Fibroids, Cysts or Hormones?

Understanding Common Causes of Pelvic Symptoms

Pelvic symptoms such as pain, bloating or heavy periods are extremely common — but the causes can vary widely.

Understanding the most common underlying conditions can help guide investigation and treatment.

Fibroids

Fibroids are non-cancerous growths in or around the uterus.

They affect around two-thirds of women during their lifetime.

Symptoms may include:

  • Heavy periods
  • Pelvic pressure
  • Abdominal swelling
  • Frequent urination

Many fibroids cause no symptoms and are discovered incidentally during ultrasound imaging.

Ovarian Cysts

Ovarian cysts are fluid-filled sacs that develop on the ovaries.

Most cysts are harmless and resolve naturally, but larger or complex cysts can cause symptoms such as:

  • Pelvic pain
  • Bloating
  • Pain during sex
  • Changes to menstrual cycles

Ultrasound helps determine whether a cyst is simple and benign or requires monitoring.

Hormonal Changes

Hormonal fluctuations can also affect menstrual cycles and pelvic health.

Common hormonal conditions include:

  • Polycystic Ovary Syndrome (PCOS)
  • Perimenopause
  • Hormonal imbalance affecting ovulation

PCOS affects around 1 in 10 women, and symptoms may include irregular periods, acne and fertility challenges.

Endometriosis

Endometriosis occurs when tissue similar to the womb lining grows elsewhere in the body.

It affects around 1 in 10 women and can cause:

  • Severe period pain
  • Pelvic pain between cycles
  • Fatigue
  • Fertility challenges

Diagnosis often takes years because symptoms can overlap with other conditions.

Why Imaging Matters

Pelvic ultrasound helps clinicians distinguish between these conditions by visualising the uterus and ovaries in real time.

It is often the first investigation used when symptoms persist.

References

When Is Pelvic Pain Normal — And When Should You Investigate?

Pelvic pain is one of the most common symptoms women experience. In many cases it is linked to the menstrual cycle and resolves naturally.

However, persistent or worsening pelvic pain should always be investigated.

When Pelvic Pain May Be Normal

Some mild discomfort during menstruation is common.

Hormonal changes can cause temporary cramping as the uterus contracts during a period.

When Pelvic Pain Should Be Investigated

Pelvic pain may warrant investigation if it:

  • Persists beyond menstrual cycles
  • Becomes progressively worse
  • Interferes with daily life
  • Occurs during sex
  • Is accompanied by bloating or abnormal bleeding

These symptoms may be associated with conditions such as:

  • Ovarian cysts
  • Fibroids
  • Endometriosis
  • Pelvic infections

Why Investigation Matters

Investigating pelvic pain helps clinicians determine the underlying cause and guide treatment.

Ultrasound is often used as an initial diagnostic tool because it provides clear imaging of pelvic organs.

Early investigation can lead to faster diagnosis and more effective treatment options.

References