Expert calls for greater awareness of misunderstood condition affecting 80% of women in Belfast

Fertility experts are calling for greater awareness of fibroids, warning that misconceptions about the condition are leaving women unnecessarily worried about their fertility.

Fibroids are the most common non-cancerous growth in the female reproductive system, affecting up to 80% of women by the age of 50. Yet despite how widespread they are, they remain widely misunderstood, with many women mistakenly believing that a diagnosis automatically results in difficulty conceiving or a higher risk of miscarrying.

During Fibroids Awareness Month this July, Dr Justin Chu, Medical Director at TFP Fertility, has answered some of the most common questions around fibroids and their impact on fertility.

1.        What are fibroids?

“Fibroids are the most common tumour we see in women in the reproductive system, but it’s important to recognise that they are benign,” Dr Chu explains.

“They’re caused by an outgrowth of the smooth muscle in the wall of the womb and can develop in any woman of reproductive age. The majority of women will develop at least one fibroid during their lifetime, yet most will never know as they don’t often interfere with daily life.”

2.        What are the symptoms to look out for?

“When fibroids start to cause problems, there are three main things to look out for: heavy menstrual bleeding, pressure symptoms and difficulty getting pregnant.

“Heavy bleeding is one of the most common signs that something isn’t right. Fibroids increase the surface area of the womb lining, which means there’s more lining to bleed. If your periods have become very heavy, it’s important to see your GP, both to investigate whether you have fibroids but also to rule out other causes of abnormal bleeding.

“Pressure on surrounding organs can also be a sign that fibroids are growing and may need attention. If fibroids are pressing on the bladder, women may find themselves constantly rushing to the toilet or feeling like they can never fully empty their bladder. Pressure on the rectum can also cause bowel symptoms.

“A third symptom is struggling to get pregnant, which is typically the point where women seek advice from a fertility specialist.”

3.        Do fibroids always affect fertility?

“One of the most common misconceptions around fibroids is that a diagnosis automatically means you’ll have trouble conceiving or a higher chance of miscarrying. Thankfully, this often isn’t the case.

“In reality, not every fibroid is a fertility problem. In many instances, they’re discovered incidentally during routine fertility investigations, such as an ultrasound scan, without having played any role in the couple’s struggle to conceive.

“Whether a fibroid is likely to affect fertility depends on its size, type and location. We always look at the complete picture first, including ovarian reserve, sperm health and whether the fallopian tubes are open. If, for example, there’s no sperm in the ejaculate and a small fibroid is found on the outside of the uterus, it’s unlikely that the fibroid is the issue.

“However, if all other factors are normal and a fibroid is present inside the womb cavity, it’s much more likely that this is the cause of any fertility issues.”

4.        Is surgery always the answer?

“There’s sometimes an instinct to remove a fibroid as soon as it’s found. It’s important to take a step back and understand whether an operation would actually benefit the patient before going ahead.

“There are several surgical approaches that can be taken, including a hysteroscopic procedure where a camera is used inside the womb to shave off a fibroid, or an abdominal operation that can be done either as keyhole surgery or as open surgery. Yet these come with their own risks.

“Removing fibroids from inside the womb can cause scarring that actually makes it harder to conceive. Abdominal operations also carry the risk of bleeding, infection and damage to surrounding structures. In very serious cases, a hysterectomy may be required as a life-saving measure, which would be devastating for someone trying to start a family.

“Beyond surgery, there are other interventions like radiological procedures to shrink fibroids or medications, but these have their own potential side effects and longer-term consequences. It’s important to weigh up each option against your own personal circumstances.”

5.        What should women do if they’re concerned?

“If you suspect you may have fibroids, it’s important to seek professional advice rather than searching online. Anxiety builds up quickly when you’re looking up symptoms online or self-diagnosing, and what you find may not reflect your individual situation at all.

“A proper clinical assessment, including a full history, an examination, appropriate imaging and potentially blood tests, will give you a much clearer picture. From there, your clinician will help you understand whether any intervention is needed and walk you through the risks and benefits of each option.

“If you’re worried about your fertility, you should also seek a fertility assessment. The sooner you get a clear picture of the full situation, the better equipped you’ll be to make the right decisions for you.”

TFP Fertility supports patients at every stage of their fertility journey, offering expert advice and personalised care to help individuals and couples make informed decisions about their reproductive health, including those where fibroids may be a factor.

For more information about fibroids and fertility, visit: https://tfp-fertility.com/en-gb/blog/how-do-fibroids-affect-fertility-