Uterine fibroids are the most common benign tumours in women of reproductive age, yet they remain widely misunderstood. This guide covers the essential facts clearly — causes, types, symptoms, and what your options actually are.
What Are Fibroids?
Uterine fibroids (also called uterine leiomyomas or myomas) are benign (non-cancerous) growths of smooth muscle tissue that develop within or around the uterine wall. They range from the size of a pea to the size of a melon. A woman may have one fibroid or dozens. Most women with fibroids are not aware of them — fibroids are often discovered incidentally during routine pelvic ultrasounds.
Types of Fibroids
Submucosal — grow into the uterine cavity. Most likely to cause heavy bleeding and fertility issues. Intramural — grow within the uterine wall. Most common type. Can cause significant symptoms when large. Subserosal — grow on the outer surface of the uterus. Can become large without causing heavy bleeding but may cause pelvic pressure, urinary frequency, and back pain. Pedunculated — attached to the uterus by a stalk, either inside or outside.
Causes and Risk Factors
The precise cause is not fully understood, but estrogen and progesterone are clearly involved — fibroids develop during reproductive years and regress after menopause. Risk factors include family history (fibroids have a strong genetic component), Black ethnicity (significantly higher prevalence and earlier onset), vitamin D deficiency, obesity, and early age of menarche.
Symptoms
Many fibroids are asymptomatic. When symptoms occur they include heavy or prolonged periods, pelvic pressure, frequent urination, lower back pain, bloating, and pain during sex. See our detailed guide on fibroid bloating and our article on fibroids and weight gain for more on specific symptoms.
Your Options
Options range from watchful waiting (for asymptomatic or minimally symptomatic fibroids) to lifestyle and natural management, hormonal treatment, minimally invasive procedures (UFE, hysteroscopic resection, MRI-guided ultrasound), and surgery. The right approach depends entirely on your fibroid type, size, symptoms, and whether fertility is a consideration. See our overview of natural approaches and our guide on hormonal drivers for practical next steps.
