July's recognition of Fibroid Awareness Month offers gynaecology nurses an opportunity to deepen their understanding and enhance care for a condition affecting nearly one in three women in the UK. Despite its high prevalence, uterine fibroids remain frequently underdiagnosed and under-discussed in clinical practice. Given our role at the frontline of women’s health, it is critically important to have a clear understanding of both the pathophysiology and the wider impact of fibroids to provide holistic, equitable care.
Fibroids are hormonally responsive tumours influenced by oestrogen and progesterone, which explains the cyclical nature of symptoms and their tendency to diminish after menopause. Patients may present with a spectrum of symptoms ranging from menorrhagia, which can cause significant iron-deficiency anaemia, to pelvic pressure or pain associated with large or degenerating fibroids. These tumours can exert significant effects on surrounding organs, producing urinary frequency or constipation, and may also contribute to dyspareunia when positioned near the cervix. Fibroids are also implicated in subfertility and adverse pregnancy outcomes due to distortion of the uterine cavity or impaired implantation.
It is important to acknowledge that evidence is clear that fibroids are more common among women and individuals of African and Caribbean descent, who are two to three times more likely to develop the condition, often at a younger age and with more severe symptoms. This group is more likely to undergo invasive procedures such as hysterectomy, frequently without adequate discussion of fertility-preserving alternatives. These disparities are multifactorial, reflecting genetic susceptibility, environmental exposures, socioeconomic determinants, and systemic biases within healthcare delivery. As nurses, awareness of these inequalities strengthens our ability to advocate for culturally sensitive, patient-centred approaches that respect reproductive choices.
In practice, our role extends beyond assessment and symptom management. We take detailed histories and recognising red flags—such as rapid uterine enlargement or postmenopausal bleeding both of which are critical for timely investigation and referral. We educate the patients about the benign but impactful nature of fibroids, this empowers them to engage actively in shared decision-making. We also discuss with the patients the treatment options available for fibroid management which includes a range of therapeutic options from medical treatments (including tranexamic acid, combined hormonal contraceptives, and GnRH analogues), to minimally invasive procedures like uterine artery embolisation (UAE) or surgery such as myomectomy, this conversation is essential for guiding patient on treatment choice and managing expectations.
Addressing the often-overlooked psychosocial consequences of fibroids is equally important. Chronic pain, fatigue, anxiety regarding fertility, and the emotional toll of living with persistent symptoms necessitate sensitive communication and linkage to appropriate psychological support services. Monitoring and managing secondary complications, such as iron-deficiency anaemia, has now become integrated into routine care pathways.
Ultimately, fibroids represent a multifaceted challenge requiring not only clinical expertise but also empathy and advocacy. As gynaecology nurses, we have a unique opportunity to improve outcomes by delivering informed, compassionate care and addressing the health inequalities that many patients face. This Fibroid Awareness Month, let us reaffirm our commitment to excellence and equity in women’s health, ensuring everyone receives the care and respect they deserve.
