Symptoms of Uterine Fibroids

The majority of women have small fibroids that do not lead to the development of symptoms. For women who do develop symptoms, they are often directly related to the size and number of tumors as well as their location within the uterus. Generally, a woman will become symptomatic if the uterus is larger than a nine week pregnancy, any single fibroid is larger than four centimeters, or a fibroid is located in the part of the uterine lining closest to its internal cavity, also called a submucosal fibroid.

The three main symptoms related to uterine fibroids are:

Abnormal Menstruation:  Typical irregularities associated with fibroids are heavy or prolonged menstruation. Occasionally menstrual bleeding can be so severe that it results in the passage of blood clots or causes anemia. Mid cycle bleeding and postmenopausal bleeding are rare and can point to alternate diagnoses, such as uterine cancer. These should not be presumed to be due to fibroids and should be evaluated further.

Pelvic Pain: Pain often occurs when large fibroid tumors create pressure on the structures surrounding the uterus. Pain can be associated with symptoms related to the part of the body structure being compressed, such as urinary frequency when the bladder is involved, or constipation when the rectum is involved.  Pain can also occur when large fibroid tumors start to break down due to inadequate blood supply. This causes severe pain lasting a few days and is treated with over the counter anti-inflammatory medication.

Complications of Pregnancy: By potentially altering the shape of the cavity within the uterus, fibroids may cause difficulty conceiving or may increase the risk of miscarriage. Depending on the size and location of fibroid tumors, other complications of pregnancy can include preterm labor, placental abruption, and restriction of fetal growth.