What to know about uterine fibroids in women over 40

Fibroids are growths made from muscle and connective tissue in the wall or near the surface of the womb. Their position and size affect symptoms more than age alone. Heavy or prolonged periods, bleeding between periods, pressure low in the abdomen, frequent urination, constipation, backache or discomfort during sex can occur. Some people have no symptoms. In the years before menopause, hormone changes may affect bleeding patterns and fibroid symptoms; after menopause, new or enlarging symptoms should be assessed rather than assumed to be fibroids.

Arrange a gynaecology review if bleeding is affecting work, sleep or intimacy, or if pelvic pressure is persistent. The clinician may ask about your cycle, examine you and arrange an ultrasound. Keep a brief record of bleeding, clots, pain, pressure and bladder symptoms. Treatment depends on symptoms, fibroid location, overall health and whether pregnancy is still desired. Options can include observation, medicines for bleeding or pain, and procedures that remove or shrink fibroids or remove the womb. Ask how each option affects fertility and recovery.

Seek urgent medical help for very heavy bleeding with dizziness, fainting, weakness, shortness of breath or chest discomfort. Get prompt assessment for severe or rapidly worsening pelvic pain, fever, or bleeding after menopause. These symptoms can have causes other than fibroids and should not be judged by how common fibroids are.

Ask where the fibroids are located, whether they could explain your bleeding or pressure, and whether you need a blood test for anaemia. Ask which treatments fit your symptoms, what recovery involves, and what changes should trigger earlier review.