- Symptoms — not size alone — drive the decision to treat.
- Watchful waiting is reasonable for small, silent fibroids.
- Rapid growth always deserves evaluation.
What fibroids are
Fibroids (leiomyomas) are benign smooth-muscle tumours of the uterus. They are extraordinarily common: by age 50, around 70–80% of women have at least one, though most cause no symptoms.
Fibroids are classified by location: submucosal (inside the cavity), intramural (in the muscle wall), or subserosal (on the outer surface). Location matters far more than size — a small submucosal fibroid can cause severe bleeding, while a large subserosal one may be silent.
When treatment is warranted
Fibroids should be treated when they cause: heavy or prolonged bleeding, iron-deficiency anaemia, pressure symptoms on bladder or bowel, pain, infertility or recurrent miscarriage, or rapid growth (which requires further evaluation).
- Heavy bleeding — flooding, clots, needing double protection.
- Anaemia diagnosed on blood tests.
- Pressure symptoms — frequent urination, constipation, bloating.
- Fertility problems where fibroids distort the cavity.
- Rapid growth — needs further imaging.
When watchful waiting is fine
Small, asymptomatic fibroids in a woman with regular periods and no fertility plans can be monitored with a scan every 12–24 months. Fibroids shrink after menopause, so watchful waiting in your late 40s is often appropriate.
Frequently asked questions
Do fibroids turn into cancer?
The risk is very low — around 1 in 350–500 for suspicious growth. Any rapidly growing fibroid should be evaluated.
Can I get pregnant with fibroids?
Many women do. Whether treatment is needed depends on the location, size and any distortion of the cavity.
Will fibroids grow bigger?
Some do, some don't. Hormonal changes influence growth; menopause typically causes them to shrink.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your imaging and giving you a clear personalised plan for uterus-sparing fibroid surgery.
Request a video consultation