The term 'benign' when used to describe fibroids, which are non-cancerous growths in the womb, often leads to the misconception that they are harmless. However, gynaecologists emphasize that these growths, composed of muscle and fibrous tissue, can range in size from a pea to a watermelon and can have a profound impact on a woman's health and daily life.
Fibroids are extremely common, affecting an estimated 70 to 80 percent of women worldwide by age 50. In the UK, approximately two-thirds of women are thought to be affected. While direct treatment costs for the NHS amount to £86 million annually, the wider economic loss is estimated to be up to £1.7 billion due to lost workdays and women leaving employment because of severe symptoms.
Despite their prevalence, awareness of fibroids remains surprisingly low. A significant factor contributing to this is the normalization of their symptoms. Women are often told that heavy periods, pelvic pain, and exhaustion are simply a part of being female. This can lead to many struggling for years before realizing fibroids might be the cause. Common signs include disruptive heavy bleeding, waking at night due to bleeding through protection, avoiding social events, passing large clots, anemia, or missing work due to pain. These symptoms should not be ignored.
Fibroids can also cause symptoms not immediately associated with the womb. Depending on their size and location, they can press on surrounding organs, leading to increased urinary frequency, urgency, constipation, bloating, lower back pain, or discomfort during sex. Many women initially attribute these issues to stress, irritable bowel syndrome, or aging, unaware that fibroids are frequently the underlying cause.
The impact of fibroids extends beyond physical discomfort, significantly affecting mental health. Chronic pain, poor sleep, unpredictable bleeding, and fertility concerns can take a toll, leading to social withdrawal, travel avoidance, work difficulties, and frustration with seeking medical help. Many women find themselves structuring their entire lives around managing their symptoms.
The exact causes of fibroids are not fully understood, but genetics play a role, with dozens of associated genes identified. Hormones are also involved, and fibroids are more likely to develop in women during their thirties and forties, often shrinking after menopause. Certain groups face higher risks; Black women, for instance, are disproportionately affected, often developing fibroids at a younger age, experiencing larger and more numerous growths, and reporting more severe symptoms.
While major risk factors such as age, ethnicity, and genetics are beyond control, maintaining a healthy weight, managing metabolic health, ensuring adequate vitamin D levels, and reducing intake of highly processed foods may support overall health and potentially lower risk. Research is also exploring the role of endocrine-disrupting chemicals in plastics and personal care products.
Treatment options for fibroids have advanced significantly, offering more than just a few choices. The best approach depends on the fibroids' size and location, symptom severity, the woman's age, fertility plans, and personal preferences. For small, asymptomatic fibroids, monitoring with annual scans might suffice. Medication can help manage symptoms, and minimally invasive procedures can shrink fibroids without major surgery. Surgical options like myomectomy can remove fibroids while preserving the uterus.
Recurrence is possible, especially before menopause, but this does not negate the effectiveness of treatment. Many women experience years of symptom relief and improved quality of life. Hysterectomy, the removal of the entire uterus, eliminates the risk of recurrence but also prevents future pregnancy and has other lasting impacts.
Gynaecologists stress that any symptoms impacting daily life warrant investigation. Heavy bleeding, pain, and exhaustion are not conditions women must simply endure; they are treatable, and fibroids, though benign, are far from harmless for millions of women.