Fibroids and the Menopause

What are fibroids?

Fibroids are little growths that can develop in the muscle wall of your womb. They are completely benign which means they are not cancer. They are very common and can occur in around 40% of women. They are more likely to be present in your 30s and 40s.

Many women have fibroids without leading to any symptoms. They can be associated with heavy periods. Some women with fibroids notice a swelling in their lower abdomen and the fibroids can sometimes press on your bowel or bladder leading to symptoms such as increased frequency passing urine or difficultly opening your bowels.

What is the treatment for fibroids?

Medication

For many women with fibroids, no treatment is necessary – especially if they are not causing any symptoms. If the fibroids are leading to heavy periods then there are different treatments, using medication, which can reduce the amount of bleeding.

Taking the combined oral contraceptive pill can reduce the amount of bleeding during your periods. Having a Mirena coil inserted can be very beneficial for many women as reduces bleeding by thinning the lining of the womb. It lasts in the body for five years. It can also be used as the progesterone component of HRT.

Surgery

There are different operations that can be very successful at removing the fibroids. The operation varies depending on the location of the fibroids.

A procedure called Uterine Artery Embolisation (UAE) is an alternative treatment in which the blood vessels supplying the womb are injected with a substance to block the blood supply to the fibroids.

How does the menopause affect fibroids?

Many women inaccurately think that fibroids can often shrink in size after the menopause due to the reduction in oestrogen levels that occur. This is not true. After the menopause when your levels of oestrogen are lower, fibroids can no longer grow. In some women, the fibroids die because there is inadequate blood supply to them but this is not very common.

Can women with fibroids still have HRT?

The vast majority of women with fibroids can safely take HRT without any problems. The doses of oestrogen in HRT are very low so they are not usually high enough to stimulate the fibroids. Occasionally having HRT can cause fibroids to grow or bleed. Women taking HRT can still have effective treatments for their fibroids.

Women who have had Uterine Artery Embolisation can safely take HRT after their menopause as the fibroids will have shrunk by the procedure and are therefore are unable to grow or be affected by oestrogen.

Many women find taking HRT very beneficial, so having fibroids should not alter your decision regarding taking HRT.

Last Updated: July 2020