You’ve probably heard the word “fibroids”. But what actually are they — and what do they mean for your health?
Maybe you were told you have a fibroid during an ultrasound. Maybe you have been living with heavy periods or pelvic pain for years and are wondering whether fibroids could be part of the picture.
Or perhaps someone has told you, “They’re benign, so don’t worry about them.”
That last part is important — fibroids are usually non-cancerous.
But “non-cancerous” does not mean “unimportant”.
For some women, fibroids cause no symptoms at all. For others, they can affect bleeding, pain, bladder or bowel symptoms, fertility and everyday quality of life.
The important thing is understanding what your fibroids are doing — not simply knowing that they are there.
So, what exactly is a fibroid?
A fibroid is a growth made up mainly of muscle and fibrous tissue that develops in or around the womb (uterus).
The medical term is uterine leiomyoma.
Fibroids are very common, particularly before menopause, and a woman can have one fibroid or several. They can also vary considerably in size and location.
And this is one of the first things worth knowing:
Having a fibroid does not automatically mean you need treatment.
Research shows that many fibroids do not cause symptoms and may never need intervention. Treatment decisions are generally based on symptoms, the characteristics of the fibroids, reproductive plans and the woman’s own preferences. [1][2]
Where the fibroid is can matter as much as how big it is
You may hear your doctor use words such as:
Intramural — the fibroid is within the muscular wall of the womb.
Submucosal — the fibroid grows towards the inside of the womb cavity.
Subserosal — the fibroid grows towards the outside of the womb.
There are also other patterns and classifications, so you do not need to memorise all the terminology.
The useful thing to understand is this:
Two women can both have a 5 cm fibroid and have completely different experiences.
Why?
Because size is only part of the picture. The number of fibroids, where they are located and how they affect the womb can all influence symptoms and treatment options. [1][2][3]
What symptoms can fibroids cause?
Some women have no symptoms.
When symptoms do occur, they can include:
- heavy or prolonged periods
- painful periods
- pelvic or lower abdominal pain
- pressure or fullness in the pelvis
- lower back pain
- needing to urinate more often or urgently
- bowel symptoms such as constipation or pressure
- discomfort during sex
- difficulties becoming pregnant in some circumstances
Not every woman with these symptoms has fibroids, and having fibroids does not necessarily mean that they are responsible for every symptom you experience.
That distinction matters.
Finding a fibroid on a scan does not automatically explain everything that is happening in your body.
Your symptoms still need to be considered alongside your examination, medical history and any other investigations that may be appropriate. [1][3]
What about heavy periods?
This is one of the areas where fibroids can make a real difference.
Heavy menstrual bleeding can affect work, relationships, sleep, exercise and simply getting through an ordinary day.
And there is another reason it deserves attention.
Heavy bleeding can contribute to iron-deficiency anaemia.
NICE recommends that women presenting with heavy menstrual bleeding have a full blood count as part of their assessment. Anaemia associated with heavy menstrual bleeding is an important clinical issue and should not simply be accepted as something women have to put up with.
So if you have very heavy periods and are also experiencing symptoms such as persistent tiredness or breathlessness, it is reasonable to raise the possibility of anaemia with your healthcare professional.
And remember: feeling exhausted is not automatically “just part of having heavy periods”.
It is worth finding out why.
How are fibroids diagnosed?
Fibroids may be suspected because of your symptoms or a physical examination.
An ultrasound scan is commonly used to look for fibroids and can help show:
- whether fibroids are present
- how many there are
- their size
- where they are located
Transvaginal ultrasound is commonly used as an initial diagnostic test because it provides a detailed view of the uterus. MRI may sometimes be used when more detailed mapping is needed or when treatment planning requires it. [3]
NHS guidance similarly notes that ultrasound can show the number, size and location of fibroids.
This is why your scan report can be so useful.
It is not simply saying “you have fibroids.”
It can give you information that helps you and your healthcare professional understand what those fibroids may or may not be contributing to.
Do fibroids always need treatment?
No.
This is an important point because discovering a fibroid can immediately make you think:
“What are they going to do about it?”
Sometimes the answer is nothing for now.
When fibroids are not causing significant problems, monitoring may be appropriate.
When symptoms are affecting your quality of life, there are several possible approaches. These can include medicines to control symptoms, minimally invasive procedures and surgery.
The right option is not the same for everyone.
Treatment decisions can depend on things such as:
- your symptoms
- the size, number and location of the fibroid
- your age and stage of life
- whether you want to become pregnant
- your preferences
- what treatments are available and suitable for you
Current evidence supports an individualized approach rather than assuming that one treatment is automatically right for every woman. [1][2][4]
And what about Black women?
This is an important part of the conversation — but it needs to be handled carefully.
Research has consistently found that fibroids are more common in Black women than in White women in several studied populations, particularly in the United States. A 2023 systematic review found consistent racial differences in fibroid prevalence, age of onset and treatment patterns in the US evidence it reviewed. [5]
There is also evidence from prospective research showing early development of fibroids among African-American women. [6]
But there is an important evidence gap here.
The research is not equally strong across all Black and African populations, and a 2022 scoping review found that robust epidemiological data from sub-Saharan Africa remain limited. [7]
So Eira’s position is not:
“Black women get fibroids because of one particular reason.”
The evidence does not support such a simple explanation.
What we can say is that there are well-documented differences in fibroid burden in some populations, and that more research is needed to understand why those differences exist and how they affect diagnosis, treatment and outcomes.
That matters because women deserve healthcare that takes their symptoms seriously and gives them access to clear, evidence-informed information.
What should you ask at your next appointment?
Knowing you have fibroids is only the beginning.
You can ask:
“How many fibroids do I have, and how large are they?”
“Where exactly are they located?”
“Could their location explain the symptoms I am experiencing?”
“Are there other possible causes for my symptoms that we should consider?”
“Because my periods are so heavy, should we check whether I have anaemia?”
“What are my options, and what would happen if we simply monitored the fibroids for now?”
These questions are not about telling your doctor what treatment you want.
They are about making sure you understand what is happening and why the next step is being recommended.
The bigger picture
Fibroids can be incredibly disruptive, but having fibroids does not mean that your experience is going to follow someone else’s.
One woman may have several fibroids and barely notice them.
Another may have one fibroid that causes significant bleeding or pressure.
Someone else may have symptoms that initially appear to be caused by fibroids but turn out to have another or additional explanation.
That is why the goal is not simply:
“Find the fibroid.”
The goal is:
“Understand the whole picture.”
At Eira, that is where we start.
Not with fear.
Not with miracle cures.
Not with telling you what decision to make.
With clarity.
Because when you understand what you have been told, know what questions to ask and understand what your options are, you can have a much more informed conversation about your next step.
A final reminder
This article is for general information and is not a diagnosis or personal medical advice.
Fibroids are common and usually non-cancerous, but symptoms such as heavy bleeding, significant pain or changes that are affecting your everyday life deserve appropriate medical assessment.
Evidence base
[1] Contemporary Management of Uterine Fibroids — Olga Połukord et al., 2026, Journal of Clinical Medicine. Consensus citation count: 1.
[2] Guideline No. 461: The Management of Uterine Fibroids — Innie Chen et al., 2025, Journal of Obstetrics and Gynaecology Canada. Consensus citation count: 12.
[3] Clinical signs and diagnosis of fibroids from adolescence to menopause — E. Mensión et al., 2024, Fertility and Sterility. Consensus citation count: 10.
[4] The impact of fibroid treatments on quality of life and mental health: a systematic review — B. Neumann et al., 2024, Fertility and Sterility, 121, 400–425. Consensus citation count: 25.
[5] Racial Disparities in Uterine Fibroids and Endometriosis — J. Katon, T. Plowden & E. Marsh, 2023, Fertility and Sterility, 119, 355–363. Consensus citation count: 83.
[6] Uterine fibroid incidence and growth in an ultrasound-based, prospective study of young African-Americans — D. Baird et al., 2020, American Journal of Obstetrics and Gynecology. Consensus citation count: 67.
[7] Epidemiology of uterine fibroid in black African women: a systematic scoping review — I. Morhason-Bello & C. Adebamowo, 2022, BMJ Open, 12. Consensus citation count: 26.
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