Fibroids may not cause you any symptoms. You may get one or more of the symptoms listed below, often depending on where the fibroid is within your womb. You may:
- have heavy periods, sometimes leading to anaemia
- have swelling in your tummy (abdomen)
- feel pain in your pelvis
- pass urine more often, or feel an urgent need to pass urine – this happens if a fibroid is pressing on your bladder
- have constipation – this happens if a fibroid is pressing on your bowel
You can get severe pain if your fibroid twists or outgrows its blood supply causing it to break down, but this is rare.
Fibroids are sometimes found during a routine gynaecological (vaginal) examination.
Your GP will ask about your symptoms and your medical history. You may be advised to have a vaginal examination if they think you have fibroids. This involves your GP inserting gloved, lubricated fingers into your vagina to gently feel for any abnormalities in your womb or cervix. At the same time, they will use their other hand to lightly press on your tummy.
Your GP will be able to check the size of your womb. This is important because fibroids can make your womb larger than normal. If your doctor thinks you may have fibroids, they may suggest you have further tests. These may include the following.
- An ultrasound scan. This uses sound waves to produce an image of your pelvis and can confirm if you have fibroids.
- Hysteroscopy. This is a test that involves your doctor putting a small camera into your vagina to look inside your womb. It can diagnose if you have submucosal fibroids. At the same time a biopsy of the lining of your womb can also be taken. A biopsy is when a small sample of tissue is taken.
- An MRI scan. This uses magnets and radio waves to produce an image of your lower abdomen. An MRI scan can show how many fibroids you have, how big they are and where they are in your womb.
- Laparoscopy. This is a test that also involves using a small camera, but it’s inserted through a small cut into your abdomen under general anaesthetic. This means you’ll be asleep during your procedure. A laparoscopy is used to look at your womb and your other organs within your pelvis. It’s usually used to see if you have any other problems other than fibroids.
- Blood tests. These can check if you have anaemia.
There are a number of treatment options for fibroids. Which treatments you’re offered will depend on a number of things.
It’s important to let your doctor know if you’re planning on having a baby in the future. This is because some of the treatments for fibroids can affect your chances of getting pregnant. Speaking to your doctor about your wish to have a baby can help them suggest the most suitable treatment options for you.
Your treatment choices will also depend on:
- the size of your fibroids
- how many fibroids you have
- the location of your fibroids
- the symptoms you’re having
Your doctor will discuss your treatment options with you to help you make a decision that’s right for you. Your decision will be based on your doctor’s expert opinion and your own personal values and preferences.
If you don't have any symptoms, or if your symptoms are mild, you may not need treatment. But if you have more severe symptoms, there’s a range of treatment options that may help.
Medicines can’t cure fibroids, but hormone-based treatments may help to relieve your symptoms.
Medicines to help relieve pain
Non steroidal anti-inflammatory (NSAID) medicines such as ibuprofen may help to relieve any pain you have. You can buy ibuprofen from a pharmacy, supermarket or other shops, without a prescription from your GP. NSAIDs can cause side-effects such as feeling sick (nausea), headache and diarrhoea. If you’re finding you need to take these medicines for a long period of time, or they aren’t helping to ease your pain, see your doctor.
Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist or your doctor for advice.
Medicines that reduce heavy bleeding
There are a number of different medicines that can be used to reduce heavy bleeding during your periods. Some of these also act as contraception. For example, the levonorgestrel-releasing intrauterine system is a small device that’s placed in your womb. It stops the lining of your womb from growing quickly, making the bleeding lighter during your periods.
If you have very heavy or painful periods, you doctor might suggest that you take a medicine called tranexamic acid or mefenamic acid. Alternatively, your doctor may offer you the combined oral contraceptive pill.
A type of contraceptive medicine called progestogen may help to treat heavy bleeding during your periods. You can have this as an injection once every 12 weeks for as long as you need it. For more information about contraception, see our FAQ.
Medicines that shrink your fibroids
Treatment with medicines called gonadotropin-releasing hormone analogues (GnRH analogues) can lower your oestrogen levels, which usually shrinks fibroids.
If you're having surgery to remove fibroids, your doctor may prescribe you GnRH analogues such as goserelin or leuprorelin acetate. You take these for three to four months before your surgery to make it easier for your surgeon to remove your fibroids.
GnRH analogues can cause you to have symptoms similar to the menopause whilst you take them. Symptoms may include hot flushes and, if used in the long-term, osteoporosis (thinning of your bones). Therefore, you can only take GnRH analogues for a maximum of six months.
There are a number of surgical options for treating fibroids.
Surgical treatment options if you want to have a baby in the future
Myomectomy is a procedure that removes your fibroids but leaves your womb in place. It may be done through a cut in your abdomen (tummy), or sometimes it may be possible for your surgeon to use keyhole (laparoscopic) surgery. A myomectomy is done under general anaesthetic so you will be asleep during the procedure.
You may be offered a myomectomy if you would like the option to become pregnant in the future. However, as your womb isn't removed there’s a chance that more fibroids will grow. This means there’s a chance that you may need to have further treatment.
Uterine artery embolisation (UAE)
In this procedure, a small tube is guided from a vessel in your leg into the blood supply of your fibroid. A chemical is then injected through this tube, which blocks the blood supply to your fibroid, causing it to shrink.
You will be offered a local anaesthetic if you have UAE. This means that feeling in the affected area is completely blocked, but you will stay awake during the procedure. You might also be offered a sedative to help you relax.
UAE may help to relieve your symptoms for up to two years. However, your symptoms might return, so you may need to have more treatment.
Although it may be possible to become pregnant after you’ve had UAE, doctors aren’t sure about how the procedure affects fertility and pregnancy. Therefore, if you wish to become pregnant in the future, it’s important that you talk to your doctor about the potential risks of having this procedure. They will help you decide whether UAE is the best option for you.
Surgical treatment options if you don’t want to have a baby in the future
This is a major procedure to remove your entire womb and can be done as open or keyhole surgery. Usually, your surgeon will remove your womb and/or your ovaries through your abdomen or your vagina. If you have a hysterectomy, your symptoms will get better and you won’t get any more fibroids. It's not possible to get pregnant after having a hysterectomy.
Endometrial ablation is a procedure which removes the lining of your womb. This is done using energy, such as microwaves, or heat. If you decide to have this procedure, you will be offered either a general or a local anaesthetic.
Endometrial ablation is typically used to treat heavy bleeding during your periods. It’s important to remember that, your symptoms may return after having this procedure and so you might need to have further treatment. Becoming pregnant after an endometrial ablation is unlikely, but can still happen. However, this procedure isn’t suitable if you’d like to have a baby. This is because you’re more likely to have a miscarriage or other complications after you’ve had an endometrial ablation. It’s important to remember that you’ll need to use contraception after your treatment. If you would like more information about this, talk to your doctor about your treatment options.
We don’t know for sure what causes fibroids. But it’s thought that certain hormones, such as oestrogen and progesterone may encourage them to grow.
You're more likely to get fibroids if you:
- are aged 30 to 50
- go through puberty at an early age
- are overweight
- are African-Caribbean – women of this background are three times more likely than Caucasian women to get fibroids
- don’t have any children
Most women with fibroids can have a normal pregnancy and delivery, but, there can be some complications. For example, submucosal fibroids can affect your womb, which can make it more difficult for you to become pregnant.
In later pregnancy, fibroids can cause your baby to lie in the breech position (with their feet or bottom first rather than their head downwards). Because of this, you may need to have a caesarean section to deliver your baby. Sometimes fibroids can cause other problems such as miscarriage, premature labour and bleeding.
If you're pregnant and have fibroids, your GP may refer you to an obstetrician (a doctor who specialises in pregnancy and childbirth) for specialist care. It’s very rare for fibroids to become cancerous. However, if you’re getting increasing abdominal pain or swelling that happens very suddenly, see your doctor.
Is it possible for fibroids to come back after surgery?
Yes, there’s a chance that they will come back after surgery, unless you have a hysterectomy.
The only way to completely get rid of fibroids is to have a hysterectomy. This is a procedure which removes your entire womb.
After having a hysterectomy you won't be able to have any children. If you plan on having a baby you’ll need to consider having a different type of surgery, such as a myomectomy, or a non-surgical treatment instead. Speak to your GP or gynaecologist (a doctor specialising in women's reproductive health) for advice on which treatment is the most suitable for you.
Will the symptoms of fibroids improve after I’ve gone through the menopause?
Yes, fibroids tend to shrink after the menopause so your symptoms should improve.
After the menopause, the amount of the hormone oestrogen in your body decreases. This will usually cause your fibroids to gradually shrink, and in turn, your symptoms should lessen or go away completely.
If you're approaching the menopause you might want to wait and see if your symptoms get better before you consider having any surgery. Speak to your GP or gynaecologist for advice as to what might be the best option for you.
Can contraception treat the symptoms of fibroids?
Yes, contraception can be used to treat some of the symptoms of fibroids.
There are different types of contraception that can be used to help with the symptoms of fibroids. It’s important to talk to your GP about your treatment options and whether you wish to have a baby in the future. This can help your GP advise you on the best treatment for you.
The combined contraceptive pill can be used to help with the symptoms of fibroids, such as heavy, painful periods. It contains the hormones oestrogen and progesterone and comes as tablets that you take every day for 21 days and then you have a seven day break.
The combined contraception pill is suitable if you’re not trying or planning to have a baby. There are other reasons why it may not be suitable, including if:
- you’re overweight
- you’re over the age of 35
- you smoke
- you have high blood pressure
The levonorgestrel-releasing intrauterine system (LNG-IUS) is another type of contraception that can help reduce the symptoms of fibroids. It’s a small device that’s placed in your womb for at least 12 months. The LNG-IUS prevents the lining of your womb from growing quickly, which in turn reduces the amount of bleeding during your periods.
Progestogen is also a type of contraception that may be used to reduce heavy bleeding during your periods. If your GP thinks that this might be a good treatment option for you, you may be given this as an injection. You can have this injection once every 12 weeks for as long as you need it. It’s worth bearing in mind that it can take a few months for your fertility to get back to normal after stopping the injections.
Speak to your GP for more information about the treatments that are available.
- Women's Health Concern
- Fibroids. NICE Clinical Knowledge Summaries. cks.nice.org,uk, published February 2013
- Uterine fibroids. The Merck Manuals. www.merckmanuals.com, published September 2013
- Fibroids. British Society of Interventional Radiology. www.bsr.org, accessed 7 July 2014
- Fibroids. PatientPlus. www.patient.co.uk/patientplus.asp, published 13 January 2013
- Menorrhagia. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published August 2012
- Uterine fibroids. BMJ Best Practice. www.bestpractice.bmj.com, published 1 December 2014
- Breech presentation. Medscape. www.emedicine.medscape.com, published 9 July 2012
- Pregnancy. Oxford handbook of general practice (online). Oxford Medicine Online. www.oxfordmedicine.com, published April 2014
- Gyneacological history and examination. PatientPlus. www.patient.co.uk/patientplus.asp, published 18 March 2011
- Martin, EA. Concise colour medical dictionary. 3rd ed. Oxford: Oxford University Press; 2002: 715, 401 (printed version)
- Joint Formulary Committee. British National Formulary (online) London: BMJ Group and Pharmaceutical Press. www.medicinescomplete.com, accessed 10 December 2014
- Contraception - IUS/IUD. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published June 2012
- Intrauterine system. PatientPlus. www.patient.co.uk/patientplus.asp, published 2 April 2014
- Progestogen-only injectable contraceptives. PatientPlus. www.patient.co.uk/patientplus.asp, published 19 October 2011
- Heavy menstrual bleeding. National Institute for Health and Care Excellence (NICE), 2007. www.nice.org.uk
- Uterine artery embolisation for fibroids. National Institute for Health and Care Excellence (NICE), 2010. www.nice.org.uk
- Uterine artery embolisation in the management of fibroids. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published 23 December 2013
- Uterine artery embolism for fibroids. National Institute for Health and Care Excellence (NICE), 2010. www.nice.org.uk
- Information for you after an endometrial ablation. Royal College of Obstetricians and Gynaecologists. www.rcog.org.uk, published 9 July 2010
- Endometrial ablation. American Society for Reproductive Medicine. www.asrm.org, published 2011
- Endometrial ablation. American College of Obstetricians and Gyneacologists. www.acog.org, accessed 10 September 2014
- Menopause. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published June 2013
- Contraception – general overview. PatientPlus. www.patient.co.uk/patientplus.asp, published 5 November 2012
- Women's Health Concern
We’d love to know what you think about what you’ve just been reading and looking at – we’ll use it to improve our information. If you’d like to give us some feedback, our short form below will take just a few minutes to complete. And if there's a question you want to ask that hasn't been answered here, please submit it to us. Although we can't respond to specific questions directly, we’ll aim to include the answer to it when we next review this topic.
Let us know what you think using our short feedback form Ask us a question
Reviewed by Hemali Bedi, Bupa Health Information Team, December 2014
Let us know what you think using our short feedback form Ask us a question
About our health information
At Bupa we produce a wealth of free health information for you and your family. We believe that trustworthy information is essential in helping you make better decisions about your health and care. Here are just a few of the ways in which our core editorial principles have been recognised.
Information StandardWe are certified by the Information Standard. This quality mark identifies reliable, trustworthy producers and sources of health information.
What our readers say about us
But don't just take our word for it; here's some feedback from our readers.
“Simple and easy to use website - not alarming, just helpful.”
“It’s informative but not too detailed. I like that it’s factual and realistic about the conditions and the procedures involved. It’s also easy to navigate to areas that you specifically want without having to read all the information.”
“Good information, easy to find, trustworthy.”
Meet the team
Head of health content and clinical engagement
- Dylan Merkett – Lead Editor – UK Customer
- Nicholas Ridgman – Lead Editor – UK Health and Care Services
- Natalie Heaton – Specialist Editor – User Experience
- Pippa Coulter – Specialist Editor – Content Library
- Alice Rossiter – Specialist Editor – Insights
- Laura Blanks – Specialist Editor – Quality
- Michelle Harrison – Editorial Assistant
Our core principles
All our health content is produced in line with our core editorial principles – readable, reliable, relevant – which are represented by our diagram.
In a nutshell, our information is jargon-free, concise and accessible. We know our audience and we meet their health information needs, helping them to take the next step in their health and wellbeing journey.
We use the best quality and most up-to-date evidence to produce our information. Our process is transparent and validated by experts – both our users and medical specialists.
We know that our users want the right information at the right time, in the way that suits them. So we review our content at least every three years to keep it fresh. And we’re embracing new technology and social media so they can get it whenever and wherever they choose.
Here are just a few of the ways in which the quality of our information has been recognised.
The Information Standard certification scheme
You will see the Information Standard quality mark on our content. This is a certification programme, supported by NHS England, that was developed to ensure that public-facing health and care information is created to a set of best practice principles.
It uses only recognised evidence sources and presents the information in a clear and balanced way. The Information Standard quality mark is a quick and easy way for you to identify reliable and trustworthy producers and sources of information.
Certified by the Information Standard as a quality provider of health and social care information. Bupa shall hold responsibility for the accuracy of the information they publish and neither the Scheme Operator nor the Scheme Owner shall have any responsibility whatsoever for costs, losses or direct or indirect damages or costs arising from inaccuracy of information or omissions in information published on the website on behalf of Bupa.
British Medical Association (BMA) patient information awards
We have received a number of BMA awards for different assets over the years. Most recently, in 2013, we received a 'commended' award for our online shared decision making hub.
If you have any feedback on our health information, we would love to hear from you. Please contact us via email: firstname.lastname@example.org. Or you can write to us:
Health Content Team
15-19 Bloomsbury Way