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Symptoms
By Mayo Clinic staffIn women who have symptoms, the most common symptoms of uterine fibroids include:
- Heavy menstrual bleeding
- Prolonged menstrual periods — seven days or more of menstrual bleeding
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying your bladder
- Constipation
- Backache or leg pains
Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.
Fibroid location influences your signs and symptoms:
- Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are thought to be primarily responsible for prolonged, heavy menstrual bleeding and are a problem for women attempting pregnancy.
- Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing constipation, or on your spinal nerves, causing backache.
When to see a doctor
See your doctor if you have:
- Pelvic pain that doesn't go away
- Overly heavy or painful periods
- Spotting or bleeding between periods
- Pain with intercourse
- Difficulty emptying your bladder
- Difficulty moving your bowels
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.
- Haney AF. Leiomyomata. In: Gibb RS, et al. Danforth's Obstetrics and Gynecology. 10th ed. Philadelphia, Pa.: Lippincott Williams & Wilkins; 2008:916.
- Baird DD, et al. High cumulative incidence of uterine leiomyoma in black and white women: Ultrasound evidence. American Journal of Obstetrics and Gynecology. 2003;188:100.
- Stewart EA. Epidemiology, clinical manifestations, diagnosis, and natural history of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- The American College of Obstetrics and Gynecologists. Alternatives to hysterectomy in the management of leiomyomas. Obstetrics & Gynecology. 2008;112:387.
- Evans P, et al. Uterine fibroid tumors: Diagnosis and treatment. American Family Physician. 2007;75:1503.
- Uterine fibroids: Frequently asked questions. The National Women's Health Information Center. http://womenshealth.gov/faq/uterine-fibroids.cfm. Accessed April 22, 2009.
- Uterine fibroids. The American College of Obstetricians and Gynecologists. http://www.acog.org/publications/patient_education/bp074.cfm. Accessed April 22, 2009.
- Stewart EA. Pathogenesis of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Management of uterine fibroids: An update of the evidence. Rockville, Md.: Agency for Healthcare Research and Quality. http://www.ahrq.gov/downloads/pub/evidence/pdf/uterupdate/uterup.pdf. Accessed April 29, 2009.
- Stewart EA. Overview of treatment of uterine leiomyomas. http://www.uptodate.com/home/index.html. Accessed April 22, 2009.
- Marshall LM, et al. A prospective study of reproductive factors and oral contraceptive use in relation to the risk of uterine leiomyomata. Fertility and Sterility. 1998;70:432.
- Faerstein E, et al. Risk factors for uterine leiomyoma: A practice-based case control study. I. African-American heritage, reproductive history, body size, and smoking. American Journal of Epidemiology. 2001;153:1.
- Chiaffarino F, et al. Use of oral contraceptives and uterine fibroids: Results from a case-control study. British Journal of Obstetrics and Gynaecology. 1999;106:857.
- Stewart EA (expert opinion). Mayo Clinic, Rochester, Minn. May 13, 2009.
