Why fibroids are so common and still so misunderstood

Globally, an estimated 40% to 80% of women develop fibroids by menopause. Around 20 to 40% experience symptoms during their reproductive years.

“In recent years, we’ve seen a steady rise in diagnoses,” says Dr Mitul Gupta, senior consultant, obstetrics and gynaecology at Cocoon Hospital. “That’s partly due to better awareness and access to scans. But lifestyle changes–delayed pregnancies, hormonal shifts, rising obesity—also play a role.”

The warning signs

“Heavy periods and fatigue are usually swept under the carpet,” says Dr Gupta. “But symptoms like persistent pelvic fullness [a constant sense of pressure or heaviness], frequent urination or ongoing bloating shouldn’t be dismissed. The more distressing signs include bleeding between cycles or pain that interferes with daily life.”

Diagnosis matters, because fibroids can affect more than your period. Depending on their size and location, they may press against nearby organs and cause backaches, constipation, urinary issues or fatigue from chronic blood loss. From a fertility standpoint, fibroids that distort the uterine lining or block the fallopian tubes can make conception difficult and increase the risk of complications during pregnancy.

Err on the side of caution and ask for a transvaginal ultrasound if this is your lived experience.

Is surgery the only option?

For many women, the first recommendation is still a hysterectomy; a permanent fix that involves removing the uterus. But for those who want to preserve fertility, laparoscopic myomectomy is often the preferred route. “It’s effective, with fewer complications and a quicker recovery,” says Dr Gupta.

Still, not everyone needs surgery. “We usually recommend it when there’s excessive bleeding, rapid fibroid growth, infertility or severe pressure symptoms,” she explains. “If the signs are milder or if someone is younger or planning a pregnancy we start with medication or lifestyle-based care.”

Gonadotropin-releasing hormone (GnRH) analogues can shrink fibroids temporarily, often used before surgery. Oral drugs like ulipristal acetate have shown promise. For some, uterine artery embolisation (UAE), a procedure that cuts off blood supply to the fibroid, can offer relief.

Even with surgery, fibroids can return in as many as 30% of cases within five years.

Rethinking lifestyle and alternative care

While conventional treatment remains central, several experts point to the role of holistic care in managing fibroids. From Ayurveda and functional nutrition to movement-based protocols, the focus is often on reducing inflammation, balancing hormones and supporting digestion.