Symptoms of Uterine Fibroids

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Uterine fibroids or leiomyoma are benign tumors of the uterus. They are very common and often asymptomatic.

You may have been diagnosed with fibroids and are wondering what symptoms you might expect. Or you may be wondering if the problems you are having are caused by fibroids.

The location, number and the size of your fibroids are a major factor in the type and intensity of your symptoms.

Fibroids are essentially “balls” of smooth muscle.

We don’t understand exactly what makes them grow but they can range in size from a pea to a small watermelon. As they grow they increase the volume and shape of your uterus.

The symptoms caused by fibroids fall into three main categories:

  • Bleeding
  • Pain
  • Pressure

Abnormal bleeding

Fibroids are a major cause of abnormal uterine bleeding. Fibroids can cause both heavy periods and bleeding at other times separate from your period. The bleeding from uterine fibroids can be significant enough to cause you to develop anemia. All uterine fibroids alter the blood flow to the uterus to some degree, which usually results in some increase in your menstrual flow. However, submucosal or transmural fibroids that distort the endometrium or lining of the uterus cause the most significant amount of abnormal uterine bleeding. If you are having very heavy menstrual periods it is likely that you have a submucosal fibroid.

Submucosal fibroids do not have to be very big to cause significant bleeding. In fact, just one small submucosal fibroid can cause enough bleeding for you to become anemic.

Pain

Fibroids can cause both cyclic and non cyclic pelvic pain. Cyclic pain is pain that is related to your menstrual cycle. Normal menstruation results from changes in your uterus that cause you to have at least some mild cramping with your period.

Because uterine fibroids are made of smooth muscle, distort the uterus and alter uterine blood flow they can significantly increase the cramping you have with your period. This condition is called dysmenorrhea.

Pain in your lower back is also common with uterine fibroids. Typically this is associated with all types of fibroids except submucosal fibroids. The enlarged uterus can push on the muscles and nerves of your lower back. This type of lower back pain can be constant or cyclic pain that is related to your period. Sometimes this pain also radiates or extends to your hips, groin or upper thighs.

Fibroids can also cause pain with intercourse a condition known as dyspareunia. Depending on the location of your fibroids this pain may only occur in certain positions.

Pressure

As fibroids grow they can significantly increase the volume and weight of your uterus. This increased weight is often felt as a sense of pressure or heaviness in your pelvis. An enlarging uterus can also put pressure on other pelvic structures especially your bladder and your rectum.

A common bladder complaint in women with fibroids is the need to urinate more frequently. Some women may actually have difficulty emptying their bladder. If you are experiencing these symptoms it is likely that you have a subserosal, transmural or a pedunculated fibroid arising from the front wall of your uterus. Since your bladder sits in front of your uterus a fibroid in this location occupies space in your pelvis and it can interfere with the ability of your bladder to expand or empty appropriately.

Similar to the pressure effects on the bladder, these types of fibroids arising from the back wall of the uterus can put pressure on the rectum. Pressure on the rectum can cause you to have difficulty with your bowel movements or even constipation.

If you think you may have fibroids or you have any questions about your diagnosis please discuss your concerns with your healthcare provider.

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