Symptoms of Fibroids
A majority of women with fibroids never experience any symptoms. It is only when their physician feels a fibroid manually during a pelvic exam that they learn of their existence. Symptoms do occur in 10 to 40 percent of patients. However, it is important to remember that not all symptoms are caused by fibroids, even if fibroids are known to be present.
Heavy menstrual flow is the most common symptom. If one’s period becomes extremely heavy or prolonged (menorrhagia), it may be serious enough to cause anemia (low blood count) or in rare cases, it may be life threatening. This is the most worrisome symptom of uterine fibroids. Usually, the menstrual flow will increase gradually over time, so the body may be able to better tolerate lower-than-normal blood counts.
In some women, pain may be associated with fibroids. Pain caused by fibroids that occurs during a woman’s period (dysmenorrhea), is usually related to an excessive buildup of blood and clots inside the uterus and the difficulty in their expulsion. Pain may occur if the fibroids rapidly increase in size and outgrow their blood supply (degeneration). This is uncommon and is most likely to occur in the middle part of a pregnancy. Some patients experience an insidious type of discomfort that is often described as pelvic pressure, bloating or heaviness.
Abdominal distention (growth in the girth of the abdomen) is a frequent symptom, especially when the fibroids become large enough that the uterus extends outside the pelvis or above the pubic bone. Usually, this symptom is relatively slow and progressive in nature and may be misinterpreted as weight gain. In some women, the uterus has been known to grow to the size of a full-term pregnancy due to fibroids. One must be sure not to overlook increasing uterine size in a postmenopausal woman. This could be consistent with a cancerous tumor and one should seek immediate medical attention.
As the uterus grows, it may affect surrounding structures like the bladder and rectum. This can result in frequent urination or constipation. Very rarely, in the most extreme cases, the ureter (tube leading from the kidney to the bladder that runs along side the uterus) becomes compressed and urine no longer can drain from the kidney. This can lead to an enlarged ureter and ultimately, to kidney damage or failure if the compression is not relieved.
Most women with fibroids never experience any symptoms and the progression of fibroids will vary from one individual to another. Most symptoms can be treated conservatively, especially if an individual is nearing menopause; fibroids tend to shrink anyway as estrogen levels fall off.
Usually, the diagnosis of fibroids is made during a routine bimanual (two-handed examination with one hand on the abdomen and two fingers from the other hand in the vagina) pelvic examination. The uterus may be noted to be enlarged and irregular in shape. As a fibroid grows and the uterus enlarges beyond the size of a three month pregnancy, it can be felt above the pubic bone and may be detected during an abdominal examination.