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What's the difference between fibroids and endometriosis?
What's the difference between fibroids and endometriosis?
Fibroids and endometriosis are common gynaecological conditions that could cause discomfort, pain and fertility issues. Around 1 in 3 women develop at least one fibroid at some point in their life, and approximately 1 in 10 women have endometriosis.
Both conditions affect the uterus and share similar symptoms, but although they might look alike, fibroids and endometriosis are distinctly different.
What are fibroids?
In the most basic possible terms, fibroids are non-cancerous growths that develop in the muscular wall of the womb.
These growths are made up of muscle and tissue and can be different sizes. Some can be the size of a pea, others can be the size of a melon. They're sometimes known as uterine myomas or leiomyomas. Fibroids are really common, with approximately a third of people who menstruate developing them at some point in their lifetime.
What is endometriosis?
While fibroid are growths of muscle and tissue in the uterus, Endometriosis occurs when tissue that is similar to the uterine lining grows outside the uterus. Endometriosis most commonly involves your ovaries, fallopian tubes and the tissue lining your pelvis but endometriosis can grow anywhere in your body. It typically affects nearby organs, like the bowel and the bladder, but can grow away from the pelvic area altogether – even spreading to the gastrointestinal tract and the lungs in some cases.[2]
What are the similarities?
People with fibroids and endometriosis can experience a lot of the same symptoms, and it's also possible for a person to have both fibroids and endometriosis.
Symptoms the two conditions have in common include:
- Pelvic pain and pain during sexual intercourse
- Growths that can vary in size
- Fertility issues
- Heavy painful periods and bleeding between cycles
Distinctive symptoms and knowing how to tell the difference
If you have endometriosis you will have symptoms that may include chronic pain and fatigue, pain during bowel movements and urination, and as scar tissue forms, you will suffer from more pain, bleeding, and inflammation. You may also experience pain even before the menstrual cycle begins.
With fibroids you will have both prolonged and painful menstrual periods, clotting during your period, constipation and bloating, pelvic pressure, and frequent urination.
The only way to know for sure if you have fibroids, endometriosis, or both is through medical imaging and other tests.
Different treatment options
Despite the similarities between these two conditions, treatment options are very different - that's why it's so important for you to receive an accurate diagnosis for your symptoms.
The bottom line
Uterine fibroids and endometriosis are two distinct gynecological conditions that can cause significant discomfort and affect your quality of life. Understanding the differences between these conditions is essential in seeking accurate diagnosis and appropriate treatment. If you experience any symptoms related to uterine fibroids or endometriosis, it's crucial to consult a healthcare professional for a comprehensive evaluation and personalized treatment plan. Early detection and management can significantly improve outcomes and help you lead a healthier life.
What are the treatment options for fibroids?
It's important to know that if you have uterine fibroids, but don't experience any symptoms or if you only experience mild symptoms, treatment for the condition may not be necessary. This is because fibroids often shrink after the menopause, and your symptoms will usually either ease or disappear completely at this stage in your life.
Of course, if you do need treatment for fibroids, the following options are available to help you manage your symptoms:
- Hormonal contraception, particularly the levonorgestrel intrauterine system (LNG-IUS). This is a small, plastic T-shaped device placed in your womb that slowly releases the progestogen hormone levonorgestrel.
It stops your womb lining growing quickly, so it's thinner and your bleeding becomes lighter. - Uterine artery embolisation (UAE), which is a non-invasive procedure to use as an alternative to a hysterectomy. UAE is carried out by a radiologist, a specialist doctor who interprets X-rays and scans. It involves blocking the blood vessels that supply the fibroids, causing them to shrink.
- A myomectomy, which is a surgery to remove the fibroids from the wall of your womb. It may be considered as an alternative to a hysterectomy if you'd still like to have children.
- Hysterectomy (removal of the uterus), in severe cases or if fertility is not a concern.
What are the treatment options for endometriosis?
There's no cure for endometriosis and it can be difficult to treat. The treatment options for endometriosis aim to manage pain, reduce inflammation, and improve fertility if desired. Options include:
- Pain medication - both over the counter and prescription options can be available for managing your endometriosis pain. It's important to speak to a doctor if you've been taking OTC painkillers for a while and still feel in pain.
- Hormone treatment, like the oral contraceptive pill or the IUS, implant or contraceptive injections. The aim of hormone treatment is to limit or stop the production of oestrogen in your body, as oestrogen encourages endometriosis tissue to grow and shed. Limiting oestrogen can shrink endometriosis tissue in the body and reduce pain from endometriosis. But hormone treatment has no effect on adhesions ("sticky" areas of tissue that can cause organs to fuse together) and cannot improve fertility.
- Laparoscopy - during laparoscopy, also known as keyhole surgery, small cuts (incisions) are made in your tummy so the endometriosis tissue can be destroyed or cut out. Adhesions and any ovarian cysts, called endometriomas, which have formed as a result of endometriosis, can also be removed using some of these techniques.
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- Lee HJ, Park YM, Jee BC, Kim YB, Suh CS, ‘Various anatomic locations of surgically proven endometriosis: A single-center experience’, Obstet Gynecol Sci. (2015 Jan);58(1):53-8. doi: 10.5468/ogs.2015.58.1.53. Epub 2015 Jan 16. PMID: 25629019; PMCID: PMC4303753.
- NHS UK, Endometriosis Treatment, accessed 20 July 2023.
- NHS Uk, Fibroids Treatment, accessed 20 July 2023.
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