Fibroids are benign, not malignant, tumours of the womb or uterus. They vary greatly in number, size and location in the uterus. They are common between the ages 30 – 40 years and have a tendency to grow. Their most common symptom is heavy bleeding during menstruation. A period is defined as ‘heavy’ if it lasts more than 6 days or there are clots or more than 10 sanitary pads are used in one cycle or night time soiling or day time embarrassment or avoiding social life because of too much bleeding during period. This may cause anaemia or low haemoglobin. Sometimes there may be spotting with blood in between two periods known as inter-menstrual bleeding. Fibroids can also cause pain or cramps in low abdomen or back or pain during intercourse. There may be a sensation of weight or complaints due to pressure of the fibroid on the urinary bladder which causes frequent urination, or
pressure on the rectum which causes constipation. Another problem with fibroids is that they may be associated with infertility or inability to get pregnant. You may also notice a hard mass or swelling in the abdomen which may grow to be quite big. Fibroid is best diagnosed by ultrasound and hysteroscopy if it is inside the cavity of the uterus. They do not always require treatment especially when small and no symptoms of bleeding, pain, pressure or infertility. Medicines are either not very effective in decreasing the size of fibroids or have unacceptable side-effects. Uterine Artery Embolization is effective but not for use in patients who desire a pregnancy in future. New technique like Magnetic Resonance Imaging guided Focussed Ultra Sound (MRIgFUS) is promising. Surgery is currently the best treatment. If one needs or desires to retain the uterus, the fibroid only can safely be removed by hysteroscope if inside the uterine cavity or by laparoscope if it is on outer wall of uterus. If uterus is not required then uterus can be removed along with the fibroid either by laparoscope, from below or by open surgery. Whether to remove fibroid or to leave it be, or which method to use to remove it or the uterus is best guided by your gynaecology specialist.