Fibroids: Understanding Your Symptoms
Uterine fibroids are benign, non-cancerous growths that develop in and around the uterus. They are incredibly common, with approximately two in three women developing a fibroid at some point in their lifetime.
While many fibroids cause no issues, they are a major cause of debilitating heavy periods and pelvic pain. Understanding what drives their growth – primarily the female sex hormones – is the key to diagnosis and effective symptom management.
This article outlines everything you need to know about Fibroid. We’ll also explain how our Advanced At-Home Hormone and Fertility Test can uncover the root causes of your symptoms and step towards a quicker diagnosis.
Quick Facts:
- Fibroids are non-cancerous growths in or around the uterus made of muscle and fibrous tissue.
- They can cause symptoms like heavy or painful periods and abdominal pressure.
- Their growth is directly influenced by oestrogen and progesterone.
- Black women, particularly of Afro-Caribbean ancestry, are up to three times more likely to develop fibroids.
- Diagnosis requires a pelvic ultrasound scan alongside hormone testing.
What are Fibroids and Where Do They Grow?
Fibroids can vary dramatically in size, from as small as a pea to as large as a melon, and you may have one or multiple growths.
Their classification depends on their location within the uterine wall:
- Submucosal fibroids: Grow into the inner lining of the womb. These are most likely to cause heavy bleeding.
- Intramural fibroids: Grow within the muscular layer (myometrium) of the womb.
- Subserosal fibroids: Develop on the outside surface of the womb, often causing pelvic pressure and bloating.
Most people who develop fibroids are completely asymptomatic. However, about one in three will experience noticeable symptoms that impact their quality of life.
The Main Symptoms of Fibroids
The most common symptoms are related to the fibroid interfering with the uterus’s function or simply taking up space:
- Heavy and/or Painful Periods: This is the most frequent complaint. Fibroids, particularly those near the inner lining (submucosal), distort the uterine cavity and increase the surface area of the lining, leading to heavy bleeding and painful cramps.
- Abdominal Pressure and Bloating: Large fibroids or clusters can press on surrounding organs, causing abdominal pain, a feeling of fullness, and lower back pain.
- Urinary and Bowel Issues: Pressure on the bladder can cause a frequent need to urinate. Pressure on the bowel can lead to constipation.
- Painful Sex: Deep pain or discomfort during sex (dyspareunia) can occur, particularly if fibroids are in certain locations.
- Fertility Issues: Some fibroids, depending on their size and location (especially submucosal), can affect fertility by preventing sperm from fertilising an egg or stopping an embryo from successfully implanting.
💡 Think you have one or more of these symptoms? Don’t ignore them!
Heavy periods can lead to anaemia and severe fatigue. If you are regularly soaking through a period product every 1–2 hours, it’s time to investigate the cause. Take our Advanced At-Home Hormone and Fertility Test to investigate your symptoms and the underlying hormonal factors.
Hormonal Causes and Risk Factors
The exact trigger for fibroid development is unknown, but they are highly sensitive to reproductive hormones, making it clear that they are a hormonally driven condition.
Oestrogen and Progesterone Dependence
Fibroids are known to grow in response to both oestrogen and progesterone throughout the reproductive years.
- Oestrogen: This hormone encourages the growth of the uterine lining, and fibroid tissue contains more oestrogen receptors than normal uterine muscle. This is why fibroids typically grow when oestrogen levels are high (e.g., during pregnancy) and tend to shrink after menopause when hormone levels naturally decline.
- Progesterone: While progesterone’s role is complex, it is implicated in fibroid development. Some targeted medical treatments for fibroids work by directly blocking the action of progesterone.
The crucial link here is that the growth of fibroids is directly related to the hormonal environment of your body.
Risk Factors and Ethnicity
Certain risk factors increase the likelihood of developing fibroids:
- Age: Risk increases with age during the reproductive years (30 to 50).
- Weight: Being overweight or obese increases the level of circulating oestrogen in the body, which can promote fibroid growth.
- Ethnicity: Black women are significantly more likely to develop fibroids – up to three times more likely than white women (Michigan Medicine, 2020). They are also diagnosed at a younger age and are more likely to have larger, more rapidly growing fibroids. While little research exists to explain this, theories suggest links to genetic factors (such as Vitamin D deficiency) or certain environmental exposures.
Diagnosis and Management
If you are suffering from heavy or painful periods, or any of the above symptoms, it is essential to seek medical advice.
Diagnosis
A definitive diagnosis relies on two steps:
- Hormone Testing: A blood test screens for complications and hormonal causes. Since heavy bleeding is a primary symptom, you will likely be tested to screen for Iron Deficiency Anaemia (a common result of heavy blood loss).
- Pelvic Ultrasound Scan: This is the gold standard for locating, mapping, and measuring fibroids, which is essential for determining the appropriate course of treatment.
Hormone Testing’s Role
Testing a full panel of personalised hormones provides essential diagnostic data needed to find the root cause, tailored to your symptoms and concerns.
- Assess Bleeding Impact: Hormonal testing helps determine if the fibroids have led to secondary issues like iron deficiency anaemia.
- Guide Hormonal Therapy: Levels of oestradiol and LH/FSH help clinicians understand your overall hormonal environment before prescribing treatments like GnRH analogues (which temporarily reduce oestrogen to shrink fibroids) or hormonal contraceptives (to reduce bleeding).
- Rule Out Other Conditions: Testing can rule out other hormonal causes of heavy bleeding, such as thyroid dysfunction (by testing thyroid-stimulating hormone (TSH) and free thyroxine), which can sometimes mimic fibroid symptoms.
Treatment Options
Treatment depends entirely on the size, location, and severity of your symptoms, as well as your family-forming goals (NHS, 2022).
- Non-Surgical (Symptom Management): Medications like tranexamic acid or anti-inflammatory drugs (NSAIDs) reduce bleeding and pain. Hormonal contraceptives (pills or IUDs) can also be used to create lighter, less painful periods.
- Hormone-Based Therapy: GnRH analogues are used to temporarily shrink fibroids before surgery by creating a menopause-like state (low oestrogen).
- Surgical Options: Procedures range from a Myomectomy (removal of fibroids while preserving the womb) to a Hysterectomy (complete removal of the womb, usually only considered if you do not want future children).
If you are struggling with your symptoms, you deserve a personalised care plan that explores all available options.
💡 Find out what your hormones are telling you
Don’t suffer through heavy or painful periods. Take our Advanced At-Home Hormone and Fertility Test to investigate the underlying hormonal factors and screen for complications like anaemia.
References
- https://www.nhs.uk/conditions/fibroids/
- https://www.nice.org.uk/guidance/conditions-and-diseases/gynaecological-conditions/endometriosis-and-fibroids
