Fibroids are non-cancerous tumours that grow in or around the womb. The growths are made up of muscle and fibrous tissue and can vary in size. Fibroids are sometimes known as uterine myomas or fibromyomas.

Although the exact cause is unknown, fibroids are linked to the female hormone, oestrogen. Oestrogen is the female reproductive hormone produced by the ovaries. Fibroids usually develop during a woman’s reproductive years (from approximately 16 to 50 years of age).

Fibroids tend to increase in size when oestrogen levels are at their highest, such as during pregnancy. They are also known to shrink when oestrogen levels are low, such as after the menopause (when a woman’s monthly periods stop at around 50 years of age).

Many women are unaware that they have fibroids as they do not have any symptoms. Fibroids are therefore often diagnosed by chance during a routine gynaecological examination, test or scan.

Fibroids can grow anywhere in the womb.

There are 5 main types:

Intramural - develop in the muscle wall of the womb and they are the most common

Subserosal - grow outside the wall of the womb into the pelvis and can become very large.

Submucosal - develop in the muscle beneath the inner lining of the womb wall and they grow into the middle of the womb.

Pedunculated - grow from the outside wall of the womb and are attached to the womb wall by a narrow stalk.

Cervical - develop in the wall of the cervix (the neck of the womb).

SYMPTOMS

Many women are unaware they have fibroids because they do not have any symptoms. Around one woman in three with fibroids experiences some symptoms.

In very rare cases further complications caused by fibroids can affect pregnancy or cause infertility.

Heavy or painful periods

If you have heavy periods (menorrhagia) can have a significant impact on everyday life. In some cases, heavy periods can cause iron-deficiency anaemia, resulting in tiredness, lethargy and shortness of breath (dyspnoea).

Abdominal pain

If the fibroids are large there may be discomfort or bloating of the abdomen. Some women also experience pain in their lower back and legs.

Frequent urination and constipation

From pressure on the bladder or rectum (large intestine)

Pain or discomfort during sex

If fibroids grow near to the vagina or cervix, pain or discomfort may be experienced during sexual intercourse (dyspareunia).

COMPLICATIONS

In rare cases, fibroids can cause significant complications.

Complications can occur as a result of the positioning in cases where they are very large.

During pregnancy

Oestrogen, can increase by as much as five times the normal amount during pregnancy. As fibroids are thought to develop due to high oestrogen levels, this may lead to complications with the development of the baby, or cause problems during labour.

In very rare cases, fibroids can cause miscarriage (the loss of pregnancy during the first 23 weeks).

Infertility

Fertility difficulties may occur in cases where a woman’s fibroids are very large.

A fibroid may block a fallopian tube, making it harder to conceive as the egg requires passage down the tube to the womb. Rarely a large fibroid may prevent the fertilised egg from implanting into the lining of the womb.

DIAGNOSIS

Fibroids are often asymptomatic so are usually discovered routinely as part of a gynaecological exam or ultrasound scan.

If your GP suspects that you have fibroids, they may recommend that you have some tests to confirm a diagnosis, or to rule out other possible causes of your symptoms.

Ultrasound scan

A scan of the womb is often used to confirm a diagnosis of fibroids. It can also be used to rule out any other possible causes of your symptoms.

Depending on the results, you may be refered to a specialist to investigate the problem further using a number of techniques:

Transvaginal ultrasound

This painless procedure involves the insertion of a small probe into the vagina. The probe uses sound waves to create an image of your womb on a TV monitor.

Hysteroscope

A hysteroscope is a small telescope used to examine the inside of your womb to see fibroids that are within the lining or cavity of the womb.

Laparoscopy

A laparoscope is a small tube relays images of the inside of the abdomen or pelvis to a television monitor. The surgeon makes a minor incision in the skin, passes the laparoscope through the incision and studies the organs and tissues inside the abdomen or pelvis.

A laparoscopy can also be used to examine the size and shape of the outside of your womb.

Biopsy

A laparoscopy may be used to take a biopsy (a tissue sample) of the inside lining or the outer layer of your womb. The sample can then be sent to a laboratory for closer examination under a microscope.

TREATMENT

Treatment may not be necessary in cases where there are no symptoms or where symptoms are minor.

After the menopause, fibroids often shrink, and it is likely that symptoms will either ease slightly or disappear completely.

To treat fibroids medication can be prescribed. However, in more severe cases, a number of surgical techniques may be considered.

Medication

Medicines are available that can treat heavy periods, but they can be less effective if the fibroids are very large.

Levonorgestrel intrauterine system (LNG-IUS)

This is a small, plastic device that is placed inside the uterus and slowly releases the progestogen hormone called levonorgestrel. This stops the lining of your womb from growing quickly, so that it is thinner and your bleeding becomes lighter.

Side effects associated with LNG-IUS include:

·         irregular bleeding that may last for more than six months

·         acne (inflamed skin on the face)

·         headaches

·         breast tenderness

·         In rare cases, LNG-IUS may also stop you having periods at all.

Tranexamic acid

These are taken three to four times a day throughout your period. They work by helping the blood in your womb to clot, which reduces the amount of bleeding.

Anti-inflammatory medicines

Ibuprofen and mefenamic acid can be taken for a few days during your period and will help minimise heavy bleeding. They work by reducing your body’s production of a hormone-like substance called prostaglandin, which is linked to heavy periods.

These medications are also useful painkillers.

Indigestion and diarrhoea are common side effects.

The contraceptive pill

This common form of contraception can help make bleeding lighter and some contraceptive pills can help to reduce period pain.

Gonadotropin releasing hormone analogues (GnRHas)

GnRHas are given by injection and work by making your body release a small amount of oestrogen, which causes your fibroids to shrink.

GnRHas stop your menstrual cycle but they are not a form of contraception. They do not affect your chances of becoming pregnant after you stop using them.

They can help to ease heavy periods and any pressure that is felt on your stomach. They can also help to improve symptoms of frequent urination and constipation.

GnRHas can cause a number of menopause-like side effects including:

·         hot flushes

·         increased sweating

·         muscle stiffness

·         vaginal dryness

Osteoporosis (thinning of the bones) is an occasional side effect.

GnRHas are only prescribed on a short-term basis and after treatment the fibroids may return.

GnRHas can also be used to shrink fibroids prior to having surgery to remove them. Sometimes, a combination of GnRHas and low doses of hormone replacement therapy (HRT) may be recommended to shrink fibroids, while preventing the side effects of the menopause.

Surgery

If the symptoms from the fibroids are particularly severe or if medication has been ineffective, surgery might be considered.

There are several different surgical procedures used:

Hysterectomy

This is a removal of the womb. It may be recommended for large fibroids or severe bleeding.

It is the best way of preventing fibroids from coming back. Hysterectomy is considered it if  the fibroids are particularly troublesome or if the woman does not wish to have further children.

Myomectomy

This surgical procedure aims to remove the fibroids from the wall of the uterus. It may be considered as an alternative to a hysterectomy, particularly for women who still wish to have children.

A myomectomy may not always be possible to perform as it depends on the size, number and position of the fibroids.

Non-surgical treatments

There are non surgical procedures that may be useful:

Endometrial ablation

This involves removing the lining of the womb. It is usually only recommended for fibroids that are near to the inner surface of the womb.

The affected womb lining can be removed by using laser energy, a heated wire loop, microwave heating or hot fluid in a balloon.

Uterine artery embolisation (UAE)

This is an alternative procedure to a hysterectomy and myomectomy for treating fibroids. It may be recommended for women with large fibroids.

UAE works by blocking the blood vessels that supply blood to the fibroids, causing them to shrink. A chemical is injected into the blood vessel supplying the fibroid, through a small tube, guided by X-ray. UAE is performed through local anaesthetic.

New treatments

·         MRI-guided percutaneous laser ablation

·         MRI-guided transcutaneous focused ultrasound

These techniques use MRI to guide small needles into the centre of the fibroid. Laser energy, or ultrasound energy, is then passed through the needles to destroy the fibroid. These treatment methods cannot be used to treat all types of fibroids, and the long-term benefits and risks are unknown.

Although research is still being done, some evidence suggests that this non-invasive procedure has short- to medium-term benefits when performed by an experienced clinician. However, the effects on pregnancy and those wishing to have a baby in the future are not fully known, so this should be taken into consideration.

If you would like to tell us your story so we can help and inform other women; there is more information available HERE

This podcast was recorded in July 2010.

Professor Lesley Regan discusses Fibroids, who they most affect and the types of treatment available today.

Fibroids: Text Version

For this month’s podcast, we are welcoming Professor Lesley Regan from Imperial College at St. Mary’s Hospital London to talk to us about fibroids.

So I think my first question is, could you tell us what a fibroid actually is?

Well, fibroids are very common, they are the most common female, benign tumour of the pelvic organs. That means that they are not malignant or sinister or cancerous, but they are growths and they are growths of the muscle of the womb wall.

So are they growths of the actual muscle itself, or are they an inflammation, or are they actual cells? I’m not clear.

Fibroids are benign growths of the muscular wall of the uterus, and they can be in various different sites in the uterus. Depending on where they are we name them differently. So if they are within the womb cavity, protruding out from the lining of the womb we call them sub-mucous fibroids. If they are in the wall of the uterus we call them intramural (inside the wall) and if they are on the external surface of the uterus we call them serosal. Then there is another type of fibroid that we call pedunculated and that means it is on the outside of the uterine wall and it is attached to the outside of the wall by a stalk, a peduncle. So there are lots of different types of uterine fibroids and these names describe their geographical location.

Absolutely, well that is very helpful. How would you suspect or know that you had a fibroid, what sort of symptoms might you get that would suggest that or would make you think ‘Oh, I must go and see the doctor’?

Well, there are lots of different symptoms that fibroids may give rise to and I think it is important to say that you may not know that you’ve got them, because some women have no symptoms at all. Of course what we would love to understand is why some women have symptoms: period problems, pain, fertility problems, all sorts of things, we’ll come back to that in a moment. Whereas others seem to manage to get away with it and only have their fibroids diagnosed by accident, because they are having, for example, a family planning appointment or a smear done or an ultrasound scan for something totally different. The person doing the scan says ‘oh look and you’ve got a fibroid’, which they may not have known. The other very interesting thing I think about fibroids is that you would expect the biggest fibroids to cause the most problems and the little fibroids not to, but unfortunately they are a law unto themselves. I have seen women with very small fibroids who are debilitated by pain or can’t get pregnant or are miscarrying. I have seen women with massive fibroids who are sailing through with no complications at all.

You said about the different types, do the different types have better or worse symptoms in terms of on the outside or on the inside?

Well, that is a good question, because in general terms those that are on the outside surface are much less likely to cause period problems or problems getting pregnant for example. Whereas if you’ve got fibroids in the cavity you can see how that might lead to heavy bleeding or pain, or problems with an embryo implanting. But, as I say, fibroids follow no rules and it is interesting that the more I get to know about fibroids, the more ignorant I realise I am. When I did not know very much about them, I thought I understood them well and now that I know a lot more about them, I realise that there is a lot more left to learn.

That always seems to be the way with science. So once you assume you are having some problems and you have been to your GP and you’re looking for some way of preventing those problems and getting some kind of treatment. What sort of range of treatments are available to people? I mean I assume it is based on pretty much what sort of symptoms or problems they are experiencing?

Well there are lots of different treatments and as you rightly say it very much depends how you present, with which symptoms, as to what is going to be the most suitable treatment. There are surgical treatments to remove them and these can be open surgical procedures like a myomectomy or even a hysterectomy for women who are at the end of their reproductive life. There are laparoscopic or key-hole procedures to remove them and of course there are the newer, minimally invasive treatments, some of which we have been pioneering at St. Mary’s. Indeed, the latest minimally invasive treatments do not even require the insertion of a telescope, we are actually performing the procedure by inserting laser fibres or the most recent by focused ultrasound. So this is under a magnetic resonance scanner, we put the woman into the scanner and basically shine high intensity ultrasound beams at the fibroids, focusing them into the fibroid. They heat the fibroid up and the fibroid dies and shrinks in size. So this is really very very pioneering and innovative stuff. But the reason why we have tried to develop those treatments at St. Mary’s is because I got interested in fibroids, because I was interested in women who were having miscarriages or were having problems in getting pregnant. We wanted to find ways that were going to treat their symptoms and preserve their fertility, without subjecting them to surgery, which may lead to subsequent subfertility.

Without causing scar tissue..

Exactly. Although myomectomy is a wonderful operation and I often recommend it, particularly for very big fibroids, a myomectomy comes with the risk of scar tissue developing, which can compromise a woman’s ability to get pregnant in the future. This is an important consideration before you commit a woman who is trying to have a baby, or trying to get pregnant in the future, to fibroid surgery. So that’s why these newer treatments have been developed. Now I’ve only mentioned surgery and these imaging techniques but, of course, there are drugs, lots of different types of drugs, such as hormonal treatments that we can use. For example the combined oral contraceptive pill can be helpful for women who present with heavy bleeding. There are drugs called gonadotrophin releasing hormones (GnRH) -these are the ones that tell your brain to shut down the female menstrual cycle and stop all the hormones going to the ovaries so you become a sort of pseudo-menopausal woman while you are taking these drugs. The symptoms are reversible but while you are taking the GnRH you get hot flushes and other menopausal symptoms because you completely knock out the cycle. Then there are all sorts of new medicines that are being trialled at the moment, for example progesterone modulators. However, in general we recognise that these medical treatments, are more a sort of stop gap or interim measure and if you need a definitive treatment you are usually going to have to pursue some form of surgical procedure or one of these new thermal ablation minimally invasive techniques.

Presumably the medical ones wouldn’t be suitable for women who are trying to get pregnant based on the fact that they are stopping the cycle?

Exactly. The last thing you want to do if you are trying to get pregnant is to take drugs that stop your natural cycle and prevent ovulation, and experience menopausal symptoms, even though these side effects are all reversible. However, there are occasions when a short sharp burst of medical therapy before the woman tries to get pregnant can be helpful.

So as a sort of starter and then you pull it away.

I think the important thing about fibroids is that you avoid taking a rigid view about what is the best treatment for a particular type of fibroid. What really matters is meeting the woman in the clinic and working out the priority list for what she wants to resolve together. I often ask women to tell me which symptom is at the top of that priority list, then I ask the question if I could only sort out one symptom, which should it be. Because sometimes treating the bleeding and the pain, or the pressure on her bladder is incompatible with the fact that this woman wants a baby. Similarly, if she has completed her family, then possibly the most important thing is to get rid of the offending fibroid and all the uterus that goes with it, so she doesn’t have any further problems. So, there are no rigid rules on how this fibroid should be treated by that treatment. It is really important that the woman is looked at holistically, so that together you can find the best option available for her. I think it is important to realise that you may need to offer one type of treatment for now and then at a later date, come back and revisit the problem and offer, for example, a different treatment when her fertility or reproductive life has been completed, she may want to focus on surgery to remove the uterus. Similarly, if the woman is having such heavy bleeding that she is becoming anaemic and coming in as an emergency to hospital, really, you’ve got to actually address that. Because women who are that unwell are not going to be able to get pregnant. You have to think ‘well, hang on, what is the most important priority here?’ and I find that if I ask the women that question, they are usually very clear about what their priorities are.

I have to say that is a wonderful approach, I wish more doctors would take that approach of asking the patient what their priority is. It is probably the most radical thing. In terms of, just to go back to the laser treatment, is that relatively available on the NHS for example or is it particular to St. Mary’s or a few centres around the UK? Is it suitable for all types of fibroids, patients..

Well, the laser treatment has now been superseded by the focused ultrasound technique and the focused ultrasound we are using is only available in the UK at St. Mary’s, but there are 80 centres worldwide who are using it and enjoying similarly very good success rates to us, so that is very hopeful. Of course the problem is that there is quite a large capital cost for the magnetic resonance scanner and the actual ultrasound equipment, but it is becoming more accessible. When we first started the treatment the company that were making the equipment funded the trials. Also there was an interim period where we had to charge patients because it is very expensive in terms of using the MR scanner and the radiological time, and expertise that is required. More recently, more and more private insurance companies are agreeing to the cost of treatment because they recognise that the woman can walk in one afternoon and then leave hospital without the need for an anaesthetic or pain killers later the same day. It also means she is back at work the next morning and is not having six weeks off to convalesce after the major surgery. There are lots of other factors to be considered when undertaking a cost benefit analysis of the treatment and we were very excited some six months ago when one of the local primary healthcare trusts agreed with us that they should make a contract for a limited number of residents in that particular area to undergo the treatment as NHS patients. Hopefully, many others will follow suit.

That is very good news I think. As I understand fibroids can grow back if you had some surgery to remove fibroids, you could then get other fibroids growing back into the womb?

That’s the problem, because we don’t really understand what stimulates their growth in the first place. So, if you have half a dozen fibroids removed surgically, I can’t guarantee that others won’t grow in the future. Perhaps not in the same place but somewhere else in the uterus, so this is also a consideration when you are trying to plan treatment. How much does the woman want to have relief of those symptoms, or an absolute end to the possibility of fibroid problems?

Is there anything the woman herself can do that isn’t a medical treatment, that would help to prevent fibroids coming or prevent them growing back?

Well some of the women I talk to, tell me they have experimented with Chinese herbal medicines and acupuncture and homeopathy and I know that there are a variety of products that are available on the internet and websites that claim to be treatments for fibroids. I’m not sure, I mean they are anecdotal reports, and of course the women that feel it has helped are very enthusiastic about them, but I don’t think, well I’m sure there haven’t been any actual randomised studies. But my belief is also that until conventional medicine has found a solution to every problem, I don’t think you should shut the door on alternative medicines. Although I would say that if you are surfing the net and looking for treatments, try to ask yourself some questions when you are reading the claims from a pharmaceutical company or a website wanting to sell you a product. You need to ask yourself how many people was this product tried out on? Was there a control group? What was the long term outcome? Was it improvement for a month or six months or several years?

So one has to be quite cautious.

I think you have to be cautious and you have to read these adverts critically but there may be products that are helpful.

Fibroids affect women’s fertility. Is that because of implantation problems?

I think that fibroids do have an adverse affect on fertility (the ability to get pregnant) but predominantly due to where they are located in the uterus. So, for example, if you’ve got fibroids inside the cavity, you can understand how it might be difficult for an embryo to implant because they may well have changed the physical or hormonal environment there. Or they may indeed be producing chemicals that are adverse to implantation but although I was saying earlier that fibroids on the outside surface of the uterus are less likely to affect your fertility, if of course they are positioned beside a fallopian tube and blocking or pressing upon it, that may well be a problem. So, it really is very individualised. But as I’ve said earlier I’ve seen women with tiny fibroids have endless problems with fertility, and women with massive fibroids have uncomplicated pregnancies. Fibroids are a law unto themselves. But, that is one of the excitements of reproductive science, I think.

That is quite interesting because I think there would be the general assumption that if it was bigger it would be worse, whereas it is clearly more random than that. I understand from a very cursory glance at the subject that it is more common in Afro-Caribbean women? Yes. Do we understand why that is?

We don’t, although there must be some sort of genetic predisposition because they are more common in Afro-Caribbean women and in these women they also they occur at a younger age. So, a very large number of women of patients coming to see me in the specialist fibroid clinic at St. Mary’s are Afro-Caribbean women who are younger and trying to preserve their fertility.

What sort of age range does it normally cover, fibroids? I am assuming you can get them through all ages, but is there a peak age for it, or is it just that you will become aware of it later on, or earlier on?

Well, they are terribly common and it is important to get this into perspective, they are so common we think as many as 40-50% of women will have fibroids not all of which may be symptomatic. On the basis of post-mortem studies, masses and masses of women have got fibroids in the uterus and many of them, if you ask their families, may not have had any complaints. Having said that they are so common and they are a very very important reason for women to seek gynaecological help. Some 20% of all Gynae outpatient appointments are fibroid related.

That is a huge number.

1 in 5 women coming to the routine gynaecological outpatients will be there because of a symptom from their fibroids. Probably the most common symptom that fibroids cause is heavy periods. When I say heavy periods, they can be torrentially heavy with fibroids. A woman may describe hers as being like a pouring tap or passing large clots, often flooding at night and not being able to go out of the front door because she is so frightened of having an uncontrollable and embarrassing accident in a public place. Some women are literally padded up as if they have got nappies on, because they can’t predict the extent of the flow. This is a dreadful imposition on a lifestyle if you cannot go out of the door every month of your life and you cannot go to work. So, period problems are one of the major symptoms that women with fibroids are likely to suffer from as well as pressure symptoms. If the fibroid is pressing on your bladder or your bowel it can be very uncomfortable, very painful and we have already discussed how a large mass can have a adverse affect on fertility. Now, when women get pregnant, there are all sorts of things that could happen. First and foremost I must emphasise again they may have no problems, the fibroid may just sit there in the uterus, it may get bigger because it is stimulated by the hormones of pregnancy to enlarge but it may not cause problems. On the other hand, it can be the cause of early miscarriages, late miscarriages, something very specific to pregnancy called red degeneration. This is when the woman presents classically at about 20/22 weeks with very severe abdominal pain. Often deciding whether she has problems with the flood or an acute appendix can be difficult. What has happened is the dramatic or rapid growth in the size of the fibroid due to the stimulus of the pregnancy hormones, has meant that the fibroid has almost outgrown its own blood supply and the centre of it dies, necroses, undergoes cell death and that degenerates and causes the release of very painful chemicals or cytokines from the fibroid which cause the pain.

Would that affect the pregnancy adversely?

Well, it may do, what you hope is that you can tide her over with pain relief and hope things quieten down. But of course what can happen is that the acute episode in the fibroid can stimulate the uterus to start contracting and then she could go into premature labour and depending on how many weeks she is, it would be classified as a late miscarriage or an early pre-term delivery/possible neo-natal death.

So, certainly something to get sorted if you have those symptoms.

Certainly. Lastly, of course, fibroids can cause problems at the time of the delivery, because if the fibroid is in the way of the baby’s head descending into the birth canal, that is going to be a problem, and you may have to undertake a caesarean section. A caesarean section for a woman who is not able to deliver the baby because the passage of the baby is being blocked by the fibroid is likely to be more difficult because after cutting through fibroid tissue in order to deliver the baby, it can be quite difficult to stop the bleeding from those fibroids, when repairing the uterine muscle again.

Ok, so quite a risky business.

Apologies, this all sounds rather gloomy.

No, it is good to know the risks.

Where I work at St. Mary’s we have a lot of women with fibroids because of our special clinic. I think I should also emphasise that there are lots of women with fibroids and have pregnancies that are successful too.

I think you have made it clear that not every fibroid is a bad fibroid and you can get through life quite happily without problems with your fibroids.

Finally, as you know we are always quite keen to talk about research here at Wellbeing of Women. Are you aware of any research that is going on to understand them better or is there more research into new treatments? I mean it sounds like the ultrasound is going well?

Well, my team are particularly interested in the minimally invasive treatments to prevent young women who want to preserve their fertility, having to undergo major surgery and having long periods of time off work. But there is lots more to be done about fibroids, I have alluded a couple of times to the fact we don’t really know why they grow. We know they get bigger in pregnancy and we certainly don’t have pre-pubertal girls with fibroids, so they must be hormone related, but we don’t really understand the mechanisms. Because oestrogen is usually thought of as the hormone that makes cells grow and proliferate, oestrogen was always thought to be the culprit if you like, but we know as well that the progesterone hormone can also promote the growth of fibroids, so it is not as simple as we used to think. I have to say, once again, that we are very ignorant about fibroids and how they develop and much more research needs to be done. One of the things that is very interesting, is that I don’t understand why some women make masses and masses of fibroids and can have a very enlarged uterus, which resembles a sack of golf balls each measuring three or four centimetres diameter, whereas other women will grow a single large fibroid which sometimes we refer to as tombstones, because they are just a great big lump. And why is it that some women’s large single fibroid becomes calcified and almost becomes rock like whereas other women will have tiny little seedling fibroids, it is quite extraordinary. They really are a law unto themselves.

A rich subject for further research.
Is there anything you would like to add that I haven’t covered in the questions? I think we have been quite thorough.

Well, I think that it is important that if you do think you have fibroids that you seek advice. If you have painful periods, heavy periods, abdominal pain or you find that you’ve got an enlarged uterus, ask for help. Sometimes women present saying they haven’t had any of those symptoms but they’ve got a lump, and of course they are terrified that it is something sinister. So go along to your doctor and ask to be referred and your doctor will probably organise for you to have an examination. Most general practitioners will be able to identify that the uterus is enlarged and they will probably organise for you to have an ultrasound scan and you can then start the dialogue about how to manage your fibroid. It may well be that you don’t need to have any treatment, because you may not have symptoms that are troublesome and if I could, for example, reassure you that the lump that you sometimes feel lying down in the morning in bed is actually quite benign and it’s a fibroid, you may not require anything further. On the other hand, you may be one of these stoical women who have suffered from debilitating heavy, painful periods for many years and just thought that was a woman’s lot. In which case you need to be reassured that we can do something to make you feel a lot better.

That’s a great message I think, don’t be stoical go and see your doctor. Thank you so much Lesley I feel I know a lot more about fibroids now, thank you very much.

Well, thank you for inviting me.

Discover the truth behind some of the myths surrounding Fibroids.

Fibroids are cancerous.

They are not malignant or sinister or cancerous, but they are growths of the muscle of the womb wall.

They make you infertile.

Many women with fibroids experience no problems during pregnancy, however depending on the size and location of the fibroids, it may be necessary to remove these surgically to improve fertility.

It’s just me- I seem to be the only one affected.

No fibroids are very common; as many as 60-70 percent of women will have fibroids. Some will experience the symptoms described above, but many others may have no symptoms at all.

To find out about our research follow this link:
Research News

• The Royal College of Obstetricians and Gynaecologists website has a wide range of information and guidelines on many women’s health topics. This can be found at: http://www.rcog.org.uk/womens-health/patient-information

• NHS Choices website also has a range of health information. This can be found at: http://www.nhs.uk/Pages/HomePage.aspx