Treatment of Uterine Fibroids

Treatment of Uterine Fibroids

We offer individually tailored medical services aimed at effective treatment of uterine fibroids. We provide consultations with experienced gynaecologists, comprehensive diagnostics, and various treatment options, including both conservative and surgical approaches.

For surgical treatment of fibroids, we place particular emphasis on minimally invasive techniques, such as laparoscopy and robotic surgery. These methods offer an alternative to traditional open surgery, which requires large incisions. Minimally invasive techniques significantly reduce postoperative pain, improve aesthetic outcomes by minimising scarring, and lower the risk of infection and surgical complications. They also support a faster recovery and earlier return to normal activities.

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Why Minimally Invasive Fibroid Surgery?

  • Smaller incisions compared with open surgery
  • Reduced postoperative pain and discomfort
  • Lower risk of infection and surgical complications
  • Better cosmetic (aesthetic) results with minimal scarring
  • Faster recovery and earlier return to normal activity

What Are Uterine Fibroids?

Uterine fibroids are benign, non-cancerous tumours that grow in the muscular layer of the uterus. They are composed of smooth muscle cells of the uterus surrounded by connective tissue. Fibroids can occur individually or in clusters, ranging in size from as small as a grain of sand to several centimetres in diameter. These tumours can grow in different parts of the uterus, including within the uterine wall (intramural fibroids), on the outer surface of the uterus (subserosal fibroids), or inside the uterine cavity (submucosal fibroids). The location of the fibroids can influence their symptoms and treatment options. Most uterine fibroids do not cause symptoms and remain undiagnosed, but in some cases, they may lead to issues such as heavy menstrual bleeding, pelvic pain, pressure on the bladder or intestines, and difficulties conceiving. Diagnosis is made using imaging tests such as ultrasound or magnetic resonance imaging (MRI), along with symptoms and a gynaecological examination.

What Are the Symptoms of Uterine Fibroids?

  • Heavy menstrual bleeding: heavy and prolonged periods that affect comfort and daily life.
  • Pain and discomfort: pain in the lower abdomen or pelvis, especially during menstruation, sometimes radiating to the back or legs.
  • Frequent urination: pressure on the bladder can lead to a constant urge to urinate.
  • Pain during intercourse: dyspareunia, causing discomfort and difficulties in sexual activity.
  • Difficulty conceiving: interference with uterine function or embryo implantation.
  • Abdominal enlargement: a noticeable bulge or increased abdominal circumference.

If any of these symptoms occur, or if there are changes in the menstrual cycle, it is important to consult a gynaecologist. Early diagnosis and treatment can help relieve symptoms and improve quality of life.

What Are the Symptoms of Endometriosis?

Endometriosis manifests in various ways and can cause multiple symptoms, making early diagnosis challenging. The most common symptoms associated with endometriosis are pain of varying intensity and location, usually occurring before or during menstruation. Women suffering from endometriosis often experience painful, prolonged, and heavy periods. Other symptoms include pain during bowel movements or after defecation, pain during intercourse, and symptoms resembling bladder infections.

Painful symptoms are primarily caused by the formation of adhesions due to inflammation associated with the disease, as well as nerve infiltration and the accumulation of blood components in endometriotic lesions. Women of reproductive age with endometriosis often face difficulties in conceiving. Estimates suggest that half of the women undergoing infertility treatment also suffer from endometriosis.

How Are Uterine Fibroids Diagnosed?

Diagnosis involves confirming the presence of fibroids, assessing their size and location, and understanding how they affect health and wellbeing.

Medical history & examination

Discussion of symptoms, menstrual history and a pelvic examination during which the doctor may feel an enlarged uterus or nodules.

Ultrasound

The primary imaging test for diagnosing fibroids. It helps assess size, number and location.

MRI

Used when more detailed evaluation is needed, especially for large or complex fibroids

Hysteroscopy

A thin endoscope is inserted through the cervix to examine the inside of the uterus and assess submucosal fibroids.

Biopsy (selected cases)

Used if there is concern about the nature of the tumour or suspicion of malignancy.

Blood tests

Haemoglobin and iron levels may be checked to detect anaemia caused by heavy bleeding.

What Are the Available Treatment Options?

If fibroids are small and do not cause significant symptoms, a doctor may recommend regular monitoring (active surveillance). Fibroid growth and symptoms are reviewed over time, and if no major changes occur, treatment may not be necessary.

Medications can relieve symptoms such as heavy bleeding or pain. Common options include contraceptive pills to regulate the menstrual cycle and reduce bleeding, non-steroidal anti-inflammatory drugs (NSAIDs) for pain, and haemostatic agents.

Hormonal medications, such as gonadotropin-releasing hormone (GnRH) agonists, may be used to reduce fibroid size and bleeding, particularly before surgery as short-term therapy.

When fibroids cause significant symptoms or complications, surgical removal may be recommended. In most cases, the fibroid is removed while preserving the uterus. Minimally invasive techniques such as laparoscopy or robotic surgery are preferred wherever possible.

The choice of treatment depends on fibroid size and location, symptom severity, age, overall health, and plans for future pregnancy. In some cases, fibroids can recur after treatment, so regular monitoring is important.

Uterine fibroids are usually benign, non-cancerous tumours that rarely pose a serious threat to health. Many are small, asymptomatic, and do not require treatment. However, they can cause heavy bleeding, pain, pressure on other organs, and fertility problems, which may significantly affect quality of life.

In rare cases, complications such as fibroid rupture, sudden bleeding, or anaemia can occur. While fibroids are benign, they can sometimes mimic more serious conditions or show worrying features, so regular monitoring and medical consultation are important.

A biopsy of uterine fibroids is not a standard diagnostic procedure. Fibroids are usually diagnosed by imaging (ultrasound or MRI) and symptoms. However, a biopsy may be considered if:

  • There is uncertainty about whether the mass is a fibroid or another type of tumour (including malignancy).
  • A pre-operative tissue diagnosis is required before removal.
  • A pre-operative tissue diagnosis is required before removal.
    The fibroid shows rapid growth or abnormal imaging features that raise concern for malignancy.

Biopsy techniques may include fine-needle aspiration under ultrasound guidance or open biopsy during surgery. The decision to perform a biopsy is made on an individual basis by the treating doctor.

Uterine fibroid rupture is rare but can be serious. It may be triggered by trauma, torsion (twisting) of the fibroid, or increased pressure in the abdominal cavity.

Symptoms of rupture may include:

  • Sudden, severe abdominal or pelvic pain
  • Internal or external bleeding with possible significant blood loss
  • Nausea, vomiting, dizziness, pale skin, rapid heart rate, and shortness of breath

A ruptured fibroid is a medical emergency. If these symptoms occur, immediate medical attention is essential.

Uterine fibroids are a chronic condition, but they can be effectively managed. Many women successfully control symptoms with appropriate treatment and regular monitoring. Options include active surveillance, medication, and surgery, depending on individual needs and preferences.

Healing time depends on the surgical method, fibroid size and location, and the patient’s general health. In the first few days, pain, bleeding, or spotting may occur. The overall recovery period can range from several weeks to several months.

Regular follow-up visits are recommended to monitor healing and detect complications. Ultrasound and other imaging may be used to assess the uterus and check for recurrence. A gradual return to physical activity is usually advised, based on individual recovery.

Uterine Fibroids After the Age of 50

During menopause, fibroids often shrink because their growth is linked to oestrogen and progesterone levels, which decline. However, fibroids may still persist and require treatment.

In women over 50, fibroids may:

  • Be associated with a higher risk of complications such as rupture
  • Mask or coexist with malignant changes, such as endometrial cance
  • Cause chronic bleeding and anaemia
  • Exert pressure on the bladder or intestines, affecting quality of life

Regular monitoring and gynaecological assessment are essential in this age group.

Uterine Fibroids and Pregnancy

Fibroids are common in women of reproductive age. They can sometimes affect fertility or pregnancy, depending on their size and locatio

  • Conception: Some fibroids may make it more difficult to conceive, though many women with fibroids get pregnant naturally.
  • Pregnancy complications: There may be a higher risk of miscarriage, preterm birth, breech presentation, or labour complications.
  • Monitoring: Additional ultrasound scans may be required to monitor fibroid growth and foetal development.
  • Treatment during pregnancy: Most fibroids are managed conservatively, but severe pain or bleeding may require medical or surgical treatment.
  • Delivery: In some cases, a planned caesarean section may be recommended.

Uterine Fibroids and Physical Activity

Light to moderate physical activity is generally safe and beneficial for women with fibroids. Activities such as walking, yoga, swimming, and cycling can support overall health.

  • Avoid excessive strain or very intense exercise that may increase pressure on the uterus.
  • Consult a doctor before starting or intensifying an exercise programme.
  • Monitor symptoms: if pain or bleeding increases with activity, seek medical advice.

Types of Uterine Fibroids

Medical history & examination

Discussion of symptoms, menstrual history and a pelvic examination during which the doctor may feel an enlarged uterus or nodules.

Ultrasound

The primary imaging test for diagnosing fibroids. It helps assess size, number and location.

MRI

Used when more detailed evaluation is needed, especially for large or complex fibroids

Other rare types include isthmic and cervical fibroids, pedunculated fibroids (attached by a stalk), and vascular fibroids with numerous blood vessels. Fibroids can vary greatly in size and may occur singly or in clusters.

Causes and Risk Factors

The exact causes of fibroids are not fully understood, but several factors may contribute:

  • Hormones: oestrogen and progesterone play a key role; fibroids often grow during reproductive years and shrink after menopause.
  • Genetics: family history increases the likelihood of developing fibroids.
  • Ethnicity: more common and often more severe in women of African descent.
  • Age: risk is highest in women in their 30s and 40s.
  • Obesity: may increase risk, though the exact mechanism is not fully understood.
  • Lifestyle: smoking, alcohol, and poor diet may also play a role.

Is There a Link Between Coffee Consumption and Uterine Fibroids?

Currently, there is no conclusive evidence regarding the relationship between coffee consumption and the development of uterine fibroids.

Epidemiological studies: some suggest a slightly increased risk with high coffee intake, particularly in younger women, while others do not confirm this

Possible mechanisms: caffeine may influence sex hormone levels such as oestrogen, but this requires further resea

More important risk factors: age, ethnicity, family history, obesity, hormone levels and lifestyle have a greater proven impact.

Limited data: most studies are observational and cannot prove a direct cause-and-effect relationship.

Long-Term Risks of Untreated Uterine Fibroids

  • Heavy bleeding leading to iron-deficiency anaemia
  • Persistent pelvic pain and discomfort
  • Fertility problems or pregnancy complications
  • Progressive fibroid growth and worsening symptoms
  • Rarely, fibroid rupture with sudden pain and bleeding

Regular monitoring and appropriate treatment can help prevent complications and protect long-term health.

Your journey step by step

Consultation

History, symptom review & examination

Diagnostics

Ultrasound, MRI, hysteroscopy & blood tests

Treatment Plan

Monitoring, medication or surgery

Procedure

Minimally invasive or open surgery where needed

Recovery

Follow-up, lifestyle advice & long-term monitoring

Recovery

Follow-up, lifestyle advice & long-term monitoring

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Disclaimer
*The Pax Medicus website provides information for guidance only and does not constitute medical advice, diagnosis, or treatment. Pax Medicus does not provide healthcare services and is not a substitute for consultation with a qualified medical professional. Always seek advice from your physician regarding any medical condition. Prices shown are indicative only and subject to confirmation by the healthcare provider. This is the official website of Pax Medicus; we do not operate through agents or third-party sites.

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