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Dr Jan AdlamGynaecologist & Urogynaecologist

GYNAECOLOGY

Fibroids &
ovarian cysts

Hearing that your scan shows a fibroid or ovarian cyst can be unsettling. A finding does not automatically mean surgery. We can look at what it means, whether it explains your symptoms and what you would like help with.

When to seek help ↓Your assessment ↓
A fibroid in the muscle of the uterus and a cyst in an ovary, shown together to compare their locations.
Two different findings. Fibroids grow in the muscle of the womb (uterus). Cysts form in or on an ovary. Illustration, not to scale.
On this page

YOUR CONSULTATION

What matters besides the size?

  1. Your symptoms and priorities

    We discuss bleeding, pain, pressure and their effect on daily life, alongside menopause, pregnancy plans and previous treatment. A finding on a scan may not explain every symptom.

  2. The detail in the scan

    A fibroid’s position and effect on the womb cavity matter. For a cyst, the contents and appearance help guide assessment. Previous scans show whether a finding has changed.

  3. Tests with a purpose

    Examination and ultrasound may be enough. Heavy bleeding usually warrants a blood count. Selected cysts need blood tests such as CA125, interpreted with the scan; that result alone cannot diagnose or exclude cancer.

We discuss any examination or vaginal scan beforehand, including your comfort and consent. You can ask to pause or stop.

UNDERSTANDING YOUR OPTIONS

What might happen next?

Some findings need no treatment. If treatment is helpful, we discuss its purpose, alternatives and risks together.

For fibroids

Observation. A fibroid causing no problems may need no treatment. Agree which changes should prompt review.

Medicines. Treatments can reduce bleeding or pain. Some hormonal treatments shrink fibroids temporarily; symptom medicines usually do not remove them.

Procedures or surgery. Depending on the finding and your priorities, options include removing fibroids, reducing their blood supply or removing the uterus.

Compare fibroid treatments

For ovarian cysts

No routine follow-up. Some reassuring cysts meet criteria for discharge, confirmed by your clinician.

Repeat assessment. Another scan may show whether a cyst resolves or changes. The timing depends on the type of cyst and your circumstances.

Surgery or specialist review. Symptoms, persistence, size or concerning features may change the plan. Discuss removing the cyst versus an ovary.

Understand cyst follow-up

YOUR STAGE OF LIFE

Include pregnancy plans and menopause.

If pregnancy matters to you

Tell me before treatment. Keeping the uterus or an ovary does not guarantee that fertility is unaffected. We discuss the likely benefit, surgical risks and timing together.

Fertility & planning

After menopause

Fibroids often shrink. Many cysts are benign, and some small simple cysts need no routine follow-up. Your clinician must confirm the criteria; symptoms or complex features need a different assessment.

Cysts after menopause

A PRACTICAL PLAN

While you’re waiting.

  1. Keep a short record

    Note bleeding, pain, pressure, bloating and what helps. Bring current and previous scan reports, relevant results and your medicine list. You can book without a diary.

    Optional symptom diary

  2. Know the next step

    Confirm whether another scan or appointment is needed, when it is due and who will explain the results. If the agreed date passes without news, contact the team; silence is not a result.

  3. Review a changing pattern

    Contact your clinician if symptoms worsen, treatment is not helping or side effects are troublesome. Follow the urgent-care advice rather than waiting for your scan date if you become acutely unwell.

COMMON QUESTIONS

You may be wondering.

Does this mean cancer?

Fibroids are benign growths and most ovarian cysts are benign. Occasionally another type of growth can look similar on a scan. A “complex” cyst is a description, not a cancer diagnosis; concerning findings need further assessment.

Is there a size that always means surgery?

No single size decides every case. Symptoms, scan appearance, location, growth, menopause and your priorities all matter. A recommendation to monitor should come with a clear follow-up plan.

What if the finding does not explain my symptoms?

Symptoms still deserve attention. Bleeding and pain can have several causes, sometimes at the same time. We can reassess rather than assuming every symptom comes from a known fibroid or cyst.

Periods & bleeding Pelvic pain

YOUR NEXT STEP

Start with a conversation.

Consultations in Claremont, with additional appointments in Simon’s Town on selected Mondays. Reception will confirm your date, time and venue.

Request an appointment Call 021 518 3416Fees & medical aidLocations & directions

General information to support your consultation. Your assessment and treatment plan are individual.

Page updated: .

Sources & further reading: NHS: fibroids · NICE: heavy menstrual bleeding · RCOG: cysts before menopause · RCOG: cysts after menopause, December 2025 update · NHS: symptoms to check

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