5 Signs You May Have Uterine Fibroids and What To Do If You Have These Signs
What are Uterine Fibroids?
Uterine Fibroids are very common benign (i.e not cancer) growths of the uterine muscle. By age 50, up to 80% of women will have at least one uterine fibroid. Unfortunately, the diagnosis is often delayed because concerning symptoms are often dismissed or normalized.
Although most fibroids do not cause symptoms, when they do severely impact your quality of life and general health. In fact, fibroids are among the top 3 most common reasons for hysterectomy in the United States. To better understand how fibroids cause their symptoms, it is important to understand the types of fibroids and which fibroids are most likely to lead to certain symptoms.
Broadly speaking, there are three main types of fibroids:
1. Submucosal fibroids
These are fibroids that push into the uterine cavity. These fibroids are most associated with heavy periods and have been linked to increased risk of infertility and miscarriage.
2. Intramural fibroids
These are fibroids that grow inside the uterine muscle and are most associated with heavy periods. In some cases, these can grow so large that they impinge into the uterine cavity and when this occurs, they are also linked to an increased risk of infertility and miscarriage. In some cases, they get large enough that they cause problems with our bladder and bowel function.
3. Subserosal fibroids
These are fibroids that grow into the outer filmy layer that covers the uterus known as the serosa. These types of fibroids are most associated with bowel and bladder function.
Fibroids in all locations can be associated with pain.
Submucosal fibroids of any size can cause significant symptoms. However intramural and subserosal fibroids 4cm or smaller tend to not cause symptom
5 Signs You May Have Uterine Fibroids
1. You have heavy and/or long periods
This is the most common presenting symptom for women with fibroids, but the definition of heavy periods can be nebulous and hard to define. Heavy periods are technically defined as losing greater than 80ml of blood, but what does that mean IRL. Your period is too heavy if: you’re soaking through a pad every hour for 2-4 hours in a row, that’s too heavy, you are afraid to leave your house because you will get stained through your pad, you get dizzy or lightheaded during your period, you are anemic because of your heavy period. If you’re experiencing any of these symptoms, you should speak with your doctor about being evaluated for heavy periods.
2. You have abdominal, lower back, pelvic or sciatic pain
As intramural or subserosal fibroids grow in size, they can begin to push on pain nerves and lead to significant pain. In some cases, this starts are pain during the period and they progress to constant pain. In some cases, the pain is worse during the period and in some cases, it is bad all the time. The nature of the pain depends on the size and location of the pain and thus evaluation with a pelvic ultrasound is important to determine if uterine fibroids are the cause of your pain.
3. You have constipation or painful bowel movements.
Fibroids can push on the bowels especially if they are located on the posterior aspect of the uterus and this can lead to increased pain with bowel movements. The location of the fibroids can also lead to difficulty completely or optimally emptying your bowels.
4. You have frequent urination or trouble with urination
Just as mentioned above with bowel movements, if the fibroid(s) is pushing on the bladder or urethra (the opening of the bladder to the outside), it can lead to difficulty emptying the uterus. It can also decrease the capacity of the bladder and lead to frequent urination which can be very bothersome.
5. You have pain with sex
This is an often-overlooked symptom of uterine fibroids, that can not only be bothersome to the patient but also affect their relationships. If you’re experiencing these symptom, it is definitely worth discussing with your physician as it may be due to fibroids or another cause that can equally be addressed to improve your quality of life.
What To Do If You Suspect You Have Uterine Fibroids?
If you have any of the symptoms listed above the best next step if to discuss your symptoms with your OBGYN or primary care physician. The evaluation for uterine fibroids is surprisingly straight forward and involves getting a pelvic/gyn ultrasound. The ultrasound is able to take images of the uterus and determine if there are fibroids present as well as the size and location of the fibroids. A common concern patients have is how to effectively communicate the heavy period symptoms to their doctor in order to get the care they need. Whereas, I don’t believe the onus should be on the patient, I will share some tips on how to effectively communicate with your doctor about your period on my IG and TikTok pages in the upcoming weeks. If you are diagnosed with uterine fibroids, the treatment options available will depend on your symptoms, your current fertility goals as well as the size and location of the fibroid(s) among other factors.