Fibroids - some useful information

Fibroids are non-cancerous growths from the muscle of the uterine wall. Professor Manyonda and Dr Talaulikar discuss when they need treatment and how they are treated.

Fibroids are non-cancerous growths from the muscle of the uterine wall. When they occur in the uterus, they are well circumscribed tumors arising from the smooth muscle layer (myometrium) of the uterus. Other names for these tumors include:

• Leiomyoma
• Fibromyomas
• Fibromas
• Myofibromas
• Myomas

Uterine fibroids are the most common tumour in women during the reproductive years, occurring in an estimated 20-50% of women over the age of 30 years. They are more common in certain ethnic populations, especially Afro-Caribbeans. They can be found in up to half of all women undergoing a post-mortem examination.

Fibroids can cause heavy menstrual bleeding, pelvic pressure and pain in the abdomen. They can also sometimes make it difficult for a woman to carry a pregnancy to term. Symptoms may vary depending on the location of the fibroid in the uterus.

The presence of fibroids does not mean that they need to be treated (if there are no symptoms). It is extremely rare for fibroids to become malignant. Treatment for fibroids depends upon the symptomatology and presence of related conditions. However, the presence of uterine fibroids can cause problems which can be solved by:

• Surgery - myomectomy (preserves child-bearing)
• Surgery - hysterectomy
• Uterine artery embolisation (UAE)
• Medical therapy
• Focused high intensity ultrasound therapy

How does the menopause affect fibroids?

After the menopause, when the levels of oestrogen are low, fibroids can no longer grow. In some women, the fibroids may shrink / degenerate due to inadequate blood supply to them, but this is uncommon.

Can women with fibroids still have HRT?

The vast majority of women with fibroids can safely take HRT without any problems. The doses of oestrogen in HRT are very low, so they are not usually high enough to stimulate the fibroids. Occasionally, having HRT can cause fibroids to grow or bleed. Women taking HRT can still have effective treatments for their fibroids.

For more information, you can contact Professor Manyonda and Dr Talaulikar at the Menopause Clinic, London