Uterine fibroids are common, non-cancerous growths that develop in or around the uterus and can affect women of different ages. Being diagnosed with fibroids can cause concern, especially when there is limited understanding of the condition. While some women with fibroids may have no symptoms, others may experience heavy menstrual bleeding, pelvic pain, abdominal pressure, or frequent urination. Understanding the causes, symptoms, and treatment options for fibroids can help women recognise possible signs and seek appropriate medical advice. Treatment depends on the size, location, symptoms, and individual circumstances, and some fibroids may not require treatment.
What Are Fibroids?
Fibroids are non-cancerous growths that develop in or on the wall of the uterus. They are made of muscle and fibrous tissue, and they are, by far, the most common non-cancerous growth affecting women during their reproductive years. The word "tumour" understandably alarms people, but it is worth saying clearly: fibroids are not cancer, and turning into cancer is extremely rare.
Fibroids vary a great deal in size, from as small as a pea to, occasionally, as large as a melon, and a woman can have just one or several at the same time. Depending on where they sit in the uterus, doctors describe them as:
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Intramural fibroids
growing within the muscular wall of the uterus. These are the most common type. -
Submucosal fibroids
growing just under the inner lining of the uterus. These tend to cause the heaviest bleeding, even when small. -
Subserosal fibroids
growing on the outer surface of the uterus, sometimes pressing against nearby organs such as the bladder or bowel. -
Pedunculated fibroids
less common, attached to the uterus by a narrow stalk.
Causes of Fibroids
It is difficult to ascertain what triggers fibroids to form. Here are some common factors that increase the risk of fibroids:
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Hormones
Oestrogen and progesterone, the hormones that regulate your monthly cycle, also encourage fibroids to grow. This is why fibroids are found almost exclusively during the reproductive years, and why they tend to shrink after menopause, once these hormone levels fall. -
Family history
If your mother or a sister has had fibroids, your own risk is higher. -
Age and time since your last pregnancy
Fibroids become more common as women get older through their thirties and forties, and are somewhat less common in women who have had children. -
Diet and weight
A diet high in red meat and low in vegetables, along with being significantly overweight, has been linked to a higher risk.
None of these factors are anyone's fault, and having one or more of them does not mean you will definitely develop fibroids. They simply help explain why some women are affected and others are not.
Common Symptoms of Fibroids
This is perhaps the most important part for patients to understand: many women with fibroids have no symptoms at all, and only discover them during a routine scan or pelvic examination. For others, symptoms can genuinely disrupt daily life. These commonly include:
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Heavy or prolonged periods
sometimes with clots, that soak through pads or cloths faster than expected. -
Pelvic pain or pressure
which can spread to the lower back. -
A feeling of fullness or swelling
in the lower abdomen. -
Frequent urination
caused by a fibroid pressing on the bladder. - Constipation or a feeling of rectal pressure.
- Pain during intercourse.
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Tiredness and breathlessness
which are often signs of anaemia from ongoing blood loss, not simply "being run down."
If you notice sudden, severe pelvic pain, this needs urgent medical attention, as it can occasionally signal a fibroid outgrowing its own blood supply.
How are Fibroids Diagnosed?
Diagnosis usually starts with a straightforward conversation about your periods, pain, and general health, followed by a pelvic examination. If your doctor suspects fibroids, an ultrasound scan is normally the next step. It is quick, painless, and gives a clear picture of the size, number, and position of any growths. Occasionally, an MRI scan is used for more detail, particularly if surgery is being planned.
At our hospital, we encourage every woman, whether or not she has symptoms, to keep up with regular gynaecological check-ups. Fibroids caught early are far easier to manage, and a scan can offer real peace of mind even when nothing is found.
What Happens If Fibroids Are Left Untreated?
Most fibroids cause no serious harm even without treatment. However, if heavy bleeding continues unaddressed for a long time, it can lead to anaemia, leaving you persistently tired and weak. Large fibroids can press on nearby organs, and in some cases, fibroids can make it harder to conceive, or slightly raise the risk of miscarriage or early labour. This is why it is worth discussing your symptoms with a doctor rather than simply living with them, particularly if you are planning a pregnancy.
Treatment Options for Fibroids
There is no single "correct" treatment for fibroids. The right approach depends on the size and position of your fibroids, how severe your symptoms are, and whether you hope to have children in the future. Your doctor should walk you through these considerations, not decide for you.
For mild symptoms, treatment often starts with medication:
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Hormonal therapy
such as birth control pills or a hormone-releasing intrauterine device (IUD), can reduce heavy bleeding. -
Pain relief medication
can ease cramping and discomfort. -
Iron supplements
may be needed if blood tests show anaemia from heavy bleeding. -
GnRH agonists
a stronger hormonal medication, can shrink fibroids temporarily and are often used to make surgery easier if it becomes necessary. Their effect is not permanent, and fibroids can regrow once the medication stops.
For larger fibroids or more severe symptoms, surgery may be recommended:
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Myomectomy
removes the fibroids themselves while preserving the uterus, making it the preferred option for women who wish to become pregnant in future. Depending on the size and position of the fibroids, this can be done through the vagina and cervix, through small abdominal incisions, or occasionally through a single larger incision for more complex cases. -
Hysterectomy
removes the uterus entirely and is the only treatment that guarantees fibroids will not return. This is generally considered only when childbearing is complete, or when symptoms are severe, and other treatments have not helped.
Each option carries its own recovery time and considerations, and your doctor should discuss the realistic benefits and risks of each with you before you decide together on a plan.
Fibroids Treatment at UMC Victoria Hospital, Uganda
At UMC Victoria Hospital in Kampala, Uganda, our gynaecology team assesses each case individually, starting with an ultrasound to understand the size, number, and position of your fibroids. From there, we walk you through the options that genuinely fit your situation, whether that means monitoring, hormonal treatment, or a discussion about surgery, including fertility-preserving procedures for women planning future pregnancies. Our department also provides endometriosis treatment and ovarian cyst treatment, so if your symptoms turn out to be linked to a different underlying condition, you can continue your care with the same team. You are involved in every decision, with clear explanations at each step. If you have symptoms that concern you, or simply want a check-up, our doctors are available for a consultation to guide you through next steps.
