Can fibroids affect my chances of getting pregnant?

Yes, especially submucosal or large fibroids that distort the uterine cavity. But many women with fibroids conceive naturally or with assistance.

Do fibroids always need treatment?

No. If they’re small and symptomless, monitoring may be enough. Treatment is tailored to your symptoms and goals.

Can fibroids shrink on their own?

Some fibroids shrink after menopause when hormone levels drop, but this is unpredictable.

Uterine Fibroids: Causes, Symptoms & Effective Treatment Options

Heavy bleeding. Pelvic pressure. Frequent urination. If these symptoms sound familiar, you’re not alone, and you may be dealing with uterine fibroids. Recent studies indicate that uterine fibroids are more prevalent among Black women, with incidence rates 2-3 times higher than those in white women. By age 50, up to 80% of Black women and approximately 70% of white women may develop fibroids. For some, fibroids are silent passengers. For others, they disrupt daily life or complicate fertility and pregnancy. In a context like India, where menstrual health is often under-discussed, understanding fibroids can be empowering. Whether you're preparing for conception, navigating discomfort, or weighing treatment options, knowing the facts is your first step toward relief.

What Are Uterine Fibroids?

Uterine fibroids (also called leiomyomas or myomas) are firm, smooth muscle tumours that grow in or around the uterus. They are:

Non-cancerous and not linked to uterine cancer
Vary in size, from seed-sized to bulky masses
Classified by location: intramural (within the uterine wall), submucosal (protruding into the uterine cavity), or subserosal (on the uterine surface).

Many fibroids are symptomless, but some can lead to significant health concerns depending on their size, number, and position.

Why Uterine Fibroids Matter for Reproductive and Pregnancy Health

Fibroids can impact both your physical well-being and fertility journey:

Menstrual Disruption: Heavy bleeding, prolonged periods, and painful cramps
Fertility Challenges: Submucosal fibroids, in particular, are associated with reduced implantation rates, lower clinical pregnancy rates, and higher miscarriage rates.
Pregnancy Risks: Increased chance of miscarriage, breech birth, or preterm labour
Pelvic Symptoms: Bloating, lower back pain, urinary frequency or urgency
Emotional Toll: Ongoing discomfort and fertility concerns may cause stress or anxiety

What Causes Uterine Fibroids?

There’s no single cause, but several factors can increase your risk:

Hormonal fluctuations: Oestrogen and progesterone promote fibroid growth
Genetic predisposition: Family history increases the likelihood
Early onset of menstruation: More lifetime exposure to reproductive hormones
Obesity: Higher body fat is linked to excess oestrogen
Vitamin D deficiency: Women with sufficient vitamin D levels had an estimated 32% lower odds of developing fibroids compared to those with deficiency.

Environmental toxins and lifestyle factors are also being explored in ongoing research.

How Are Fibroids Diagnosed?

Diagnosis typically includes:

Pelvic examination: May detect an enlarged uterus or an irregular shape
Ultrasound: First-line imaging to identify size, number, and location
MRI scan: Offers clearer detail when planning surgery or complex cases
Hysteroscopy or saline sonography: Used when submucosal fibroids are suspected
Blood tests: To assess anaemia due to heavy bleeding

Fibroids are often found incidentally during fertility workups or pregnancy scans.

Treatment and Management Options

Not all fibroids need treatment. Options depend on symptoms, size, and your reproductive goals:

Watchful waiting: For small, symptomless fibroids
Medications: Hormonal therapies (e.g., GnRH analogues) to shrink fibroids or control bleeding
Non-invasive options: MRI-guided focused ultrasound (not widely available in India)
Minimally invasive surgery: Uterine artery embolisation (UAE), laparoscopic myomectomy
Open surgery: Myomectomy or hysterectomy for large or multiple fibroids

Recent advancements have introduced new medical therapies, such as Linzagolix, a GnRH antagonist approved for the treatment of moderate to severe uterine fibroid symptoms. This oral medication offers a non-surgical option for symptom management. And, while myomectomy remains a fertility-preserving surgical option, it's important to note that uterine artery embolisation (UAE), though less invasive, may not be suitable for women seeking to maintain fertility due to potential impacts on ovarian reserve and pregnancy outcomes.

Always speak with your gynaecologist before starting or stopping treatment. Some medications may not be suitable if you’re trying to conceive or are pregnant.

Emotional and Practical Support Matters

Living with fibroids can be overwhelming. You may worry about your fertility, appearance, or chronic symptoms. Don’t hesitate to seek:

Counselling or support groups to manage anxiety or body image issues
Financial planning if treatment involves surgery or assisted reproduction
Holistic care like yoga, stress management, and dietary adjustments (under guidance)

Remember, you’re not overreacting. Your pain and concerns are real, and you deserve answers.

Fibroids are common, but you don’t have to accept their symptoms as “normal.” Whether you’re managing heavy periods, facing fertility challenges, or pregnant with fibroids, help is available. With the right care and clear guidance, you can take control of your health and future.

FAQs on Uterine Fibroids

Can fibroids affect my chances of getting pregnant?
Yes, especially submucosal or large fibroids that distort the uterine cavity. But many women with fibroids conceive naturally or with assistance.
Do fibroids always need treatment?
No. If they’re small and symptomless, monitoring may be enough. Treatment is tailored to your symptoms and goals.
Can fibroids shrink on their own?
Some fibroids shrink after menopause when hormone levels drop, but this is unpredictable.