Uterine Fibroid Symptoms and Non-Surgical Treatment Options

Uterine fibroids are the most common benign masses in the female reproductive system. They typically make themselves known through heavy menstrual bleeding, pelvic pain, or a feeling of pressure in the abdomen. The good news is that most fibroids are not cancerous. Thanks to advancing medical technology, they can often be treated successfully with minimally invasive or non-surgical methods, without the need for a major operation.

• Fibroids are benign (non-cancerous) growths developing from the muscle tissue of the uterus.
• Approximately 70 to 80 percent of women of reproductive age will develop a fibroid at some point in their lives.
• The most common symptoms include prolonged periods with blood clots and groin pain.
• Diagnosis is usually quick, made during a routine gynaecological exam and ultrasound.
• Treatment options range from medical management and blocking the uterine blood vessels (embolisation) to surgical procedures.

What is a Uterine Fibroid?

A uterine fibroid (medically known as a leiomyoma) is a benign tumour originating from the smooth muscle tissue of the uterus. Their size can vary dramatically—from as small as an apple seed to as large as a melon, which can distort the shape of the uterus and reach all the way up to the rib cage. You might have just a single fibroid, or multiple growths scattered within and around the uterus.

Highly common among women of reproductive age, these masses are usually diagnosed in a woman's 30s or 40s. As women enter menopause and female hormone levels naturally drop, fibroids typically shrink in size. Medical professionals categorise fibroids into three main groups based on where they grow. Those that bulge into the inner lining of the uterus are called submucosal; those confined within the muscular wall are intramural; and those growing outward from the surface of the uterus are subserosal fibroids. Each type causes different symptoms, and your doctor will tailor your treatment plan based on this exact location.

Causes and Risk Factors

While the exact cause of fibroids remains somewhat of a mystery, science has proven that genetics and hormones play a massive role in their development. Oestrogen and progesterone, the hormones that thicken the uterine lining each month in preparation for pregnancy, are known to fuel fibroid growth. Because of this, fibroids can grow rapidly during pregnancy when hormone levels are surging, whereas they tend to shrink during menopause as those hormones taper off.

Genetic predisposition is another major risk factor. If your mother or sister has a history of fibroids, your chances of developing them are significantly higher. Additionally, starting your period at an early age (before 10), obesity, vitamin D deficiency, a diet high in red meat and low in green vegetables, and alcohol consumption are all factors that can increase your risk. While maintaining a healthy weight and eating a balanced diet won't completely eliminate the risk of fibroids, it can certainly help keep them under control.

Symptoms of Uterine Fibroids

Many women go about their daily lives without ever realising they have fibroids, simply because small masses often cause no symptoms at all. However, as the growths enlarge or if they sit close to the uterine lining, symptoms can emerge that seriously disrupt your quality of life. The most frequent complaint is menstrual bleeding that is far heavier and lasts much longer than usual. Patients often ask, "Do fibroids cause bleeding?" The answer is yes; submucosal fibroids in particular can interfere with the uterus's ability to contract, leading to severe, clotted bleeding that can eventually cause anaemia.

Beyond bleeding, a constant feeling of heaviness, fullness, or pressure in the pelvic area (the lower abdomen and groin) is very common. Symptoms shift depending on the size of the fibroid and which organs it might be pressing against. A fibroid pressing on the bladder can make you feel like you need to urinate constantly or can't fully empty your bladder, while masses pressing against the bowels can cause chronic constipation. Furthermore, pain during intercourse, or unexplained pain radiating to your back or legs, can also be red flags. Because these symptoms vary so much from person to person, a proper medical evaluation is essential.

Diagnosis: How is it Diagnosed at the Hospital?

A fibroid diagnosis is often made by chance during a routine gynaecological check-up. Your doctor might notice that your uterus feels irregular in shape or larger than normal during a pelvic exam. To confirm the diagnosis and pinpoint the exact number, size, and location of the fibroids, the first method of choice is usually a transvaginal or abdominal ultrasound. Ultrasound uses sound waves to provide a clear picture of the inside of the uterus and is a completely painless procedure.

In more complex cases, or if surgery is being considered, Magnetic Resonance Imaging (MRI) might be requested to map out the uterus in much greater detail. For patients whose primary complaint is bleeding, doctors may use hysteroscopy (examining the inside of the uterus with a tiny camera) or sonohysterography (an ultrasound performed after filling the uterus with fluid). Regular gynaecological check-ups are critical, not just for catching fibroids, but for the early detection of cervical diseases. Just like the Smear Test, regular screenings are the most fundamental step in protecting female reproductive health.

Fibroid Treatment and Non-Surgical Methods

Fibroid treatment is completely personalised, based on the patient's age, the severity of her symptoms, her desire to have children, and the size of the fibroids. For small, symptom-free fibroids, a "watch and wait" approach is usually adopted; patients are monitored with regular ultrasounds. For those suffering from severe bleeding and pain, the first step is often medication. While hormone-based drugs, painkillers, or medications that reduce bleeding can ease symptoms, they do not make the fibroids disappear completely.

Non-surgical fibroid treatment options have advanced significantly in recent years. Minimally invasive methods like uterine artery embolisation (blocking the blood vessels that feed the fibroid to shrink the mass) and MRI-guided focused ultrasound (HIFU) provide excellent results for suitable patients. However, if the masses are very large, growing rapidly, or failing to respond to other treatments, fibroid surgery becomes necessary. If a patient wishes to preserve her fertility, a myomectomy (removing only the fibroid, usually via a closed, laparoscopic method) is preferred. For patients who do not wish to have children and are experiencing debilitating symptoms, a hysterectomy (complete removal of the uterus) offers a definitive cure.

Complications and Risk Groups

Although fibroids are generally not life-threatening, leaving them untreated can lead to complications that deeply affect your quality of life. The most common complication is iron-deficiency anaemia, driven by excessive menstrual bleeding. Anaemia restricts daily activities by causing persistent fatigue, weakness, pale skin, and shortness of breath.

Another critical area of risk involves reproductive health and pregnancy. Fibroids that bulge into the uterine cavity (submucosal) can make it difficult for an embryo to implant, potentially paving the way for infertility. If you already have fibroids during pregnancy, the surge in hormones can cause them to grow, leading to severe pain. Furthermore, fibroids increase the risk of serious pregnancy complications such as recurrent miscarriages, premature birth, breech presentation of the baby, or placental abruption (the placenta separating early). Therefore, it is highly important for women planning a pregnancy to undergo a detailed gynaecological evaluation beforehand.

When to See a Doctor

Even though fibroids are slow-growing, certain symptoms require prompt evaluation by a specialist. If your periods last longer than a week, are heavy enough to require changing a pad or tampon every hour, and are accompanied by large blood clots, you must see a doctor. Similarly, if you experience bleeding or spotting between periods, a constant feeling of heaviness in your pelvis, or unexplained chronic pain, seeking medical support is essential.

In some cases, emergency medical intervention may be required. If you experience any of the following symptoms, you should immediately go to the nearest emergency room or call 112:

• Sudden, very severe, sharp, or stabbing pain in the groin or abdomen (this could be a sign that a fibroid has twisted on its stalk or is degenerating).
• Severe dizziness, lightheadedness, or feeling faint due to excessive blood loss.
• Inability to urinate or a complete halt in bowel movements accompanied by abdominal bloating.

The Process at BHT CLINIC

Patients suspecting they have fibroids, or those who have already been diagnosed, are meticulously evaluated by our expert medical team in the Obstetrics and Gynaecology department at our hospital. During your first consultation, a detailed medical history is taken, and the internal structure of your uterus is examined using our advanced ultrasound equipment. If deemed necessary, advanced imaging like MRI can be scheduled on the same day to quickly establish a definitive diagnosis. Throughout the treatment process, we offer the most up-to-date options—ranging from medical management to closed (laparoscopic) surgery—while carefully considering the patient's expectations and medical condition.

When coming to our hospital, bringing any previous ultrasound reports, blood test results, and a list of medications you are currently taking will help the process move much faster. In emergency situations, such as sudden severe pain or heavy bleeding that won't stop, BHT CLINIC İstanbul Tema Hastanesi is always by your side with our 24/7 Emergency Department and on-call specialist team.

Frequently Asked Questions

Can a fibroid turn into cancer?

Uterine fibroids are benign tumours, and the risk of them turning into cancer is almost non-existent (less than one in a thousand). Having fibroids does not increase your risk of developing uterine cancer; however, regular medical follow-ups are essential to distinguish rapidly growing masses from rare malignant tumours.

Do fibroids go away on their own?

Fibroids do not completely disappear on their own during a woman's reproductive years. However, as a woman enters menopause and oestrogen levels drop, they typically shrink and regress to a size where they no longer cause symptoms.

Can fibroids grow back after surgery?

After a myomectomy (where only the fibroid is removed), the structure of the uterus is preserved, meaning there is always a risk that new fibroids could develop in the years to come. In a hysterectomy (where the entire uterus is removed), there is no possibility of fibroids recurring.

Can you get pregnant if you have fibroids?

Yes, many women with fibroids can get pregnant without any issues and deliver healthy babies. However, if a fibroid is pressing against the inner lining of the uterus, it can make getting pregnant more difficult or increase the risk of miscarriage; therefore, a pre-pregnancy check-up is highly important.

Do fibroids cause bleeding?

Yes, one of the most prominent and common symptoms of fibroids is abnormal uterine bleeding. Fibroids located close to the inner lining of the uterus, in particular, can cause periods to be very heavy, clotted, and prolonged, which can lead to anaemia.

If you are experiencing fibroid symptoms or would like to have your routine gynaecological check-up, you can consult our expert physicians by booking an appointment without delay.

This article is for informational purposes only; please consult your doctor for diagnosis and treatment.