Fibroids are non-cancerous growths in or on the muscular wall of the womb. They can vary in number and size, according to the individual. Some fibroids can be as small as a pea, but others can be as large as a seven- or eight-month-old foetus.
What are the symptoms?
The main symptom of fibroids is heavy periods. When fibroids grow inside the womb (submucosal or intramural), the mechanism that operates menstrual flow may not work properly. The heavy bleeding can be a result of the fibroids making the womb bigger (creating a larger surface of womb lining that has to bleed every month), or the pressure of the fibroids may disrupt the normal blood flow. As a result many women with fibroids will have heavy periods, but experience no pain.
Some women do experience pain with fibroids — not necessarily intense period pains, but a feeling of pressure and a dragging sensation in the abdomen.
If fibroids are on stalks (pendiculated), they can twist, causing extreme pain.In some cases, the bleeding can be so severe that sufferers develop anaemia.
During menstruation, some women lose clots of blood that resemble pieces of liver. If the blood flow is heavy, the anti-clotting factors that are normally present in the menstrual blood may not be able to keep the blood flowing smoothly, hence the pieces of clotted blood.Other women can experience periods that go on for weeks, sometimes with no real break between one period and the next.
Fibroids can cause pain in 2 distinct ways:
1. By causing heavy menstrual flow which includes passage of blood clots. When these clots travel from the uterus through the cervix in to the vagina this elicits pain.
2. Fibroids that are large enough to press on adjacent pelvic nerves can cause pelvic pain which can radiate in to the lower back, hips, buttocks, and even down the legs.
Heavy Bleeding and Cramping
Many women experience persistent, heavy uterine bleeding and pelvic pressure or cramping. There are many causes for irregular bleeding, including anovulation (not ovulating each month), uterine fibroids, uterine polyps, endometrial hyperplasia (uterine pre-cancer) or carcinoma, cervical or vaginal neoplasia, endometritis (inflammation/infection of uterine lining), adenomyosis, bleeding associated with pregnancy or post-partum.
Persistent heavy bleeding can significantly affect a woman’s quality of life, require frequent bathroom trips/clothing changes and/or double protection, and even cause weakness or fatigue due to iron-deficiency anemia.
Treatment will be necessary for women with heavy bleeding that causes severe anemia or, very rarely, for blockage of the ureters (tubes that pass urine from the kidneys to the bladder) by very large fibroids. Some women may also chose treatment for heavy bleeding, pelvic pain or pressure, urinary frequency or incontinence that interferes with their quality of life. But, this decision is for each woman to make based on her own sense of her quality of life.