Uterine fibroids are frequently diagnosed during pelvic examinations, and the size and location of the fibroids can usually be determined during a gynaecological examination, most commonly by ultrasound.

The time from the onset of symptoms to diagnosis can be up to five years¹⁹.

Uterine fibroids can be diagnosed in a number of different ways⁸ as transvaginal ultrasonography, magnetic resonance imaging, hysterosonography, hystersalpinography and hysteroscopy.

Uterine fibroids (uterine leiomyoma) are benign, monoclonal, hormone-sensitive, smooth muscle tumours of the uterus^{2, 8}. They are the most common benign tumours of the female reproductive tract in pre-menopausal women.

While literature-reported incidence rates for uterine fibroids vary, in part due to the large proportion of women who go undiagnosed, uterine fibroids are estimated to affect between 20% and 40% of women of reproductive age². Uterine fibroids are reported to be more frequent in the mature age group (40% to 70% of women between 35 years and 50 years) ^9,10.

Although a number of risk factors have been linked to the development of uterine fibroids, the causes of uterine fibroids are not fully understood¹¹. Factors such as African or Black-American ethnicity, older age, family history of uterine fibroids, nulliparity (the condition of never having given birth) or lower parity (number of times a woman has given birth), and obesity have all been associated with a higher risk of developing uterine fibroids ^{11, 12}.

Uterine fibroids are often asymptomatic, but when symptomatic, the primary symptoms are heavy (uterine) bleeding, anaemia, abdominal pressure, abdominal pain, increased urinary frequency and infertility². In particular, heavy menstrual blood loss is one of the most frequently disabling symptoms of uterine fibroids⁸.

Women with uterine fibroids experience significantly worse Health-Related Quality of Life (HRQoL) than women without fibroids³. Heavy menstrual bleeding (HMB) is common in women with symptomatic fibroids, and is associated with a considerable QoL burden, including psychological and social factors, and disruption to a normal routine³⁹. Uterine fibroids impair productivity, increase absenteeism, and are associated with increased disability claims for symptomatic women⁴⁰. In the CHASM study⁴ which was carried out in five European countries (France, Germany, Italy, Spain and UK) and used WPAI-SHP to measure absenteeism scores, employed women with uterine fibroids reported an absenteeism rate of 32.7%. Furthermore productivity was impaired by 36.1% and activity was impaired by 37.9%⁴.

Surgical treatment for uterine fibroids place a significant demand on health care resources. A further economic burden may be associated with the complications resulting from surgery, or the need for re-surgery, particularly in cases where the women have undergone UAE or myomectomy.

Like hysterosonography, hysterosalpinography can be used to evaluate the extent of uterine fibroids. The procedure is carried out by use of a dye to highlight the uterine cavity and fallopian tubes in collaboration with X-ray. This procedure is mainly used where infertility is a problem, as a result of the fibroids, and this test can not only investigate the fibroids but also determine if the fallopian tubes are open or closed. The procedure like the hysterosonography is a relatively invasive procedure.

Hysterosonography, also known as a ‘saline infusion sonogram’, uses sterile saline to expand the uterine cavity, making it easier to obtain images of the uterine cavity and endometrium. This test is a useful tool when the subject is suffering from heavy menstrual bleeding despite normal ultrasound results. This procedure is also used to evaluate the extent of submucosal fibroids, but is a relatively invasive procedure.