Black women are more likely to develop uterine fibroids, experience more severe symptoms, and face longer delays in diagnosis and treatment, the Royal College of Obstetricians and Gynaecologists (RCOG) has said, as it publishes a new position statement on fibroid care against the backdrop of growing waiting lists and widening inequalities.
This follows the RCOG’s recent report, New Year: Still waiting for a way forward, which found that Black women are disproportionately represented on gynaecology waiting lists - highlighting a major barrier to timely diagnosis and treatment for conditions such as fibroids.
Uterine fibroids are among the most common gynaecological conditions, with up to two-thirds of women developing at least one fibroid during their lifetime, and international estimates suggesting 70–80% of women will have fibroids by the age of 50.
Evidence consistently shows that Black women develop fibroids at a younger age, experience more severe symptoms, and face longer delays in diagnosis and treatment than white women. These longstanding disparities are now being compounded by mounting pressure on gynaecology services, with the RCOG’s latest analysis showing Black women are overrepresented on waiting lists compared to their share of the female population.
A survey by the Caribbean and African Health Network1 of more than 500 women living with fibroids - over 70% of whom identified as Black British - found that more than one in four were offered no treatment following diagnosis. Over half experienced diagnostic delays of more than two years, and one in four reported living with fibroids for over a decade before receiving care.
In England, fibroids are among the leading causes of gynaecological surgery, with hysterectomy remaining the most common treatment worldwide. Fibroids are estimated to cost the NHS around £86 million each year in direct healthcare expenditure, with wider economic losses from sickness absence and reduced productivity reaching up to £1.7 billion annually.
Following the first national roundtable on fibroid care convened by the RCOG, clinicians, researchers and patient advocates have come together to develop a new position statement setting out how fibroid care can be improved and inequalities addressed.
In response to persistent disparities in outcomes and the growing impact of gynaecology backlogs, the RCOG’s position statement calls for:
- earlier recognition of fibroids and risk-based identification in primary care
- direct access to community ultrasound services
- standardised care pathways across England
- regional specialist networks for complex cases
- improved data collection to monitor outcomes and inequalities
Dr Alison Wright, President of the Royal College of Obstetricians and Gynaecologists said:
“The latest NHS England data demonstrates that although elective waiting times for gynaecological care have fallen slightly, they still remain unacceptably high, with more than 560,000 women currently waiting.
"Fibroids are one of the main conditions affecting women on waiting lists, and our recent analysis shows that Black women are disproportionately affected by delays in accessing diagnosis and treatment.
"Urgent action is needed to improve care for women suffering from symptomatic fibroids, and to address these persistent inequalities. Our new position statement sets out how targeted investment in gynaecology services can lead to meaningful improvements in care."
Dr Christine Ekechi, Consultant Gynaecologist, Lead Author of the statement and spokesperson for the RCOG said:
“Fibroids show what happens when the health system fails to prioritise the conditions women live with every day. Delays in diagnosis, limited access to imaging and inconsistent care pathways mean that a common condition becomes life-limiting for far too many women.
“The impact is not felt equally. Black women are more likely to develop fibroids, experience more severe symptoms and wait longer for treatment. These inequalities are not inevitable. This position statement sets out practical steps to fix this, from earlier recognition in primary care to better access to diagnostics and specialist services, so women are not left waiting years for care that should be routine.”
Dawn Heels, Fibroids advocate and campaigner, said:
“Fibroids took away years of my life, when I should have been building my future, not planning my days around pain. I spent years in debilitating pain, managing anaemia, fertility challenges and the emotional toll of being left without a care plan or clear support. While my diagnosis came quickly, I was left to navigate a system alone, until someone finally listened.
“Delayed intervention meant more invasive treatment for me; something far too many black women experience. Improving fibroid care, particularly addressing inequalities, is not about awareness alone; it is about preventing years of unnecessary physical and psychological suffering and ensuring women are supported before avoidable harm shapes their lives.”
Saschan Fearon-Josephs, RCOG Women’s Network member said:
“Living with fibroids can take over every part of your life - your health, your work, your confidence and your sense of control over your own body. For many women like me, the hardest part isn’t just the symptoms, but the long waits, the uncertainty and the feeling of not being taken seriously.
“I’m proud to have been involved in shaping this position statement, because it sets out what needs to change so women aren’t left living in pain for years. Turning this into real action could make a life-changing difference for women with fibroids across England.”
The RCOG is calling on the UK Government to make 2026 a turning point for women waiting for gynaecology care by delivering immediate support to tackle backlogs, protecting women’s health hubs, and using national health plans to address the structural causes of delays in accessing timely, appropriate care.
- Read the new policy position here: Improving early detection and care pathways for uterine fibroids in England | RCOG
- Read the RCOG’s updated ‘New Year still Waiting for a way forward’ report here: New Year: Still Waiting For A Way Forward