Uterine fibroids are common.
It’s common for women to have uterine fibroids, which are smooth, usually benign muscle tumors of the uterus, says Dr. G. Thomas Ruiz, an obstetrician-gynecologist at MemorialCare Orange Coast Medical Center in Fountain Valley, California.
“The tumors are firm, white, fibrous nodules of various sizes that can be found in up to 50% of women,” Ruiz says. “Most women are completely unaware they have these tumors.”
Uterine fibroids are primarily found in three locations:
— The uterine surface.
— Within the muscle of the uterus.
— In the endometrial lining.
Risk factors for uterine fibroids
Fewer than 1 in 1,000 fibroids are cancerous, according to the Office on Women’s Health within the U.S. Department of Health and Human Services. Though the risk of having a cancerous tumor is small, fibroids should not be ignored, says Dr. Omar Cabrera, a board-certified obstetrician-gynecologist at Texas Health Women’s Care in Stephenville, a Texas Health Physicians Group practice.
Uterine fibroids are frequently found in women incidentally during CT scans of the abdomen or pelvis being performed for other reasons. An ultrasound or an MRI can confirm the diagnosis, according to UCLA Health. Symptomatic uterine fibroids are the most common reason a woman obtains a hysterectomy.
Risk factors for developing uterine fibroids include:
— Increasing age during child-bearing years.
— Exposure to greater amounts of endogenous hormones.
— Family history.
— Higher body mass index.
— Eating red meat.
African American women are about three times more likely to have uterine fibroids than white women.
Types of uterine fibroids
There are four types of uterine fibroids, according to Cabrera:
— Intramural fibroids. These are the most common type of fibroid. They appear within the muscular wall of the uterus and may go undetected if they don’t produce noticeable symptoms. Heavy bleeding is the most common symptom reported.
— Subserosal fibroids. This type of fibroid sits on top of the uterus and has a broader base. If this kind of fibroid grows large enough, a woman’s womb may appear bigger on one side. These fibroids cause pain and put pressure on nearby organs as they grow in size.
— Pedunculated fibroids. Pedunculated fibroids are a type of subserosal fibroid that has developed a slender base or stalk. They tend to cause less bleeding but could cause an increased urgency to urinate and constipation because of their bulkiness and the pressure they may put on nearby organs.
— Submucosal fibroids. These can be the most problematic type of uterine fibroid. These fibroids may lead to heavy bleeding or other serious complications like infertility or pregnancy complications. They are often removed when found.
Here are six signs and symptoms of uterine fibroids:
1. Heavy, painful uterine bleeding
As the size of the uterus and its surface area increases, a woman may experience heavier bleeding, says Dr. Linda Bradley, a professor of obstetrics-gynecology and reproductive biology and director of the Center for Menstrual Disorders Fibroids and Hysteroscopic Services at Cleveland Clinic. The reasons aren’t well known but may have to do with alterations in uterine musculature, biochemical factors and contracting of the uterus.
“Patients may pass large clots which cause pain as they are passing through the cervix, and increased levels of a chemical called prostaglandin may be associated with heavy pain and bleeding,” Bradley says.
2. Pelvic pressure
The normal uterus is the size of a lemon. Fibroids increase the size of the uterus. “A uterus with fibroids also has increased weight,” Bradley says. “So the number of fibroids, their size or location will impact pelvic/abdominal symptoms.”
3. Bladder pressure
The bladder is located in front of the uterus. Therefore, as the fibroid in the uterus gets larger, it can cause pressure on the bladder, causing a variety of symptoms, Bradley says.
Symptoms could include:
— Urgent need to urinate.
— Inability to urinate.
— Urinary hesitancy.
— Loss of urine with coughing, sneezing or exercising.
4. Pain with sex
Fibroids impact the pelvic floor and vaginal muscles such that some patients experience painful coitus with deep thrusting, Bradley says. “The location of fibroids, particularly on the posterior wall of the uterus, may cause pain.”
5. Severe uterine cramping
Women with uterine fibroids may experience significant pelvic cramps. “The uterus is a muscle and when it contracts to expel blood, higher levels of a chemical called prostaglandin is released and causes pain,” Bradley says.
The pain can be mild to severe and could affect the woman’s ability to work, enjoy hobbies and participate in typical daily activities.
Fibroids that are located in specific locations can contribute to infertility, Bradley says. This includes fibroids located within the uterine cavity, those that alter the shape of the uterine cavity, distort the anatomic relationship of the ovaries to the tubes or occlude the tubal opening.
To summarize, here are six signs and symptoms of uterine fibroids:
1. Heavy, painful uterine bleeding. 2. Pelvic pressure.
3. Bladder pressure.
4. Pain with sex.
5. Severe uterine cramping.
More from U.S. News