10 Common Uterine Fibroids Symptoms You Should Know About

Uterine fibroids, also known as leiomyomas or myomas, are non-cancerous growths that develop in or on the uterus. These fibroid tumors are surprisingly common, affecting up to 70-80% of women by the age of 50. While many women with fibroids in uterus experience no symptoms at all, others may face significant discomfort that impacts their daily quality of life.

Understanding the symptoms of fibroids is crucial for early detection and appropriate management. The severity and type of symptoms often depend on the size, number, and location of the fibroids within the uterus. Some women may have small fibroids that cause minimal issues, while others develop large fibroid tumors that create noticeable physical changes and health complications.

In this comprehensive guide, we’ll explore the ten most common uterine fibroid symptoms, helping you recognize the warning signs and understand when it’s time to consult with a healthcare provider.

1. Heavy Menstrual Bleeding (Menorrhagia)

One of the most prevalent and disruptive symptoms of uterine fibroids is abnormally heavy menstrual bleeding, medically termed menorrhagia. Women with this symptom often report needing to change sanitary pads or tampons every hour or more frequently, sometimes even during the night.

This excessive bleeding occurs because fibroids can increase the surface area of the uterine lining and interfere with the uterus’s ability to contract properly during menstruation. The bleeding may be so severe that it contains large blood clots, sometimes the size of a quarter or larger.

Heavy menstrual bleeding can lead to several complications:

• Chronic fatigue and exhaustion
• Iron-deficiency anemia
• Disruption to daily activities and work
• Anxiety about bleeding through clothing
• Social isolation due to fear of accidents

If you find yourself consistently experiencing periods that last longer than seven days or bleeding that significantly interferes with your normal activities, it’s essential to discuss this with your healthcare provider.

2. Prolonged Menstrual Periods

Closely related to heavy bleeding, many women with uterine fibroids experience menstrual periods that last significantly longer than the typical 3-7 days. Some women report periods extending to 10-14 days or even longer.

These prolonged periods occur due to the fibroid’s interference with normal uterine function. The uterus may struggle to shed its lining efficiently when fibroids are present, particularly if they’re located within the uterine cavity (submucosal fibroids) or grow into the uterine wall (intramural fibroids).

Extended menstrual periods can be particularly draining both physically and emotionally. The constant need for menstrual products, the physical discomfort, and the inability to plan activities around your cycle can significantly impact your quality of life. Additionally, the prolonged bleeding increases the risk of developing anemia, as your body loses more blood than it can effectively replace.

3. Pelvic Pain and Pressure

Persistent pelvic pain or a feeling of fullness and pressure in the lower abdomen is a hallmark symptom of uterine fibroids, particularly when the fibroids are large or numerous. This sensation is often described as a constant, dull ache or heaviness in the pelvic region.

The pain and pressure result from several factors:

• The physical size of the fibroids taking up space in the pelvic cavity
• Fibroids pressing against surrounding organs like the bladder or bowel
• The weight of large fibroids pulling on the uterine ligaments
• Inflammation around the fibroid tissue

Some women compare the sensation to feeling pregnant, with a noticeable swelling or bulge in the lower abdomen. The discomfort may worsen during menstruation when the uterus is already experiencing cramping and contractions. In some cases, large fibroids can cause the abdomen to visibly protrude, leading to changes in clothing fit and body image concerns.

4. Frequent Urination

When fibroids grow on the outer surface of the uterus or become large enough, they can press against the bladder, leading to frequent urination. Women with this symptom often find themselves needing to urinate much more often than usual, sometimes every hour or even more frequently.

This symptom can be particularly disruptive at night, causing multiple trips to the bathroom that interrupt sleep and lead to chronic fatigue. The constant urge to urinate can also interfere with work, travel, and social activities, as you may find yourself constantly searching for available restrooms.

In some cases, the pressure from fibroids on the bladder can also make it difficult to completely empty the bladder, leading to a feeling that you still need to urinate even after just using the bathroom. This incomplete emptying can sometimes increase the risk of urinary tract infections, as stagnant urine in the bladder provides an environment for bacterial growth.

5. Difficulty Emptying the Bladder

Related to frequent urination but distinct in its manifestation, difficulty emptying the bladder occurs when fibroids physically obstruct or compress the bladder or urethra. This can create a situation where you feel the urge to urinate but have trouble fully voiding your bladder.

Women experiencing this symptom may notice:

• A weak or interrupted urine stream
• The need to strain to begin urination
• A sensation of incomplete bladder emptying
• Urinary retention in severe cases

This condition can be uncomfortable and frustrating. The inability to fully empty the bladder may lead to a constant feeling of bladder fullness and can increase the risk of urinary tract infections. In rare, severe cases, complete urinary retention may occur, which is a medical emergency requiring immediate attention.

6. Constipation and Bloating

Large fibroids, particularly those growing on the back wall of the uterus, can press against the rectum and intestines, leading to digestive symptoms such as constipation and bloating. This pressure can interfere with normal bowel movements and digestive function.

Women with this symptom often report:

• Difficulty passing stools or infrequent bowel movements
• A feeling of rectal fullness or pressure
• Abdominal bloating and distension
• Discomfort during bowel movements
• Hemorrhoids developing due to straining

The digestive issues caused by fibroids can be mistaken for other gastrointestinal conditions, which is why it’s important to consider all symptoms together when evaluating the possibility of uterine fibroids. The bloating can also contribute to abdominal swelling, making clothing feel tight and uncomfortable, particularly around the waistline.

7. Lower Back Pain

Lower back pain is a frequently overlooked symptom of uterine fibroids, but it can be quite significant, particularly when fibroids grow on the posterior (back) surface of the uterus. These posteriorly located fibroids can press against the muscles and nerves of the lower back and pelvis.

The back pain associated with fibroids is typically characterized as:

• A dull, constant ache in the lower back
• Pain that may radiate down the legs
• Discomfort that worsens with prolonged standing or sitting
• Pain that may intensify during menstruation

Because lower back pain has many potential causes, from poor posture to disc problems, fibroid-related back pain is often misdiagnosed or attributed to other conditions. However, when back pain occurs alongside other fibroid symptoms like heavy menstrual bleeding or pelvic pressure, it’s important to consider uterine fibroids as a possible underlying cause.

8. Leg Pain and Swelling

In some cases, particularly with very large fibroids, women may experience pain or swelling in their legs. This occurs when fibroids become large enough to press against the blood vessels or nerves that supply the legs, particularly the veins that return blood from the legs to the heart.

Leg-related symptoms from fibroids may include:

• Aching or pain in one or both legs
• Swelling in the legs, ankles, or feet
• A feeling of heaviness in the legs
• Varicose veins developing or worsening
• Numbness or tingling sensations

These symptoms typically develop gradually and may be more noticeable at the end of the day or after prolonged periods of standing or sitting. In rare cases, large fibroids can compress major blood vessels enough to cause significant circulatory problems, though this is uncommon. If you experience sudden, severe leg pain or swelling, especially in just one leg, seek medical attention immediately as this could indicate a blood clot.

9. Pain During Intercourse

Pain during sexual intercourse, medically known as dyspareunia, is a distressing symptom that some women with uterine fibroids experience. This symptom can significantly impact intimate relationships and quality of life, yet many women feel uncomfortable discussing it with their healthcare providers.

The pain may occur due to several mechanisms:

• Fibroids located near the cervix causing discomfort with deep penetration
• General pelvic sensitivity due to fibroid-related inflammation
• Pressure on surrounding organs creating discomfort during intercourse
• Large fibroids changing the position or angle of the uterus

The pain might be described as a sharp, stabbing sensation, a deep ache, or general discomfort during or after intercourse. Some women find that certain positions are more comfortable than others, while others may experience pain regardless of position. This symptom can lead to anxiety about intimacy, relationship strain, and avoidance of sexual activity.

10. Abdominal Swelling and Enlarged Abdomen

When fibroids grow large or are numerous, they can cause visible abdominal swelling that makes the belly appear enlarged or distended. Some women describe looking several months pregnant due to the size of their fibroids, with some fibroid tumors growing as large as a grapefruit or even larger.

This visible swelling can have significant impacts:

• Clothing, particularly pants and skirts, becomes tight or no longer fits properly
• Noticeable changes in body shape and silhouette
• Self-consciousness about physical appearance
• Uncomfortable questions from others about pregnancy
• Difficulty finding comfortable sleeping positions

The rate of abdominal growth can vary widely. Some women notice gradual changes over months or years, while others experience more rapid growth. In some cases, you may be able to feel a firm mass in your lower abdomen. The enlarged uterus can also contribute to feelings of heaviness and can affect posture and balance.

What Causes Uterine Fibroids?

While the exact cause of uterine fibroids remains not fully understood, medical research has identified several factors that contribute to their development. Understanding these causes and risk factors can help women recognize their personal risk level.

Hormonal Factors:

Estrogen and progesterone, the two hormones that regulate the menstrual cycle, appear to play a crucial role in fibroid development. These hormones stimulate the growth of the uterine lining each month in preparation for pregnancy, and research shows they also promote fibroid growth. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells, making them more responsive to these hormones. This explains why fibroids often grow during pregnancy when hormone levels are high and typically shrink after menopause when hormone production decreases.

Genetic Factors:

Family history is a significant risk factor for developing uterine fibroids. If your mother or sister has fibroids, your risk of developing them is approximately three times higher than someone without a family history. Researchers have identified several genetic changes in fibroid cells that differ from normal uterine muscle cells, suggesting a hereditary component to fibroid development.

Growth Factors:

Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth. These growth factors can stimulate fibroid cells to multiply and grow, contributing to the development and enlargement of fibroids over time.

Other Risk Factors:

• Age: Fibroids become more common as women age during their reproductive years, with peak incidence occurring in women in their 40s and early 50s
• Race: African American women are at higher risk of developing fibroids and tend to develop them at younger ages with more severe symptoms
• Obesity: Women who are overweight or obese have a higher risk of developing fibroids, possibly due to increased estrogen production in fatty tissue
• Diet: High consumption of red meat and low intake of green vegetables, fruit, and dairy products may increase fibroid risk
• Early menstruation: Beginning menstruation at an early age increases the risk of fibroid development
• Never having been pregnant: Women who have never been pregnant have a higher risk of fibroids compared to those who have carried a pregnancy
• Vitamin D deficiency: Research suggests that low levels of vitamin D may be associated with increased fibroid risk

Frequently Asked Questions About Uterine Fibroids

Can uterine fibroids turn into cancer?

Uterine fibroids are almost always benign (non-cancerous) and do not increase your risk of developing uterine cancer. Cancerous fibroids, called leiomyosarcomas, are extremely rare, occurring in less than 1 in 1,000 cases. However, it’s important to have any new or changing symptoms evaluated by your healthcare provider.

Will fibroids go away on their own?

Fibroids typically shrink naturally after menopause when estrogen and progesterone levels decline. However, during reproductive years, fibroids usually don’t disappear on their own and may continue to grow. Some small fibroids may remain stable in size for years without causing problems.

Can I get pregnant if I have uterine fibroids?

Many women with fibroids can and do get pregnant successfully. However, depending on their size and location, fibroids can sometimes interfere with fertility or increase the risk of pregnancy complications. If you have fibroids and are trying to conceive, discuss your specific situation with your healthcare provider.

How are uterine fibroids diagnosed?

Fibroids are often discovered during a routine pelvic examination when your doctor feels an irregularly shaped or enlarged uterus. To confirm the diagnosis and determine the size and location of fibroids, your doctor may order imaging tests such as ultrasound, MRI, or other specialized procedures.

Do all women with fibroids have symptoms?

No, many women with fibroids experience no symptoms at all. An estimated 20-50% of women with fibroids are asymptomatic and may only discover they have fibroids during a routine examination or imaging test performed for another reason. Symptoms tend to correlate with the size, number, and location of fibroids.

What’s the difference between fibroids and polyps?

While both are growths in the uterus, fibroids develop from the muscular tissue of the uterine wall and can grow quite large. Polyps, on the other hand, are overgrowths of the uterine lining (endometrium) and are typically smaller and attached by a stalk. Both can cause similar symptoms like heavy bleeding, but they are different conditions requiring different approaches.

Can lifestyle changes help with fibroid symptoms?

While lifestyle changes cannot eliminate existing fibroids, maintaining a healthy weight, eating a balanced diet rich in fruits and vegetables, exercising regularly, and managing stress may help control symptoms and possibly reduce the risk of developing new fibroids. However, always consult with your healthcare provider about the best management approach for your situation.

When should I see a doctor about fibroid symptoms?

You should contact your healthcare provider if you experience persistent pelvic pain, heavy or prolonged menstrual periods, bleeding between periods, difficulty emptying your bladder, or any other concerning symptoms. Seek immediate medical attention if you experience severe pelvic pain or very heavy bleeding that soaks through pads or tampons every hour for more than a couple of hours.

References:

• Mayo Clinic – Uterine Fibroids
• American College of Obstetricians and Gynecologists – Uterine Fibroids
• National Institute of Child Health and Human Development – Uterine Fibroids
• Office on Women’s Health – Uterine Fibroids
• NHS – Fibroids