Fibroid Symptoms

Do all fibroids cause symptoms?

Fibroids are very common and most fibroids do not cause any symptoms. In fact, most women with fibroids (often quite large) may not even know of their presence. Some fibroids (approximately 40%) will cause some symptoms. These symptoms depend on location of fibroids, their size, changes within the fibroids. Submucous fibroids are often likely to cause bleeding problems while intramural and subserous fibroids tend to cause pressure symptoms. Fibroids tend to grow and undergo degeneration during pregnancy and consequently fibroids are more likely to cause problems like pain, preterm delivery during pregnancy.

What are the common symptoms with fibroids?

Abnormal Uterine Bleeding:

Excessive menstrual bleeding (medically termed ‘menorrhagia’) is one of the most common symptoms reported by women with uterine fibroids. Bleeding abnormalities caused by uterine fibroids include:

Heavy menstrual bleeding

Lengthy periods - longer than 6 days

Bleeding between periods

Frequent periods - more often than every 24 days

Irregular / unpredictable periods

Many women with excessive menstrual bleeding mistakenly assume that their heavy periods are normal and do not seek care.In some women, excessive bleeding can be severe enough to cause iron-deficiency anemia; leading to fatigue, weakness, headaches, dizziness, and other more severe complications.

Pressure symptoms:

Pressure sensations on the bladder or inside your abdomen

Feeling bloated

Frequent urination or urinary incontinence

Difficulty urinating

Hydronephrosis (swelling of the kidneys due to the inability to drain urine)

Constipation or tenesmus (persistent feeling of having to evacuate the bowels

Fibroids can press on the surrounding organs such as bladder and bowel. This can lead to urinary frequency and constipation. Occasionally, pressure on the bladder neck can lead to urinary retention. Large fibroids can cause pressure on pelvic blood vessels which can lead to swelling of legs, deep vein thrombosis and back pressure on kidneys.

Pelvic Pain:

Abnormal pain during menstrual cycle&Pain occurring mid-cycle during ovulation

Acute pelvic pain

Chronic pelvic pain, not related to your cycle

Backache or leg pain

Pain or discomfort during intercourse

Pain when using the bathroom

It’s 2-3 times more common for women with uterine fibroids to experience abnormal pain after their period ends or mid-cycle pain when ovulating than it is for women without uterine fibroids.

Fibroids can cause heaviness and fullness in the pelvic area. Large fibroids can cause mass and pressure effects. Sometimes the fibroids can outgrow their own supply and can undergo central degeneration and become extremely painful. Some of the fibroids can cause dyspareunia (pain during sex) because of their position.

Pregnancy Challenges:

Infertility

Miscarriage

Pain during pregnancy

Obstetric (childbirth) complications

Fibroids usually do not lead to fertility issues and most women with fibroids will achieve pregnancy without any difficulty. In fact, many of the fibroids are diagnosed on ultrasound scans performed during pregnancy. Submucous fibroids can obstruct the uterine cavity and prevent implantation very similar to an Intrauterine Device (IUD). Some fibroids can obstruct the fallopian tubes and cause difficulty in conceiving. There is some evidence that myomectomy can improve fertility rates by approximately 50%. Removal of fibroids larger than 4cm and submucous fibroids will improve fertility rates and risk of complication during pregnancy.

A number of obstetrical (childbirth) outcomes have been studied in women with symptomatic uterine fibroids. Women with fibroids are more susceptible to:

Miscarriage

Preterm labor

Malpresentation (abnormal position of the fetus at time of delivery)

Placenta previa (placenta blocks the neck of the uterus)

Placental abruption (separation of placenta from the wall of the uterus)

Cesarean section

Postpartum bleeding / hemorrhage

Retained placenta

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