Previous research suggests that women attending gynaecology clinics experience high rates of psychological distress and psychiatric morbidity. Although the reasons for this are poorly understood, certain conditions appear to cause women particularly high levels of anxiety and depression. This paper reports a qualitative study, using Interpretative Phenomenological Analysis (IPA), to examine the illness experiences of women with the common gynaecological condition of fibroids. The study employs semi-structured interviews, guided by Leventhal's self-regulation model, to explore 18 women's understanding and experiences of having fibroids. Qualitative analysis revealed eight themes drawn into two higher-order themes - 'Managing uncertainty' and 'Struggling between defeat and optimism'. These higher-order themes illustrate the multiplicity of experiences and meanings used by women attempting to understand their condition, treatment options and future health outcomes. The differences in women's illness representations may account for differences in their relative distress levels. The findings indicate the importance of considering an individual's illness representations in order to facilitate the provision of appropriate medical and psychological care to women with fibroids.