The 10 Most Common Fibroid Symptoms: Early Signs of Uterine Fibroids

Fibroids are abnormal growths in a woman’s uterus or around the uterus. Fibroids are benign tumors. They can become large, but these growths are not cancerous, and a very small number of fibroids transform into cancer (almost none).

Fibroids are the most common tumor in females. They are known by different names, such as fibromas, or their clinical names: uterine myomas and leiomyomas. Most of the time, patients with fibroids do not report any symptoms at all, and it is estimated that every 1 in 3 patients with fibroids will have symptoms. Most women with fibroids are not even aware they have them in the first place. Fibroids are benign tumors in the smooth muscle of the uterus and may transform into a malignant form called leiomyosarcoma, but this is very rare.

Why do fibroids develop? It is an important question because no exact cause has been identified until now. There are risk factors, though. For example, hormonal imbalances may stimulate the progress of fibroids. There are two main hormones produced by the ovaries known as estrogen and progesterone. Estrogen, being the primary reproductive hormone in females, is at its peak from 16 years old until synthesis becomes reduced around 50 years old. After this age, women do not have estrogen during menopause. It is during these active years that females develop fibroids because estrogen is responsible for the regeneration of the lining tissues of the uterus. Thus, when the endometrial linings of the uterus get estrogen in excess, it results in these abnormal growths. Other risk factors include pregnancy and a positive family history of fibroids

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Fibroids do not usually grow at one single location. They are usually multiple, found at different positions above the uterus or inside the uterus muscle layer. The symptoms of fibroids are linked to the location and number of tumors. The symptoms of fibroids that usually lead to the diagnosis of this condition are as follows:

Menorrhagia

Under normal circumstances, females undergo a natural menstrual cycle in which the linings of the endometrium (inner surface of the uterus) undergoes hormonal changes that result in bleeding after every 28 days. Typically, this bleeding remains for 2 to 3 days until the endometrium is completely destroyed. After clearance, a new lining starts growing in the presence of estrogen hormone.
In females with fibroids, these patients will likely complain of heavy bleeding during her periods or in between her periods, which may contain blood clots. This bleeding continues for a very long period, sometimes more than one week, and a massive volume of blood is lost. One way to measure menorrhagia is through the use of sanitary pads, which get soaked in a short period of time. Thus, your doctor may ask you how many sanitary pads you need to replace every day as a means to know how much blood you’ve lost.

Lower Back Pain

Anatomically, the uterus is located anteriorly to the spine, and a mass over the uterus or inside the uterus results in the compression of key nerves supplying this organ and other adjacent structures. These masses over the uterus will also push the adjacent structures and compress the spine when they grow large, resulting in more pain in the pelvic area and the lower back. Other causes of lower back pain include heavy weight lifting, disc herniation, poor posture, intestine, and kidney-related problems and repetitive movements of the back. Thus, every case of back pain should be investigated before labeling it as a cause of fibroids.

Anal Irritation

In some cases, fibroids can also lead to the development of hemorrhoids, and patients may come to the doctor with signs and symptoms of both fibroid and hemorrhoids. The symptoms such as itching, pain and swelling around the anus usually lead to the diagnosis of hemorrhoids. The reason why fibroids cause hemorrhoids is that it is generally associated with constipation, which forces patients to push harder and increase the pressure on the pelvic floor. Additionally, large fibroids may press against the rectum and change the pressure of its blood vessels.

Dysmenorrhea

Also known as menstrual cramps, dysmenorrhea is the clinical name of a type of throbbing pain in the lower abdomen that interferes with the daily lives of the patient and appears during menstruation. Patients with fibroids also get menstrual cramps before or during the menstrual cycle. These cramps occur because of a strong contraction of the uterine muscles that results in decreased blood supply to the structures below the uterus. Pain may be located in the belly, the upper and lower thighs, or the lower back.

Polyuria

This is a characteristic feature in patients with diabetes, but increased urination may also occur in patients with fibroids. The abnormal masses, when they are formed over the uterus, put pressure over the urinary bladder, resulting in increased frequency to urinate, and increase the urge to urinate as well. In other words, the patient urinates more often and feels the urgency of going to the bathroom immediately each time. The patient also gets up to void frequently at night; a symptom called nocturia. When the size of the fibroid is too large, it can also put pressure on other parts of the urinary tract other than the bladder.

Painful intercourse

During intercourse, patients with fibroids often report pain or discomfort because fibroids put more pressure on the uterus, especially when they are very large. Even small-sized fibroids may cause painful intercourse when they are located in the cervix or near this structure. Uncomfortable or painful intercourse is a common cause of consultation, and there are other diagnoses to rule out as well, including vaginal infections and endometriosis.

Abdominal swelling

Enlarged Fibroids put pressure over the bladder, the colon and posteriorly over the lower back. The lower abdomen in these patients may become enlarged, and they usually have altered bowel movements and constipation. The swelling of the abdomen may also be due to excessive levels of estrogen and the accumulation of abdominal fat.

Miscarriage

There are many possibilities of miscarriage in patients with fibroids who are pregnant, mainly because hormonal increases in pregnancy may result in further enlargement of fibroids. These masses in the uterus may cause miscarriage, which means the death of the embryo or fetus before 20 weeks. However, miscarriage risk widely depends on the location of the fibroids and their size.

The health of the fetus also gets affected by increased levels of estrogen and progesterone. The symptoms of miscarriage include vaginal bleeding, back pain, weakness, cramps, vomiting and fever. Miscarriage may occur in up to 20% of fibroid patients, so it is a very important reason for consultation.

Anemia

During the menstrual cycle, significant blood in lost over a few days, and women with fibroids increase their blood loss during menses. In normal circumstances, losing blood in menstruation is one of the reasons why hemoglobin is a bit lower in females compared to males. However, in patients with fibroids, the blood loss is even greater and more prolonged. This blood loss causes the hemoglobin levels in the body to go down below the normal threshold, and the oxygen supply to the tissues in the body are compromised in a process called anemia. If the hemoglobin levels are low, they can be significantly improved through a proper diet, but in some cases, very low levels may need blood transfusions and other measures to improve.

Constipation

There are fibroids that grow at the back of the uterus and push a part of the colon externally, causing decreased bowel movements, and resulting in constipation. Moreover, patients with fibroids usually take iron supplements to correct their anemia. Iron causes constipation by itself and it might add up to the causes of difficult bowel movements.

Fibroids are treated with medications that maintain the balance of hormones. The goal is to induce the regression of the fibroids. When the drugs cause a decline in the levels of progesterone and estrogen, menstruation stops and fibroids regress. Intrauterine devices and birth control pills are also used in the treatment of fibroids. It is also vital to prescribe medicines for bleeding, inflammation and to trigger symptomatic relief, and the majority of them are over-the-counter.

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However, large masses can only be solved by surgery. Open myomectomy is done through a large incision made to reach the uterus in order to remove the abnormal masses. A laparoscopic procedure can also be used. In these procedures, a camera and instruments are introduced through small incisions, and fibroids are found and cut out.

After surgery, there’s always a chance of growing back of fibroids. The prognosis depends upon the age, site and size of the uterine mass. Fibroids are usually not treated when they are small in number and when the age of the patient is very near or above 50 years old because when estrogen levels go down, the fibroids shrink on their own. Conversely, a pregnant woman with fibroids requires more attention because of a higher chance of complications.