What Are The Signs And Symptoms Of Fibroids?

Many women with fibroids have no symptoms at all. In fact, it is estimated that 75% of women with fibroids do not have symptoms, therefore many women are unaware they have fibroids.

Whether or not you have symptoms depends on the size of the fibroids and where they are located. These factors will also affect the type of symptoms that a patient will have. If a small fibroid is growing in the wall of the uterus, it probably won’t cause any problems, however if a large fibroid is growing outwards from the uterus it may press against the woman’s bladder, consequently causing bladder problems. 

One of the main symptoms that a patient will notice when they have fibroids is the fact that their periods are abnormal. This abnormality could be a prolonged period or a heavy period. Women with these symptoms may notice that instead of bleeding for five days, they may bleed for ten days. Their period may have changed in character, its color may be darker or they may find clots.

Heavy bleeding is not always due to fibroids, but when it is, it is usually associated with fibroids that grow into the womb (submucous). Although it is unclear exactly why fibroids cause bleeding, it may be that fibroids stretch the lining of the womb and creating more lining to be shed during a period. In addition to the inconvenience, heavy bleeding may also cause anemia and fatigue.

Some women with fibroids may find they have painful periods which resemble endometriosis. This pain could be due to degeneration or torsion of the fibroid. Torsion is the twisting of the fibroid from its pedunculated root. Its blood supply may be cut and fibroids may degenerate. Fibroids may also cause painful sex due to its location. Cramps and significant pain could also be caused by the uterus trying to force out a submucous fibroid that is growing on a stalk in the cavity of the womb.

Other common complaints with fibroids include pressure on the bladder which is significant if the fibroid is growing in the front part of the uterus. This pressure may cause frequent urination and some women may notice their belly growing larger, particularly below the belly button. If the fibroid is located in the back of the uterus it may put pressure on the rectum causing a change in bowel habits. Fibroids can also make it difficult for a woman to conceive or carry a child. Therefore, the most common symptoms women with fibroids may detect are symptoms of bleeding, pain, and pressure or fertility problems.

These symptoms are all related specifically to the location of the fibroid and not necessarily the size of it. When a woman is having problems caused by a fibroid, an endovaginal sonogram that is done in a doctor’s office is the most valuable tool to detect the location of the fibroid. 

When a fibroid grows large, it can cause a feeling of pressure in the pelvis. It is sometimes possible to feel a hard spot where large fibroids are present. Large fibroids on the outer part of the womb (Subserous) distort the shape of the uterus and cause it to press on other organs. Large fibroids can make the womb big and bulky, which can lead to lower back pain or pelvic discomfort. Occasionally, fibroids can cause sudden severe pain in the pelvic area or lower back. This again could be due to torsion - a fibroid on a stalk (pedunculated) that has become twisted. This kinks the blood vessels in the stalk and cuts off the blood supply to the fibroid.

Fibroids that are impinging on the endometrial cavity in a submucosal or pedunculated way may cause heavy bleeding, clots and anemia. These types of fibroids are also the ones that cause problems with reproduction and fertility problems. Some fibroids block the tubal openings and due to its pressure on the tubal openings they may also cause reproductive problems.

Some women with fibroids feel a dull ache in their thighs or develop varicose veins in their legs. This happens when fibroids become so large they press on nerves and blood vessels that extend to the legs.