Health condition · Clinically reviewed
Uterine fibroids, benign muscle tumours — with modern medical and surgical options.
Non-cancerous smooth-muscle tumours of the uterus. Very common — treatment ranges from watchful waiting to medical management, uterine artery embolisation, myomectomy or hysterectomy.
Why trust this guide
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Clinically reviewed
Written by our editorial team and reviewed by a registered UK clinician before publication.
- 02
Sourced from guidance
Every claim is checked against NICE, RCOG or peer-reviewed sources you can see at the end.
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Current for 2026
Reflects current UK guidance on imaging, medical management and uterus-preserving treatment.
Key facts
Uterine fibroids at a glance.
The essentials, in plain English — what they are, how common they are, how they are diagnosed, and how they are treated in the UK today.
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What it is
Benign uterine leiomyomas — non-cancerous smooth-muscle tumours arising from the wall of the uterus.
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How common
Affects up to 70% of women by the age of 50 — one of the most common conditions in gynaecology.
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Symptoms
Vary hugely — many fibroids are asymptomatic, others cause heavy bleeding, pressure or pain.
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Diagnosis
Transvaginal ultrasound is first-line; pelvic MRI is added for surgical planning or complex cases.
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Modern medical options
GnRH analogues and relugolix combination therapy give effective non-surgical control for many.
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Uterus-preserving care
Uterine artery embolisation is a fertility-preserving alternative to surgery for many women.
Why this guide matters
More choice than most women are told.
Fibroids are very common, and treatment has changed. The three points below shape everything else on this page.
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Asymptomatic fibroids usually need no treatment
A fibroid seen on a scan does not automatically need to be removed — many need only periodic review.
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Modern medical options are highly effective
GnRH analogues and relugolix combination therapy control bleeding without surgery for many women.
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Embolisation is uterus-preserving
Uterine artery embolisation shrinks fibroids without cutting the uterus — a good alternative for many.
How the diagnosis is made
From first symptoms to a clear plan.
The steps a UK GP and gynaecologist will normally follow, in order — so you know what to expect and why.
Phase 1 · Recognising
History and examination to raise suspicion
Phase 2 · Confirming
Ultrasound and MRI to map disease
Phase 3 · Managing
Bloods and gynaecology plan
- 01
Recognising
Symptom history
A careful account of bleeding, pressure and pain — cycle pattern, clot size, and impact on daily life.
- 02
Recognising
Pelvic examination
An abdominal and bimanual examination can detect an enlarged, irregular uterus suggestive of fibroids.
- 03
Confirming
Transvaginal ultrasound
First-line imaging — accurately locates fibroids, their number, size and relationship to the endometrial cavity.
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Confirming
Saline infusion sonohysterography
Adds fluid to the cavity for better assessment of submucosal fibroids that distort the endometrium.
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Confirming
MRI pelvis
Detailed mapping for surgical or embolisation planning — number, size, position and vascularity.
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Managing
Full blood count and iron studies
Heavy bleeding often causes iron-deficiency anaemia — treated alongside the fibroids themselves.
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Managing
Gynaecology consultation
To agree a plan — from watchful waiting through medical treatment to embolisation or surgery.
Typical timeline: weeks from first appointment to a settled plan, longer when surgery or embolisation is planned.
Symptoms
What fibroids actually feel like.
Many fibroids cause no symptoms at all. When they do, the picture is usually a mix of heavy bleeding, pressure and pain — often building slowly.
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Heavy menstrual bleeding
Prolonged, heavy periods with clots — often the most disruptive symptom of fibroids.
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Pelvic pressure
A sense of fullness or heaviness in the lower abdomen from a bulky uterus.
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Dysmenorrhoea
Painful periods — cramping that can be worse than usual with larger or degenerating fibroids.
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Pregnancy complications
Fibroids can affect implantation, cause pain in pregnancy and increase risk of malposition or caesarean.
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Bladder pressure symptoms
Frequency, urgency and incomplete emptying from a fibroid pressing on the bladder.
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Bowel pressure symptoms
Constipation or a feeling of incomplete emptying when a posterior fibroid presses on the rectum.
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Fertility concerns
Submucosal fibroids in particular can reduce fertility and increase miscarriage risk.
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Red flag — acute pain
Sudden severe pain in a known fibroid (degeneration or torsion) — urgent gynaecology assessment.
Treatment
How fibroids are treated in the UK.
A stepwise plan — from watchful waiting through medical treatment to embolisation and surgery — matched to symptoms, fertility plans and disease extent.
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Watchful waiting
Asymptomatic fibroids often need no treatment — periodic review to check for change.
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Combined pill or IUS
Combined oral contraceptive or a levonorgestrel-releasing IUS lightens bleeding and reduces pain.
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Tranexamic acid + NSAID
Non-hormonal first-line for heavy bleeding — taken during periods, often together.
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GnRH analogue (goserelin)
Shrinks fibroids and stops bleeding — used with add-back HRT to protect bones and quality of life.
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Relugolix combination
A modern oral GnRH antagonist with add-back — controls heavy bleeding without injections.
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Uterine artery embolisation (UAE)
Interventional radiology procedure that shrinks fibroids by blocking their blood supply — preserves the uterus.
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Myomectomy
Surgical removal of fibroids — open, laparoscopic or hysteroscopic — the uterus-preserving surgical option.
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Hysterectomy
Definitive treatment when family is complete or other options have failed.
What this guide is based on
The sources behind every claim on this page.
UK national guidance and specialist society standards, current at the time of last review.
Key references
Guidelines and standards we relied on.
A quiet reminder
This guide is for information, not medical advice.
Your GP or gynaecologist knows your history and can tell you which parts apply to you. If in doubt, seek assessment — especially with any red-flag features.
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NICE. Heavy menstrual bleeding: assessment and management (NG88).
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Royal College of Obstetricians and Gynaecologists (RCOG). Guidance on uterine fibroids and treatment.
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British Society for Gynaecological Endoscopy (BSGE). Standards for hysteroscopic and laparoscopic fibroid surgery.
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European Society of Human Reproduction and Embryology (ESHRE). Fibroids and reproductive outcomes.
Red flags
When fibroids need urgent care.
Most fibroid symptoms are stable and can be managed in clinic. These are the patterns that need urgent assessment — do not push through them.
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Acute severe pelvic pain
Sudden severe pain in a known fibroid suggests degeneration — urgent gynaecology assessment.
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Cord compression from massive fibroid
Rare — a very large fibroid causing neurological symptoms is a surgical emergency.
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Pregnancy complications
Bleeding, severe pain or reduced fetal movements with known fibroids — urgent obstetric review.
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Rapid growth in postmenopause
A fibroid that grows after the menopause raises suspicion of leiomyosarcoma — urgent assessment.
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Anaemia requiring transfusion
Severe iron-deficiency anaemia from bleeding — needs same-day medical assessment.
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Post-embolisation infection
Fever, offensive discharge or worsening pain after UAE — contact the interventional team same day.
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Post-operative bleeding
Any concerning bleeding after myomectomy or hysterectomy — contact the surgical team urgently.
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Recurrence
Return of heavy bleeding or a lump after treatment — arrange follow-up imaging and review.
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Fertility loss with surgery
Any planned fibroid surgery carries fertility risks — discuss these carefully before proceeding.
Living with it
A common condition, and a very treatable one.
Four things that make the biggest difference day to day — iron, choice of treatment, fertility conversations and the right team.
A quiet reminder
The right treatment depends on your goals.
Fertility, symptom control and how definitive you want the treatment to be all shape the best plan for you.
- 01 Iron
Treat the anaemia early
Iron replacement — oral or intravenous — alongside treatment of the fibroids themselves.
- 02 Choice
You usually have options
From watchful waiting to hysterectomy — most women can choose the treatment that fits their life.
- 03 Fertility
Have the conversation early
If you may want children, discuss uterus-preserving options with your gynaecologist ahead of time.
- 04 Specialist care
The right team matters
Complex fibroid surgery and UAE should be done by teams who do them often.
Frequently asked
Everything we get asked about fibroids.
Quick answers on diagnosis, imaging, medical options, embolisation, surgery and fertility.
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What are uterine fibroids?
Benign smooth-muscle tumours of the uterus — very common, non-cancerous, and often asymptomatic. When they cause symptoms, these are typically heavy bleeding, pressure or pain.
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How are fibroids diagnosed?
Transvaginal ultrasound is first-line — it accurately shows the number, size and position of fibroids. MRI is added for surgical or embolisation planning and to characterise complex cases.
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Do I need treatment for fibroids?
Not always. Asymptomatic fibroids often need only periodic review. Treatment is offered when they cause heavy bleeding, pressure, pain or fertility problems.
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What is uterine artery embolisation?
A minimally invasive interventional-radiology procedure that shrinks fibroids by blocking their blood supply. It preserves the uterus and is a good alternative to surgery for many women.
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Can fibroids affect fertility?
Submucosal fibroids that distort the endometrial cavity can reduce fertility and increase miscarriage risk. Other fibroids often have less effect. A gynaecologist can advise on your individual situation.
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Are fibroids cancerous?
No — uterine fibroids are benign. A very rare malignant tumour called leiomyosarcoma can look similar; rapid growth, especially after the menopause, raises suspicion and needs urgent assessment.
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