Fibroids: who gets them, the symptoms and the treatment choices

SASian Anderson, Writer and editor, MyGLP. Sources checked 5 November 2026.

What fibroids are

The NHS fibroids page describes fibroids as common, non-cancerous growths which develop in or around the womb. They mainly affect women who have not been through the menopause. The exact cause is unknown.

Who gets them

The NHS lists these factors as raising your risk:

• Being from a Black or Asian background.
• Being overweight or obese.
• Never having had a full-term pregnancy.
• High blood pressure or diabetes.
• A close relative with fibroids.

The best-known study of how common fibroids are used ultrasound to screen women whether or not they had symptoms. Baird and colleagues, writing in the American Journal of Obstetrics and Gynecology in 2003, found 51% of premenopausal women with no previous diagnosis had fibroids on the scan. They estimated the cumulative incidence by age 50 at more than 80% for Black women and nearly 70% for white women. The study was American. The NHS names a Black or Asian background as a risk factor for UK women too.

In December 2024 the Women and Equalities Committee of MPs called for primary care staff to be trained to take menstrual symptoms seriously, including by challenging racial bias, as Endometriosis UK reports. Knowing your own risk is a good reason to push for a scan if you have symptoms.

Symptoms

Many women with fibroids have no symptoms at all. When symptoms happen, the NHS lists:

• Heavy or painful periods.
• Stomach pain or lower back pain.
• Needing to pee more often or suddenly, or being unable to control it.
• Bloating, constipation or pain when pooing.
• Pain or discomfort during sex.
• Difficulty getting pregnant.

Large fibroids can press on the bladder. Heavy bleeding from fibroids can lead to iron deficiency anaemia, which our iron guide covers. Rarely, fibroids cause fertility problems or miscarriage.

How fibroids are found

Your GP will ask about your symptoms and examine you, including an internal examination if you agree. If fibroids are suspected, the NHS says you are usually referred for an ultrasound scan, which shows the number, position and size of the fibroids. Fibroids are sometimes found by chance on a scan done for another reason, such as a pregnancy scan.

The NICE guideline on heavy menstrual bleeding, NG88, says to offer a pelvic ultrasound when the womb can be felt through the tummy or a mass is suspected, and an outpatient hysteroscopy, a camera passed into the womb, when your history suggests fibroids inside the womb cavity.

Treatment depends on size and position

If fibroids cause no symptoms, the NHS says no treatment is needed. When they do, NICE NG88 splits the choices by size.

The main options in plain terms, from the NHS:

• Painkillers such as ibuprofen, naproxen or diclofenac for pain.
• Tranexamic acid, a non-hormonal tablet taken on heavy days to reduce bleeding.
• The combined pill or other hormone treatment for heavy bleeding.
• Uterine artery embolisation, a procedure which blocks the blood supply to the fibroids so they shrink, without major surgery.
• Myomectomy, an operation to remove the fibroids and keep the womb.
• Hysterectomy, removal of the womb and the fibroids with it.
• Endometrial ablation, which uses heat to remove the lining of the womb.

Some treatments affect whether you can have children. The NHS advises talking to your doctor about this before you choose if you plan a pregnancy. Ask the specialist directly: "Which of these options keeps my womb, and which keeps my chance of pregnancy?"

Fibroids and weight

The NHS names being overweight or obese as a risk factor. A 2021 systematic review and meta-analysis in the Journal of Epidemiology and Community Health pooled observational studies and found obesity raised the odds of fibroids by 19%. The link was not a straight line: the authors described an inverse J-shaped pattern with BMI. The review looked at risk. It did not test whether losing weight shrinks fibroids you already have, and no weight loss medicine is licensed to treat fibroids.

If you take a weight loss medicine and have fibroids, keep these points in mind:

• If the combined pill is your fibroid bleeding treatment, the MHRA warned in June 2025 that Mounjaro may reduce how well oral contraceptives work in people who are overweight. The hormonal coil is a non-oral option NICE puts first for small fibroids.
• Weight loss can change your cycle, and heavier bleeding for a cycle or two is common. Persistent heavy bleeding still needs checking. See our guide to periods on weight loss injections.
• Eating less lowers the iron coming in. Ask for a blood test if you feel tired or short of breath.
• If you are planning a pregnancy, the medicines need stopping weeks to months before you try. Our fertility guide gives the times from each leaflet.

Questions to ask

1. How many fibroids do I have, how big are they and where are they?
2. Are they inside the womb cavity, in the wall, or on the outside?
3. Which treatments keep my womb and my fertility?
4. What is my blood count?
5. If this treatment does not work, what is the next step and when do I come back?

For heavy bleeding with or without fibroids, our heavy periods guide sets out the full NICE approach.

Sources

1. Fibroids (NHS)
2. High cumulative incidence of uterine leiomyoma in black and white women: ultrasound evidence (Baird et al, American Journal of Obstetrics and Gynecology, 2003)
3. Association between obesity and the risk of uterine fibroids: a systematic review and meta-analysis (Qin et al, Journal of Epidemiology and Community Health, 2021)
4. Heavy menstrual bleeding (NG88), full recommendations (NICE)
5. How and when to take tranexamic acid (NHS)
6. Women and Equalities Committee report on menstrual health, December 2024 (Endometriosis UK)
7. Weight loss injections: contraception warning for women, June 2025 (MHRA, via the Department of Health Northern Ireland)