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Most uterine fibroids do not cause symptoms. Therefore, they never require treatment. Only 10 to 20 percent of women who have uterine fibroids experience classic uterine fibroid symptoms, which include:
- Menorrhagia: Heavy or prolonged bleeding, accompanied by pain, during menses. This can cause iron-deficiency anemia.
- Bulk symptoms: Urinary frequency or urgency, constipation, bloating and fullness.
- Pelvic pain or pressure that does not subside.
- Pain with intercourse.
- Infertility and/or miscarriage.
Uterine fibroids typically do not cause symptoms. When present, uterine fibroid symptoms can range from excessive bleeding to abdominal wall distortion and bulk symptoms.
If you experience severe vaginal bleeding, or sharp, sudden pelvic pain, seek medical care promptly.
Fibroids are usually diagnosed during a gynecologic internal examination. If a fibroid is suspected, a doctor will conduct a pelvic exam to determine whether the uterus is enlarged.
Uterine Fibroid Symptoms Depend upon Tumor Type
There are three main types of fibroid tumors of the uterus. Each fibroid type is classified by where it grows on the uterus. The tumor's location on, or around, uterine tissue — has a direct relationship with the severity and scope of resulting uterine fibroid symptoms.
Uterine fibroid symptoms relate to fibroid type, of which there are three: submucosal, subserosal and intramural.
- Submucosal: Submucosal fibroids develop within the lining of the uterine cavity, between the muscles of the uterus. Corresponding uterine fibroid symptoms include heavy menstrual periods, or periods that last more than one week. Submucosal fibroids also can interfere with pregnancy.
- Subserosal: Subserosal fibroids grow in the outer uterine wall and expand outwardly. While subserosal fibroids do not affect menstrual flow, they can exert pressure on the pelvis and cause back pain.
- Intramural: Intramural fibroids are the most common uterine fibroid type. These fibroids grow within the wall of the uterus. They can yield a combination of all of the above uterine fibroid symptoms: heavier menstrual bleeding, pelvic pain and general pressure.
Excessive and Prolonged Menstrual Bleeding
As excessive menstrual bleeding is associated with submucosal and intramural uterine fibroids, clot passage — accompanied by severe menstrual cramping — is fairly common. Prolonged menstrual cycles and longer periods (as long as 35 days) are other forms of excessive bleeding.
Unfortunately, the relationship between excessive bleeding and fibroids is not clear. Research suggests that fibroids can interfere with the muscular contractions of the uterus, allowing excessive blood to pass during a period.
Another possible source of excessive bleeding can be pressure, exerted by fibroids as they grow, on the veins of the uterus wall. Pressure on the wall of the uterus can cause veins in nearby uterine lining to become swollen with blood.
Pelvic Pain and Pressure
Just as they put pressure on uterus veins, fibroids can exert pressure on surrounding structures: the bladder, colon and abdominal wall. This can cause a sensation of bloating, heaviness, discomfort and pressure in the pelvis. Discomfort may increase during exercise, bending and sexual intercourse.
Pressure on the urinary system also can contribute to an increased need to urinate, as well as heighten the urgency to urinate.