Diagnosis of Fibroids
The diagnosis of fibroids often begins when a woman presents with symptoms such as heavy periods, pelvic pressure, or difficulty conceiving. However, many fibroids are found incidentally during routine gynaecological check-ups or imaging for unrelated issues. Confirming their presence and determining the type is essential for planning treatment.
Clinical History and Physical Examination
Doctors begin by asking about:
Menstrual patterns and bleeding severity
Pelvic pain, cramping, or discomfort
Bladder and bowel symptoms
Fertility concerns or history of miscarriage
Family history of fibroids or other gynaecological conditions
During a pelvic examination, the uterus may feel enlarged, irregular, or firm—suggesting the presence of fibroids.
Ultrasound
Pelvic ultrasound (transabdominal or transvaginal) is the first-line imaging tool
It helps measure the size, number, and location of fibroids
Transvaginal ultrasound offers clearer images for smaller or deeper fibroids
Ultrasound is safe, non-invasive, and widely available.
MRI (Magnetic Resonance Imaging)
Provides detailed images of the uterus and surrounding structures
Useful in complex cases or when surgery is being considered
Can distinguish fibroids from other uterine masses, such as adenomyosis
MRI is not always necessary but is helpful for treatment planning, especially before embolisation or myomectomy.
Hysteroscopy
Involves inserting a thin camera into the uterus through the cervix
Helps detect submucosal fibroids that grow into the uterine cavity
Often done as an outpatient procedure, especially before surgical removal
Hysteroscopy is ideal when fibroids are suspected to affect the uterine lining and cause bleeding or infertility.
Sonohysterography
A special type of ultrasound using saline to highlight the uterine cavity
Provides better visualisation of small submucosal fibroids
Sometimes used in fertility assessments
Blood Tests
Full blood count (FBC) checks for anaemia in women with heavy periods
Hormonal tests may be done to rule out other causes of irregular cycles
Diagnosis of Fibroids
The diagnosis of fibroids requires a combination of clinical skill and imaging. Once confirmed, the size, location, and impact of the fibroids guide the next steps in treatment and management.
[Next: Treatment Options for Fibroids →]
