans

Risk Factors

African descent — 2–3x higher prevalence than other ethnicities
Age 30–50 — fibroids grow under oestrogen stimulation
Family history of fibroids
Early menarche (periods starting before age 11)
Obesity
Dietary factors — high red meat consumption associated with increased risk

When to Seek Help

SoonHeavy periods causing anaemia, significant pelvic pain, or pressure symptoms affecting daily life — treatment options can significantly improve quality of life.

SoonDifficulty conceiving with known fibroids — particularly submucosal fibroids that may need treatment before or alongside fertility treatment.

RoutineKnown fibroids without significant symptoms — annual monitoring ultrasound and blood count to track size and anaemia.

Tests & Diagnosis

🧪 Pelvic Ultrasound

The primary test for diagnosing and measuring fibroids — identifies number, size, location, and relationship to the uterine cavity.

🧪 Full Blood Count (FBC)

To assess for iron-deficiency anaemia from blood loss. Haemoglobin below 10g/dL warrants iron treatment and consideration of interventions to reduce bleeding.

🧪 MRI (Pelvis)

More detailed mapping of fibroids before surgery or uterine artery embolisation.

🧪 Hysteroscopy

Direct examination of the uterine cavity — identifies submucosal fibroids that distort the cavity and can be treated during the same procedure.

Treatment Options

Watchful Waiting

For small, asymptomatic fibroids — regular monitoring with no treatment. Fibroids shrink significantly at menopause. This is appropriate for many women.

Medical Management

Iron supplementation for anaemia. Hormonal treatments (Mirena IUS, GnRH analogues) reduce bleeding and fibroid size — used to manage symptoms or prepare for surgery.

Endometrial Ablation

Destroys the uterine lining to reduce heavy bleeding. Not suitable if future pregnancy is desired.

Myomectomy (Fibroid Removal)

Surgical removal of fibroids while preserving the uterus. The preferred option for women who want to maintain fertility.

Hysterectomy

Definitive cure — removal of the uterus. Appropriate for women who have completed their family and have significant symptoms.

Uterine Artery Embolisation (UAE)

A radiological procedure that blocks the blood supply to fibroids, causing them to shrink. Preserves the uterus.

Frequently Asked Questions

Do fibroids turn into cancer?

Virtually never. Less than 0.1% of fibroids contain cancerous change. Fibroids themselves are benign.

Will fibroids go away on their own?

Fibroids shrink after menopause when oestrogen levels drop. Before menopause, they generally grow slowly. They do not disappear without intervention.

Can fibroids affect pregnancy?

Most women with fibroids have normal pregnancies. Some — particularly large fibroids or those distorting the uterine cavity — can affect implantation or increase miscarriage risk. Specialist monitoring is recommended.

What is the best treatment for fibroids?

It depends on symptoms, size, location, age, and whether you want more children. There is no single "best" treatment — we tailor management to your situation.

Can diet reduce fibroids?

Research is promising. A diet rich in vegetables, fruit, and dairy, and low in red meat, may reduce fibroid risk. Vitamin D deficiency has been linked to larger fibroids.