What are uterine fibroids?
Uterine fibroids - also called myomas or leiomyomas - are benign tumors that develop from the muscle of the uterus. They are very common, affecting up to 70% of women during their reproductive years. Most are not dangerous, but they can cause symptoms that affect quality of life.
Fibroids are described by their location:
- Submucosal fibroids - grow just under the uterine lining and can cause heavy bleeding and fertility issues.
- Intramural fibroids - develop within the muscular wall, potentially enlarging the uterus.
- Subserosal fibroids - grow on the outer surface and tend to cause pressure symptoms.
Common symptoms
Many fibroids are silent and discovered during routine examinations. When symptoms occur, they commonly include:
- Heavy or prolonged menstrual periods, sometimes with clots
- Pelvic pain or cramps, especially during menstruation
- A feeling of pressure or fullness in the lower abdomen
- Frequent urination or difficulty emptying the bladder
- Difficulty conceiving or recurrent pregnancy loss
If you are experiencing heavy periods, pelvic pain, or difficulty conceiving, book a consultation to discuss your situation.
Diagnosis
Diagnosing fibroids combines your clinical history with imaging. For most women, a detailed consultation and a quality ultrasound are enough to define a plan. Additional tests may include:
- Pelvic ultrasound - the key exam for identifying, counting, and localising fibroids
- Saline infusion sonography - to assess the impact of fibroids on the uterine cavity
- Pelvic MRI - useful when there are many fibroids or when planning surgery
- Blood tests - to check for anaemia and iron stores
Treatment options
Treatment depends on symptoms, fibroid size and location, age, and reproductive plans.
Watchful waiting
When fibroids are small and asymptomatic, it may be safe to monitor with periodic ultrasounds, avoiding unnecessary treatment.
Medical treatment
Hormonal contraception, hormone-releasing intrauterine devices, and other medications can reduce bleeding and cramps and may stabilise fibroid growth.
Minimally invasive surgery at Hospital da Luz Lisbon
When surgery is needed, Dra. Joana Faria favours minimally invasive techniques, performed at Hospital da Luz Lisbon:
- Laparoscopic myomectomy - removal of fibroids through small abdominal incisions, preserving the uterus. Offers faster recovery and less post-operative pain.
- Hysteroscopic myomectomy - removal of submucosal fibroids through the cervix without abdominal incisions. Particularly indicated for fibroids that distort the uterine cavity.
- Open surgery - in selected cases with very large fibroids, a traditional abdominal approach may be necessary.
Hospital da Luz Lisbon provides leading teams and technology for gynaecological surgery, ensuring safety and comfort throughout.
For a deeper explanation of the surgical procedure itself - approaches, recovery, and fertility considerations - see Myomectomy in Lisbon.
Hysterectomy
Removal of the uterus may be an option for women who no longer wish to become pregnant and have severe symptoms. It is a definitive solution but requires careful, informed discussion.
Fibroids and fertility
Not all fibroids affect fertility. Submucosal fibroids, which distort the uterine cavity, are the ones most likely to interfere with embryo implantation. Dra. Joana Faria coordinates care with reproductive medicine teams when fibroids are part of a broader fertility plan.
Why choose Dra. Joana Faria for fibroid treatment?
- Specialist in minimally invasive gynaecological surgery with advanced training at IRCAD (France)
- Surgeries performed at Hospital da Luz Lisbon, a leading healthcare centre
- Personalised approach: every plan is tailored to each patient's symptoms, age, and goals
- Consultations in English, Portuguese, French, and Spanish
- In-person consultations at XClinic and online via video
