Uterine Fibroid Symptoms

Uterine Fibroid Symptoms

Though most fibroids are smaller than a golf ball they can grow to the size of a melon. While some women have only one fibroid, others can have dozens, on average six to seven. A combination of the size, number, and location of fibroids may determine the extent and type of symptoms.

Fibroid symptoms can be grouped into abnormal bleeding, pelvic pain, and those caused by mass effect by the enlarged uterus (bulk-type symptoms). 

(Image on the right: MR-guided ultrasound ablation of uterine fibroids.)

Women may develop one or more of the following symptoms:

  • Abnormal bleeding - This type of bleeding can manifest as prolonged or profuse menstrual bleeding (menorrhagia) or bleeding between periods (metromenorrhagia).
  • Pelvic pain – This is typically associated with heavy menstrual flow with cramping (dysmenorrhea).
  • Bulk-type symptoms – These symptoms are caused by individual fibroids, or the enlarged uterus, compressing adjacent structures.
    • Pelvic pressure or discomfort – This is a generalized feeling of heaviness/pain caused by displacement of nearby structures. If nerves are compressed, there can be pain in the lower back, flank, or legs.
    • Abdominal distortion - As the fibroids enlarge the uterus, it can extend above the pelvic bone and cause from a small paunch to a very distended abdomen with an appearance suggestive of pregnancy. In fact, gynecologists frequently size the enlarged uterus by referencing it to a comparably sized pregnant uterus (number of weeks gestational size).
    • Frequent urination – This is caused by compression of the bladder leading to decreased capacity. It can be disruptive to sleep and daytime activities. Occasionally compression of the bladder can result in stress incontinence (leakage of urine during straining) or bladder outlet obstruction. On rare occasions the ureter (connecting the kidney to the bladder) can be compressed and compromise kidney function.
    • Constipation or bloating – This can occur when there is compression of the rectum.
    • Pain during sexual intercourse (dyspareunia) – This may be due to a variety of causes, including fibroids that distort the vagina.
  • Reproductive dysfunction – Symptoms could include infertility, recurrent miscarriages, premature labor, and complications of labor. While controversial, and not well studied, these complications are thought to occur when fibroids distort the uterine cavity. Infertility caused by fibroids is thought to represent only two to three percent of all infertility cases. Fibroids can block the cervix or opening to the fallopian tubes, thus causing infertility.