Answer first
Fibroids can cause heavy or painful periods, pelvic pressure, bladder or bowel symptoms, and sometimes fertility concerns. An assessment considers your symptoms and how they affect your life. Treatment is not always needed; if it is, the options depend on the number, size and position of fibroids, your health, your wishes about fertility and keeping your uterus, and your preferences.[1] [2]
What are uterine fibroids?
Fibroids are non-cancerous growths that develop in or around the womb. Anyone with a womb can get them. They are more often found before menopause, and many people do not know they have them because they have no symptoms.[1]
A fibroid finding does not prove that it causes every symptom. Pelvic pain, irregular bleeding and pressure symptoms can have other causes. A clinician uses your history, examination and any appropriate tests to decide what needs attention.
Symptoms that can occur with fibroids
Symptoms vary. Heavy menstrual bleeding can have a major effect on quality of life, which NICE places at the centre of assessment and treatment discussions.[2]
| Area | Possible symptoms |
|---|---|
| Bleeding and pain | Heavy or painful periods and pain in the lower tummy or back. |
| Bladder and bowel changes | Needing to pass urine more often or urgently, or bowel symptoms such as bloating, constipation or pain when opening your bowels. |
| Sex and fertility | Pain or discomfort during sex, or difficulty becoming pregnant. These symptoms have several possible causes. |
See a clinician if symptoms affect your daily life, work or relationships, or if pain relief is not helping. For heavy periods, our guide to irregular periods and when to seek assessment may help you prepare for the conversation.[1]
How fibroids are assessed
A clinician may ask about your bleeding pattern, pelvic pain or pressure, and the impact on your quality of life. The assessment can include an abdominal or pelvic examination when appropriate. For people with heavy menstrual bleeding, NICE recommends a full blood count alongside any treatment offered for the bleeding.[2]
Ultrasound can show whether fibroids are present, how many there are, and their size and position. NICE advises clinicians to choose ultrasound or hysteroscopy according to the history and examination. For suspected larger fibroids, pelvic ultrasound may be appropriate. It also explains that pelvic ultrasound has limits for finding causes inside the uterine cavity, so further assessment may sometimes be needed.[1] [2]
Pelvic ultrasound
Learn about the scan and the pathway the clinic confirms at booking.
Blood tests
Explore blood-test pathways, including full blood count information.
Treatment decisions are individual
NHS and NICE guidance does not set one treatment for every fibroid. A treatment discussion should take account of symptoms, fibroid size, number and position, other health conditions, and whether you want to retain fertility or your uterus.[1] [2]
| Situation | What a discussion may cover |
|---|---|
| No troublesome symptoms | Some fibroids do not need active treatment. A clinician can discuss whether observation is appropriate for your situation. |
| Heavy bleeding or period pain | The discussion may include medicines to manage bleeding or pain, taking account of your medical history and preferences. |
| Larger fibroids or persistent symptoms | Specialist options can include procedures or surgery. NICE lists uterine artery embolisation, myomectomy and hysterectomy among the options considered in the relevant circumstances. |
| Fertility or uterus-retention wishes | These preferences should guide the discussion. Treatments can have different implications for future pregnancy and for keeping the uterus. |
If heavy bleeding has led to iron deficiency or anaemia, the clinician can consider that alongside the underlying cause. Read our iron deficiency anaemia guide for general information on symptoms, testing and treatment pathways.
Seek urgent help when you need it
A routine appointment is not a substitute for urgent care. If you feel seriously unwell or need urgent medical advice, contact NHS 111. Call 999 for a life-threatening emergency. [3]
Frequently asked questions
Are fibroids cancer?
Fibroids are non-cancerous growths that develop in or around the womb. A clinician should assess new, persistent or worrying symptoms rather than assuming that fibroids are the cause.
Do all fibroids need treatment?
No. Some people have no symptoms and do not need treatment. The decision depends on your symptoms, the fibroids, your health and what matters to you.
Can fibroids cause heavy periods and anaemia?
Fibroids can be associated with heavy periods. Heavy bleeding can lead to iron deficiency anaemia. NICE recommends a full blood count for women with heavy menstrual bleeding, alongside treatment offered for the bleeding.
Is an ultrasound enough to explain heavy bleeding?
Ultrasound can show fibroids, including their size and position. It does not answer every question about heavy bleeding. NICE recommends that a clinician chooses ultrasound or hysteroscopy using the history and examination findings.
Will fibroids affect fertility?
Some fibroids may be relevant when someone is having difficulty becoming pregnant, but the effect varies. Discuss your own circumstances with a gynaecology clinician before drawing conclusions or choosing treatment.
Related information
Private gynaecology
Discuss symptoms and assessment pathways
Pelvic ultrasound
Understand pelvic imaging
Ovarian cysts
Read about another pelvic finding
Irregular periods
Learn when bleeding changes need assessment
References
- [1] NHS. Fibroids. Last reviewed 17 March 2026. View source
- [2] NICE. Heavy menstrual bleeding: assessment and management. NICE guideline NG88, last updated 7 July 2026. View source
- [3] NHS. When to call 999. View source