Health Insights · Women's Health
Fibroids: common growths that can cause heavy periods
Fibroids are benign growths of muscle in the wall of the womb. They are extremely common — affecting most women at some point, and disproportionately Black women, in whom they occur earlier and are often larger. Many cause nothing at all. Whether they cause symptoms depends far more on where they sit than how big they are.
Seek urgent assessment if you have
- very heavy bleeding with dizziness, breathlessness or a racing heart
- sudden severe pelvic pain, particularly with fever or vomiting
- inability to pass urine
- bleeding after the menopause
- a rapidly enlarging abdominal mass, especially after the menopause
- severe pain in pregnancy
A fibroid that outgrows its blood supply causes sudden severe pain (red degeneration), most often in pregnancy. Rapid growth after the menopause is uncommon and needs investigating. Postmenopausal bleeding always requires investigation regardless of known fibroids.
Symptoms
- Heavy or prolonged periods, often with clots — the commonest symptom, and a frequent cause of iron deficiency
- Pelvic pressure, bloating, or a swollen lower abdomen
- Urinary frequency, or difficulty emptying the bladder
- Constipation, or pressure in the back passage
- Pain during sex, and lower back pain
- Occasionally difficulty conceiving or recurrent miscarriage
Why position matters more than size
Submucosal fibroids bulge into the cavity of the womb — even a small one causes heavy bleeding and can affect fertility and implantation. Intramural fibroids sit within the muscle wall and cause heavy bleeding and pressure when large. Subserosal fibroids grow outwards and can become very large while causing little bleeding, though they press on the bladder and bowel. A 2cm submucosal fibroid may cause far more trouble than a 7cm subserosal one, which is why the scan report matters as much as the measurement.
Diagnosis
Usually a pelvic examination followed by ultrasound, which is the first-line test. Where the cavity needs assessing, saline infusion sonography or hysteroscopy gives a clearer picture, and MRI is used for mapping before surgery or embolisation. A full blood count and ferritin should always be checked, since iron deficiency from heavy bleeding is very common and frequently untreated.
Treatment
- No treatment if they are not causing symptoms — entirely reasonable, with monitoring.
- Tranexamic acid and anti-inflammatories taken during periods to reduce bleeding, without affecting the fibroids themselves.
- The hormonal coil reduces bleeding substantially and is recommended first-line, though it is less suitable where fibroids distort the cavity.
- The combined pill or progestogens to control bleeding.
- GnRH analogues to shrink fibroids temporarily before surgery, usually with add-back HRT.
- Hysteroscopic resection for submucosal fibroids — day case, no abdominal incision, and often transformative for bleeding.
- Myomectomy — removing fibroids and preserving the womb. The option where fertility is a priority.
- Uterine artery embolisation — blocking the blood supply, avoiding surgery. Effective, with a shorter recovery.
- Hysterectomy — definitive, for women who have completed their family and want a permanent solution.
Fibroids and fertility
Most women with fibroids conceive normally. Those distorting the cavity have the clearest effect on fertility and miscarriage, and removing them improves outcomes. In pregnancy, fibroids often grow and can cause pain; they occasionally affect the baby's position or the placenta. If you are planning a pregnancy, say so early — it changes which treatments are appropriate, and embolisation in particular is generally avoided if you want children.
After the menopause
Fibroids are oestrogen-dependent and usually shrink and become symptom-free after the menopause. New growth or new symptoms after the menopause is unusual and should be investigated.
Why come to us. Fibroids are frequently found on a scan and then left with no explanation of what the findings actually mean for you. We offer women's health appointments 7 days a week with a female clinician available on request, pelvic ultrasound performed on site and explained in the same visit, and full blood count and ferritin taken here — because treating the iron deficiency matters as much as treating the fibroid. We prescribe medical treatment, and arrange hysteroscopy, embolisation or surgery through our CQC-registered partners.
Private fibroid assessment and ultrasound in London
Fibroids are common, non-cancerous growths of the womb that may cause heavy periods, pelvic pressure or bloating — or no symptoms at all. Our private women’s health clinic in London can assess you and arrange a pelvic ultrasound, and a private GP in East London can start treatment for heavy bleeding while arranging further care. Fibroids are assessed at our private women's health service in Whitechapel, East London, close to Canary Wharf, Aldgate and the City.
Fibroids: symptoms, scans and treatment options
Do fibroids always need treatment?
No — many cause no problems and need no treatment. Treatment is offered when they cause symptoms such as heavy bleeding.
How are fibroids diagnosed?
With a pelvic examination and an ultrasound, which we can arrange, sometimes with further imaging.
What are the treatment options?
Options range from medication for bleeding to procedures that shrink or remove fibroids, depending on symptoms and plans.
Do I need a referral?
No — you can book women's health directly or start with a private GP.
Where can I get a pelvic ultrasound for fibroids near me?
Our private ultrasound in London and women’s health clinic in London at Whitechapel, near Canary Wharf, can scan for fibroids and plan treatment.
Do fibroids always need treatment?
No — many need no treatment, but heavy periods or pressure symptoms can be managed; our heavy periods service can help.
Scanned and explained in the same visit
Female clinician available, ultrasound and bloods on site.