The facts about fibroids

Diagnosis of fibroids
A pelvic examination performed by a doctor is usually the first attempt at diagnosing fibroids. Your doctor should be able to feel a uterus with fibroids because the uterus often feels enlarged and/or irregular and, if large enough, may also be felt abdominally above the pubic bone.

You may have an ultrasound scan if a potential problem is detected, and this will be able to tell exactly where the fibroids are within the womb and give an idea of their size. Sometimes they are detected by seeing them on laparoscopy, a minor operation where a small telescope is passed through an incision in the abdominal wall, or on hysteroscopy, where the telescope is passed up into the uterine cavity through the vagina.

If you have heavy or prolonged bleeding or multiple miscarriages, your doctor may recommend an assessment of the uterine cavity because a submucous fibroid might go undetected on a regular ultrasound. The assessment can be done by hysteroscopy, as above, or by the X-ray examination known as hysterosalpingography, when a dye is injected into your uterus and then pictures are taken.

Treatment of fibroids
If your symptoms are not severe and the fibroids are small, your doctor may just 'watch and wait' rather than going on to treat them immediately. A scan or pelvic examination every six months is a good idea to check that there has been no sudden rapid growth of a fibroid. Many women find that their fibroids decrease in size of their own accord after the menopause.

Asymptomatic fibroids will rarely need therapy unless the fibroids press on the kidneys or ureters, which can lead to kidney damage.

Surgical interventions depend on where the fibroids are located, how big they are, the type of symptoms they are causing, your age and fertility concerns.