Uterine fibroids, or leiomyomas, are benign tumours consisting of muscular and fibrous tissue that develop in or around the uterus. While non-cancerous, these growths can substantially impact women’s health and daily functioning.
Symptoms vary widely depending on the fibroid type—subserosal (located under the outermost lining of the uterus), intramural (in the uterus), or submucosal (that originates under the uterine lining)—as well as size and location. They may range from asymptomatic in some women to causing heavy menstrual bleeding, pelvic pain, pressure symptoms, and infertility in others.
The growth of fibroids is hormonally driven, primarily influenced by estrogen and progesterone levels. These hormones fluctuate across a woman's lifespan, affecting how fibroids manifest at different ages.
In women in their twenties, fibroids often remain undetected until discovered incidentally through imaging for other concerns, such as polycystic ovary syndrome or menstrual irregularities. At this stage, symptoms may be mild, like slightly heavier bleeding or occasional cramps, which are often overlooked.
Dr. Ritu Choudhary, Lead Consultant in Obstetrics and Gynaecology at Apollo Cradle & Children’s Hospital, Electronic City, Bengaluru, advises women to monitor menstrual cycles carefully and maintain regular communication with their gynaecologist for early detection.
In the thirties, fibroids may cause more noticeable symptoms, including heavy bleeding, pelvic pressure, and fertility difficulties. Submucosal fibroids in particular can interfere with embryo implantation and increase miscarriage risk. Diagnostic imaging, such as ultrasound or MRI, is recommended to evaluate these fibroids. Treatment options during this phase include hormone therapy or surgery tailored to symptom control and fertility preservation, making early assessment crucial for reproductive planning.
During the forties, fibroids often show accelerated growth due to prolonged hormone exposure. Women may experience prolonged, heavy menstrual bleeding, severe cramps, pelvic heaviness, and urinary or bowel symptoms from large fibroids pressing on nearby organs. However, the approach to treatment may be conservative as fibroid size sometimes decreases naturally with the decline in estrogen levels approaching menopause. Close monitoring for rapid fibroid growth or unusual symptom changes remains essential, with timely consultation advised.
Regarding prevalence, studies show that uterine fibroids affect a significant proportion of Indian women, with variations based on geography and demographic factors. Research indicates that fibroid prevalence in rural India can be as high as 37.65 per cent, while urban Indian women show around 24 per cent, according to a study published in the International Journal of Reproduction, Contraception, Obstetrics and Gynaecology.
Another study from Telangana found an 11.6 per cent prevalence among women aged 18 to 50 attending gynaecology clinics. Wider estimates suggest fibroids may affect anywhere between 20 per cent and 68 per cent of women of reproductive age in India, with increased risk linked to age, marital status, overweight, pregnancy history, and menopausal status. These data confirm fibroids as a major gynaecological health concern in the country, often associated with symptoms like heavy menstrual bleeding and pelvic pain that impair quality of life.
Lifestyle modifications play a critical role in managing fibroids holistically alongside medical treatments. Dr. Divya Mani, Specialist Obstetrician and Gynaecologist at Apollo Cradle and Children's Hospital, advocates addressing estrogen dominance through nutrition by reducing intake of red meat, sugar, processed foods, and excess caffeine. She recommends increasing anti-inflammatory foods such as leafy greens, whole grains, and lentils to support hormone balance and minimise inflammation related to fibroid symptoms.
Weight management is equally important, as adipose tissue produces estrogen, which can accelerate fibroid growth. Even modest weight loss of 5 to 10 per cent contributes to symptom improvement. Regular moderate exercise like walking, swimming, or yoga promotes weight control, insulin regulation, and stress reduction. Since stress elevates cortisol levels that disrupt hormonal balance, incorporating practices such as deep breathing, journaling, or meditation is recommended.
Environmental factors also deserve attention. Reducing exposure to endocrine-disrupting chemicals—common in plastics used for food storage and certain cosmetics—can help, as these chemicals mimic estrogen and potentially promote fibroid development.
Overall, with their high prevalence and significant impact, uterine fibroids require increased awareness among women and healthcare providers in India. Early detection combined with lifestyle interventions and timely medical management can improve symptoms, preserve fertility, and enhance quality of life for women across their reproductive years.