Discovering you have fibroids when pregnant can be a worrying diagnosis, especially if you’re not too familiar with the condition.
Fibroids are non-cancerous growths of muscle and tissue that develop around the womb. It’s a condition that’s often listed next to others that affect the reproductive system, such as endometriosis. But fibroids are very different, most people don’t even know they’re there until they’re discovered during an ultrasound scan (opens in new tab).
To find out what you need to know about the diagnosis, we’ve asked consultant gynaecologists Mr Shaheen Khazali and Miss Shirin Irani to share their advice.
- What are fibroids and why do they develop?
- How can fibroids impact your pregnancy?
- Is it possible to get pregnant safely with fibroids?
- Treatment for fibroids when pregnant
What are fibroids and why do they develop?
Fibroids are growths around the womb consisting of muscle and fibre tissue. They have other names as well, including uterine myomas or leiomyomas.
“Around one in three women develop them at some point in their lives,” says Mr Shaheen Khazali, consultant gynaecologist at The Lister Hospital (opens in new tab) . “They often go unnoticed if women don’t suffer any symptoms.”
Miss Shirin Irani, consultant gynaecologists at Spire Parkway Hospital (opens in new tab) agrees. She says, “In many cases, women will only realise they have fibroids when they’re picked up during an ultrasound scan - possibly for something else. Symptoms may also differ between women due to the location, size and how many [fibroids] the woman has.”
Common ones include heavy or painful periods (opens in new tab), abdominal pain, lower back pain, the frequent need to urinate, symptoms of constipation (opens in new tab), and pain or discomfort during sex.
They most commonly occur in women aged between 30 and 50, Mr Khazali says. They are caused by "an increased level of oestrogen as well as genetic factors.”
How can fibroids impact you when pregnant?
“Fibroids are very common and most women will experience no effects from fibroids when trying for a baby,” Mr Khazali says.
“Very large fibroids or those that grow close to or inside the cavity of the uterus could sometimes prevent the fertilised egg from attaching itself to the lining of the womb, or prevent the egg from being fertilised in the first place.”
There is also risk to the development of the baby after conception or difficulties during labour, our expert says.
“If you have large fibroids, you may experience abdominal pain throughout your pregnancy and if your fibroids block the neck of the womb, you may need to have a caesarean.
“Some fibroids can grow during pregnancy and large fibroids can cause problems in pregnancy. For example, they can increase the risk of premature delivery. Or they can prevent the baby from getting into the correct position,” he says.
And in very rare cases, fibroids can cause a miscarriage early in the pregnancy.
If you have fibroids and you are pregnant, speak to your GP or midwife. They will be able to offer advice more personal to your situation.
Is it possible to get pregnant safely if you have fibroids?
If you are considering trying for a baby, discuss the size and the position of your fibroids with your doctor as this could cause problems, our expert Mr Khazali from the Lister Hospital, part of HCA Healthcare UK, suggests.
There are a range of fertility-friendly treatment options available for fibroids if you’re looking to reduce symptoms before getting pregnant.
Is there any treatment for fibroids when pregnant?
Unfortunately, there aren't too many ways to get rid of fibroids if a doctor discovers them during pregnancy.
Bed rest, drinking more water and mild, pregnancy-friendly painkillers are some of the solutions for pregnant people who have fibroids.
In extreme cases, there is a procedure called a myomectomy. Women can have this surgery in the second half of their pregnancy. This involved removing fibroids from the outside of the uterus or within the uterine wall, while keeping the uterus secure. But doctors will generally leave any fibroids that grow into the uterine cavity until after birth. Operating on these would be a serious risk for the fetus.
There are treatment options if the fibroids appear pre-pregnancy.
“The choice of treatment will depend on the size of the fibroids,” Miss Irani says. “They can be as small as the size of a pea. And because often these won’t cause symptoms, they can be left and monitored to see if they grow. In other cases, fibroids can increase to the size of a melon and cause more severe symptoms that require treatment.”
Options include medicines that treat heavy periods - such as a levonorgestrel intrauterine system (LNG-IUS). According to the NHS (opens in new tab), anti-inflammatory medicines and the hormone progesterone, both in pill and injection form, have also been shown to reduce the more uncomfortable symptoms of fibroids.
Those with fibroids that could seriously damage their health have other options. But these may leave the woman unable to carry a child.
“Medication, surgery, blocking the blood supply with a uterine artery embolisation or a complete hysterectomy are some of the [most extreme] options available,” Miss Irani says.
If your GP diagnoses you with fibroids either while pregnant or before, chat to them about your options. They’ll be able to lay out whether anything needs to be done. If so, they can also offer a suitable treatment plan to go through while pregnant.