Fibroid Treatment in Singapore: Which Option Is Right for You?

Living with fibroids can quietly take more from you than you realise. The heavy periods that leave you planning your week around your cycle. The bloating that makes your favourite clothes feel uncomfortable. The tiredness you have stopped trying to explain to people who do not understand.

If any of this sounds familiar, you are not the only one feeling this way, and you do not have to keep living around it. Several treatment options are available in Singapore, ranging from medication to minimally invasive procedures and surgery, and the right one depends on your symptoms, your stage of life, and what matters most to you.

What are fibroids?

Fibroids are non-cancerous growths that develop around or within your uterine wall. They are made of muscle and fibrous tissue, and they can range from very small (about the size of a pea) to quite large. You may also hear them called uterine myomas or leiomyomas.

Fibroids are so common that up to 80% of women develop them by age 50, yet most cause no symptoms and go unnoticed.

How do fibroids form?

The exact cause of fibroids is not fully known, but doctors believe a combination of factors plays a role.

Oestrogen and progesterone, the hormones that regulate your menstrual cycle, appear to encourage fibroid growth. This is why fibroids tend to develop during your reproductive years and often shrink after your menopause, when your hormone levels drop naturally.

Other factors that may increase your risk include:

• A family history of fibroids

• Starting your period at a young age

• Being overweight

• A diet low in fruits and vegetables

Fibroids grow slowly, which is why symptoms can take time to appear. This also explains why you may not realise you have them until a routine scan picks them up.

When should you see a doctor?

Many women with fibroids experience no symptoms at all and do not need any treatment.

You should speak to a doctor if you notice:

• Heavy menstrual bleeding that soaks through your pads or tampons quickly

• Pelvic pain or pressure, especially a feeling of fullness or bloating in your lower abdomen

• Frequent urination or difficulty fully emptying your bladder

• Constipation or a feeling of pressure in your back passage

• Pain during sexual intercourse

• Lower back pain

• Your periods lasting longer than a week

If you are experiencing very heavy bleeding alongside symptoms like dizziness, breathlessness, or persistent tiredness, seek medical attention promptly. These may be signs of anaemia caused by ongoing blood loss, which should be assessed by your doctor

How are fibroids diagnosed?

If your doctor suspects you have fibroids, they will usually begin by asking about your symptoms and carrying out a pelvic examination.

To confirm the diagnosis, they may recommend:

• Ultrasound: 

  • Uses sound waves to create images of your uterus, showing the size and location of your fibroids. It can be done on your abdomen or internally through a transvaginal ultrasound.

• Magnetic resonance imaging (MRI): 

  • An MRI scan may be recommended when your ultrasound results are unclear or to help distinguish your fibroids from other conditions.

• Hysteroscopy: 

  • During a hysteroscopy, your doctor passes a thin, flexible camera gently through the cervix. This is especially helpful for detecting fibroids that sit within your uterine cavity.

• Sonohysterography: 

  • A small amount of fluid is gently introduced into the uterus before an ultrasound scan, which makes it easier to spot fibroids inside your uterine cavity.

Knowing the size, number, and exact location of your fibroids helps your doctor recommend the most suitable treatment for you. For example, fibroids inside your uterine cavity are more likely to cause heavy bleeding and may be treated differently from those on the outer surface of your uterus.

What treatment options are available for fibroids in Singapore?

Not all fibroids require treatment. If yours are small and not causing you any problems, your doctor may recommend simply monitoring them over time.

When treatment is needed, your doctor will walk you through options ranging from medication to surgery, depending on the size and location of your fibroids, your symptoms, and your fertility goals.

Medication

Medication does not remove your fibroids permanently, but hormonal therapies and other options may help you manage your symptoms.

These may include:

• Hormonal contraceptives: 

  • The combined pill, hormonal coil, or injections may help reduce heavy bleeding and ease your period pain.

• GnRH analogues:

  • These are injections or nasal sprays that temporarily reduce the hormones driving your fibroid growth. 

  • They may shrink your fibroids and reduce your bleeding and are often used short-term before surgery to make your procedure safer and easier.

• Tranexamic acid and anti-inflammatory pain relief:

  • These are taken during your period to help reduce your blood loss and ease your pain.

• Progesterone receptor modulators:

  • These tablets work by blocking progesterone, which may reduce the size of your fibroids and help control your bleeding.

The right medication depends on how severe your symptoms are, whether you are planning a pregnancy, and how close you are to the menopause. Some options are suitable for long-term use, while others are intended as a short-term measure before a procedure.

Surgical and procedural options

When medication does not provide enough relief, or when fibroids are causing more significant problems, your doctor may discuss surgical or procedural options with you. 

Depending on your situation, your doctor may recommend:

• Myomectomy: 

  • A myomectomy surgery removes the fibroids while leaving your uterus in place. 

  • Depending on the size and location of your fibroids, it may be performed as open surgery, laparoscopic myomectomy, or hysteroscopic myomectomy.

• Hysterectomy: 

  • A hysterectomy involves removing the uterus. Because your uterus is removed, your fibroids cannot return. 

  • This is usually considered when other treatments have not worked for you and a future pregnancy is not part of your plans.

• Uterine fibroid embolisation (UFE): 

  • UFE is a non-surgical procedure carried out by an interventional radiologist. 

  • Tiny particles are injected into the blood vessels that supply your fibroids, reducing their blood supply, which may cause them to shrink over time.

• Endometrial ablation: 

  • This procedure removes the lining of your uterus to reduce heavy bleeding. 

  • It is not a fibroid treatment as such, but it may help manage your bleeding if you have smaller submucosal fibroids and do not plan to conceive in the future.

The right option depends on whether you want to preserve your fertility, how quickly you need relief, and how you feel about surgery.

Myomectomy and UFE preserve the uterus, while hysterectomy resolves fibroids permanently as the uterus is removed but ends your possibility of becoming pregnant. Your doctor may help you understand which approach suits your situation and what recovery would look like with each option.

From ultrasound scans to surgical treatments, fibroid care involves several steps. Request an appointment with Thomson Medical to understand your options and receive personalised recommendations.

What does fibroid treatment cost in Singapore?

The cost of your fibroid treatment in Singapore varies depending on the type of treatment, where it is performed, and whether you are seen in a public or private setting.

The table below gives a general overview of estimated costs:

These are approximate figures and can vary. If you are a Singaporean citizen or permanent resident, MediShield Life, Medisave, or your insurance coverage may help cover some of the costs.

Note: These figures are estimates based on Ministry of Health Singapore (MOH) guidelines. Your actual costs may vary depending on your circumstances, the hospital you attend, and any subsidies or insurance cover that apply to you.

Many women with fibroids never need any treatment at all, and those who do have a range of treatment options to explore with their doctor. Your doctor may guide you on fibroid management in a way that fits your reproductive health, your lifestyle, and your future plans.

Planning for fibroid treatment involves both medical and financial considerations. Request an appointment with Thomson Medical for a comprehensive consultation and cost overview.

FAQ

Do I need surgery if I have fibroids?

Not necessarily. If your fibroids are small and your symptoms are manageable, your doctor may suggest monitoring them over time rather than pursuing surgery straight away. Surgery is usually considered only when symptoms significantly affect your quality of life.

When should fibroids be treated?

Treatment is generally considered when fibroids are affecting your daily life, whether through heavy bleeding, pelvic pain, pressure, or difficulties with fertility. If symptoms are mild or manageable, a monitoring approach may be all that is needed for now."

Can medication shrink fibroids?

Some medications, such as hormonal treatments or GnRH analogues, may temporarily shrink fibroids or reduce symptoms, but the effects are usually not permanent once treatment stops.

Do fibroids recur after removal?

It is possible. After a myomectomy, new fibroids can develop over time, although this does not happen for every woman. However, in the case of a total hysterectomy, where the entire uterus is removed, fibroids cannot return.

How can I treat fibroids at home?

While there is no way to remove fibroids at home, some measures may help you manage symptoms more comfortably. This may include using pain relief medication under medical advice, taking iron supplements for anaemia, applying a heat pad to ease pelvic discomfort, and maintaining a healthy lifestyle and weight. There is no proven natural remedy that permanently shrinks fibroids.

Can fibroids turn into cancer?

Fibroids are benign growths and do not turn into cancer. In rare cases, a type of uterine cancer may be found alongside or mistaken for fibroids, but this is a separate condition, not a fibroid that has become cancerous.

Can fibroids increase in size over time?

They can. Fibroids tend to grow slowly during the reproductive years, often in response to hormonal changes. They often shrink after menopause due to reduced hormone levels.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today. 

References:

Ministry of Health. (n.d.). SI709U - Uterus, Fibroids, Myomectomy (Simple, <5cm). https://www.moh.gov.sg/managing-expenses/bills-and-fee-benchmarks/cost-financing/tosp-si709u-bill-information/

Ministry of Health. (n.d.). SI713U - Uterus, Sub-Total/Total Hysterectomy (<12 Weeks). https://www.moh.gov.sg/managing-expenses/bills-and-fee-benchmarks/cost-financing/tosp-si713u-bill-information/
Ministry of Health. (n.d.). SI815U - Uterus, Fibroids, Myomectomy (Complicated E.g. >5cm, Multiple >2, Challenging Location). https://www.moh.gov.sg/managing-expenses/bills-and-fee-benchmarks/cost-financing/tosp-si815u-bill-information/