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What Are Fibroids: The 3 Most Common Uterine Fibroid Symptoms Every Woman Should Know

Dr Eisen Liang - Friday, January 27, 2017

What Are Fibroids: The 3 Most Common Uterine Fibroid Symptoms Every Woman Should Know

Uterine fibroids are benign tumours found in the uterus and are the most common tumours in women. It affects one in four women who are at the reproductive age. In fact, 800,000 Australian women have the potential to have the disease at any time.


While the tumours are non-cancerous, 10-40% of women who have uterine fibroids require some form of treatment due to the tumours' accompanying symptoms. The most common of these are heavy bleeding during menstruation, period pain different from the usual cramps, and frequent and urgent urination. Most would find these symptoms bothersome, inconvenient, and painful.  

These symptoms fall into two major categories—heavy menstrual bleeding, and what are known as “bulk symptoms”. Symptoms are attributed to types of fibroids, either submucosal, intramural, or subserosal. Submucosal means these fibroids develop on the inner side of the uterus, protruding into its cavity. Intramural means they are between the muscles of the uterus. Subserosal means they are found on the outer surface of the uterus.


Heavy bleeding during menstruation is the most common symptom experienced by women with fibroids Studies have linked both intramural and submucosal fibroids to heavy bleeding.


1. Heavy Periods

Fibroids cause heavy periods, also known as menorrhagia, when they distort the inner lining of the uterus. Menorrhagia causes a lot of inconveniences for women. They have to change tampons and pads more frequently, they worry about blood staining their clothes during long travels, exercise, or when they're out with other people. Prolonged menorrhagia may lead to anaemia, a deficiency in red blood cells or hemoglobin that leads to weariness and fatigue. Severe anaemia can cause shortness of breath, palpitations, and even heart failure. If hemoglobin in the blood is too low, blood transfusions are needed.


2. Bulk Symptoms

Other common symptoms of uterine fibroids are connected to the third type of fibroid, the subserosal type. Subserosal fibroids are largely responsible for bulk symptoms as they grow outward from the uterus and may press against neighboring organs in the abdominal cavity. This can cause a protrusion in the lower abdomen making it seem like weight has been gained. Intramural fibroids that grow large or are abundant can also contribute to bulk symptoms. 

A normal size uterus lies below the pubic bone, well down in the pelvis. It is just above the bladder, in front of  the rectum, and surrounded by the intestines. Since it is so near to these other organs, growth of the uterus from fibroids may cause pressure or, rarely, pain in the pelvis. The uterus is normally about the size of a small pear and weighs about 100-200 grams. But with fibroids, the uterus will enlarge and can cause an awareness of fullness or pressure.

If the uterus gets to be as large as a rockmelon, it may be seen as a noticeable swelling in the lower abdomen, perhaps even making a woman appear pregnant. While not dangerous, the enlarged uterus may cause enough discomfort or enough visible change for women to want to seek treatment.

3. Urinary Symptoms

The uterus normally sits on top of the bladder. Enlarged uterus with fibroids can push against the bladder and can cause urinary symptoms. One can experience frequent urination and feel the urge to rush to the washrooms. Exercise and even just coughing or sneezing can cause the bladder to lose control.

While the above symptoms are very common amongst women with fibroids, the symptoms does not necessarily indicate the presence of uterine fibroids. Women should see their doctors to discuss about their symptoms and have an ultrasound if needed.

Dr Eisen Liang is an interventional radiologist with special interest in gynaecological intervention such as Uterine Fibroid Embolisation (UFE), adenomyosis embolisation and ovarian vein embolisation for pelvic congestion syndrome. He performed his first UFE in 1998 and has been performing UFE at Sydney Adventist Hospital since 2007.
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