A fibroid is a benign, non-cancerous growth that occurs in or around the uterus. It is also known as leiomyoma, or simply myoma, in medical terminology.
A woman can have a single fibroid or multiple fibroids. These growths constitute fibrous tissues and muscles. Fibroids can be minuscule or conspicuous. However, in most cases, they tend to become extremely large.
According to the National Institutes of Health, most American women are likely to develop fibroids during their lifetimes.
The causes of fibroids remain relatively unknown, although they are mostly genetic. Obese women are more likely to develop fibroids than healthier women.
According to the U.S. Department of Health, 20 to 80 percent of women develop fibroids by age 50. It is especially common in women between age 30 and 40.
Since fibroids thrive on the reproductive hormones estrogen and progesterone, they are most likely to occur during the reproductive years.
The risk of developing fibroids increases with age during the reproductive years. This is the reason women going through menopause are at the highest risk.
Because fibroids have a tendency to recur, doctors often suggest a hysterectomy to combat fibroid-growth for a hassle-free, post-menopausal life.
While not life-threatening, fibroids can prove highly uncomfortable and adversely affect the overall quality of a woman’s life.
Here are 10 warning signs that you may have fibroids.
1. Excessive & Prolonged Bleeding
If you experience abnormally profuse menstrual bleeding, or if your periods last more than 7 or 8 days at a stretch, you might be suffering from fibroids.
Many women disregard occasional heavy blood flow, or simply do not notice it. Here’s a simple test: if you find yourself using more sanitary products in a day than you would normally use, something’s not right.
You may also notice the passage of blood clots during menstruation.
According to a 2012 study published in BMC Women’s Health, 9.4 percent of women in the UK reported uterine fibroids.
Of those, 59.8 percent reported heavy bleeding, 37.3 percent reported prolonged bleeding and 33.3 percent reported bleeding between periods.
Consult your doctor if you notice any such abnormalities in your menstrual cycle.
2. Non-Menstrual Pelvic Pain
If you frequently experience pain in the pelvic region outside of your menstrual cycle, this could be indicative of fibroid growth. Large fibroids exert pressure on and around the surrounding areas.
Sometimes fibroids grow very close to the pelvis, in which case their location, and not their size, is what exerts pressure and causes pain.
Out of the 15 percent of 635 patients who reported uterine fibroids, 2.6 percent reported non-menstrual pelvic pain, according to a 2003 study published in Fertility and Sterility.
Therefore, if you often notice your pelvic region hurting for no reason, especially outside of your menstrual cycle, consult a gynecologist.
3. Abnormal Urinary Patterns
The bladder is located in close proximity to the uterus. When multiple and large fibroids grow from the uterus, they put excessive pressure on the neighboring organs, including the bladder. This causes frequent and often painful urination.
This pressure on the bladder is the highest when laying down. Therefore, the need to urinate especially at night increases with fibroid growth. Loss of bladder control is also a symptom of fibroid growth.
Out of 78 women diagnosed with uterine fibroids, 91 percent reported a spike in nighttime urination, 59 percent reported an increase in urinary frequency, and 45 to 54 percent reported a loss of bladder control, according to a 2011 study published in Female Pelvic Medicine and Reconstructive Surgery.
Therefore, if you suffer any of these lower urinary tract symptoms, consult a gynecologist as soon as you can.
4. Painful Intercourse
The presence of large fibroids in and around the uterus can make intercourse extremely painful for a woman. A woman may experience acute pain when the fibroids grow around the vaginal tract or the cervix, which connects the vagina and uterus.
The fibroids may exert pressure on the cervix during intercourse and may cause irritation and pain. It can also cause mild bleeding.
That pain might also exacerbate when assuming certain positions.
According to a 2014 study published in The Journal of Sexual Medicine, the majority of the 827 premenopausal women, ages 35 to 49, reported a positive association of fibroids with pain during intercourse.
Fundal fibroids, which occur at the top of the uterus, were more strongly associated with intercourse-pain than other kinds of fibroids, according to the study.
If you experience painful intercourse, get yourself checked.
5. Abdominal Swelling
Multiple and large fibroids jetting out of the uterus can cause the abdomen to appear swollen or larger in size.
Since people are more likely to associate a large abdomen with weight gain, it is one of the most misunderstood and ignored symptoms of a fibroid-growth.
A majority (59.1 percent) of 300 multi-ethnic women with genetic uterine fibroids reported abdominal swelling, according to a 2005 study published in Human Reproduction.
If you have noticed your belly (abdomen, in particular) jetting out and you’ve been blaming it on your poor diet, it is time to reconsider and consult your gynecologist.
6. Lower Back Pain
You might be wondering how growth on the uterus causes pain in the lower back. The mass and position of fibroids determine the parts of the body that are affected and to what degree.
The size of fibroids varies, and some are excessively large and heavy. Furthermore, such large and bulky fibroids are often located on the lower back surface of the uterus. When this happens, your lower back experiences pressure, inducing pain.
While a number of reasons can contribute to lower back pain, if it occurs frequently, and especially with other reproductive symptoms, it might indicate a fibroid growth.
Submucosal or endometrial fibroids are the rarest type of fibroids. They develop under the muscles of the uterine lining and toward the endometrium.
Large, submucosal fibroids block the fallopian tubes and hamper the passage of eggs from the ovaries to the uterus.
While studies have not shown a positive association between other fibroids and infertility, submucosal fibroids are known to cause infertility and lower the prevalence of pregnancy.
A 2009 study published in Fertility and Sterility further substantiates that submucosal fibroids increase the risk of infertility and suggests removing the fibroids to increase the rate of pregnancy.
If you have been facing problems conceiving, consult your gynecologist for possible fibroids.
Submucosal fibroids (emerging from the uterine lining) and intracavity fibroids (located within the cavity) can often lead to miscarriages.
When a fertilized egg travels through the fallopian tubes and lodges into the uterine cavity, a submucosal fibroid may obstruct the passage of blood to the embryo.
Fibroids may cause inflammation within the lining and hamper the proper growth of the fetus.
Both of these factors can contribute to miscarriage.
Fibroid growth was positively associated with women who had suffered recurrent miscarriages in the mid-trimester, according to a 2011 study published in Human Reproduction.
If you have suffered recurrent miscarriages, seek medical attention for possible fibroid growths.
Subserous fibroids are those present on the outside surface of the uterine wall.
Large, bulky subserous fibroids exert pressure on the rectum. This hampers the body’s normal bowel functions and can cause constipation. You may also experience rectal pain.
Constipation is one of the major symptoms of fibroids in women, according to a 2011 study published in The Practitioner.
Constipation can occur for a variety of reasons. However, if you suffer from constipation regularly and notice other symptoms of fibroids along with it, consult a gynecologist.
10. Leg Pain
Subserous fibroids may press against the spinal nerves. Since spinal nerves directly correlate to the legs, this pressure can cause leg and thigh pain.
Leg pain can also occur for many reasons. However, if you have leg pain along with the other symptoms of fibroids regularly, seek medical attention for possible fibroids.
Expert Answers (Q&A)
Answered by Dr. Daniel M. Breitkopf, MD (Obstetrician and Gynecologist)
Do the symptoms worsen if the fibroids are left untreated?
Fibroids may grow over time which is often characterized by a progressive worsening of symptoms. Fibroids that don’t cause symptoms do not require treatment.
Can fibroids rupture and cause bleeding?
Fibroids are solid growths of the uterine muscle and connective tissue. They do not rupture as they grow. They can make menstrual bleeding worse, particularly if they are located near or within the lining of the uterus.
Are fibroids a sign of uterine cancer?
Fibroids are benign growths of the uterus. They are not a sign of uterine cancer but may be confused with sarcomas, which are cancerous tumors. Uterine sarcomas are uncommon cancers.
People above 45 years of age or those who are prone to tamoxifen use or have undergone pelvic radiation treatment are increasingly predisposed to developing sarcomas. Sarcomas are hard to diagnose, but ultrasound and MRI tests can help differentiate them from fibroids.
How can we prevent the growth of fibroids?
There are no proven methods to prevent fibroids from growing. There are hormonal treatments that induce menopause which causes the fibroids to shrink in size, but only temporarily and only while using the medication. Fibroids do decrease in size after the natural onset of menopause as well.
Can fibroids be cured without any medical intervention or surgery?
Some fibroids may resolve over time without treatment. The reasons for this phenomenon are not known.
Please provide some additional tips or inputs regarding fibroids.
Fibroids are very common. Some studies estimate that 30-40% of women will have at least one fibroid in their lifetime. Fibroids that don’t cause symptoms don’t need treatment.
There are several minimally invasive treatments for fibroids to relieve symptomatic pain or bleeding problems without undergoing major surgery such as hysterectomy.
These treatments include embolization (reducing the fibroid’s blood supply), focused ultrasound (heating the fibroid with an ultrasound beam), and radiofrequency ablation (heating the fibroid with a small probe).
About Dr. Breitkopf, MD: He received his M.D. degree from the State University of New York-Downstate College of Medicine and completed residency training in Obstetrics and Gynecology at the University of Vermont. After spending 12 years at the University of Texas Medical Branch, he joined Mayo Clinic’s Department of Obstetrics and Gynecology in 2010 where he serves as the community division chair. His clinical and research interests include minimally invasive surgery and medical education.