How uterine fibroids differ in women over 40

Uterine fibroids are non-cancerous growths in or around the muscle of the womb. Around perimenopause, changing hormone levels can alter bleeding patterns and symptoms. Fibroids may cause heavy or prolonged periods, pressure in the pelvis, frequent urination, constipation, or pain. Some cause no symptoms and need only observation.

A new change in bleeding after 40 can have several causes, including fibroids, hormonal transition, polyps, medication effects, or conditions of the womb lining. A clinician may recommend an examination, blood tests, and ultrasound to identify the cause. Fibroids do not automatically explain every new symptom.

Track bleeding days, clots, pain, pressure, urinary symptoms, and how symptoms affect daily activities. Bring a list of medicines and any history of anaemia or previous scans. Treatment may include monitoring, medicines to reduce bleeding or pain, procedures that target fibroids, or surgery; the choice depends on symptoms, fibroid location, general health, and pregnancy plans.

Book an assessment for bleeding between periods, bleeding after sex, periods that are much heavier or longer than your usual pattern, persistent pelvic pain, or increasing abdominal swelling. Seek urgent care for very heavy bleeding with weakness or faintness, severe sudden pain, or difficulty passing urine. Bleeding after menopause should always be assessed promptly.

Ask whether your symptoms could be from fibroids or another cause, which tests are appropriate, and whether you need a blood count. Discuss how each treatment affects bleeding, pain, fertility, and recovery, and agree on when symptoms should be reviewed.