Uterine Fibroids Symptoms: Heavy Periods, Pressure and When to Be Seen

What it involves

MedlinePlus explains that uterine fibroids are noncancerous tumors that grow in and around the uterus. They are made of muscle cells and other tissue, and they can grow alone or in clusters. They are the most common noncancerous tumors in women of childbearing age. The cause is unknown, though hormones and genetics appear to play a part.

Who this is for

• Women with heavy, long or painful periods or bleeding between periods.
• Patients with lower belly fullness, back pain or pressure on the bladder.
• Women who feel tired and wonder whether heavy bleeding has caused low iron.
• Anyone with a mother or sister who had fibroids and who wants to know what to watch for.

What to expect

• Questions about your cycle, how heavy the bleeding is, pain, urination and any plans to become pregnant
• An exam of the abdomen and blood work, which the practice offers, to check for anemia
• A referral for pelvic exam, ultrasound or other imaging, since the practice does not list those services
• A plan for symptoms, and a gynecology referral if treatment beyond primary care is needed

Who is more likely to have fibroids

The encyclopedia says up to about one in five women of childbearing age may have fibroids, and about half of women have them by age 50. They are rare before age 20. MedlinePlus lists older age, a mother or sister with fibroids, starting periods before age 10 and never having been pregnant as risk factors. Black women often develop them younger and may have larger fibroids with worse symptoms. Obesity and low vitamin D are also listed, and risk falls with each pregnancy.

Symptoms to track

Fibroids cause problems according to their size, number and location. MedlinePlus lists bleeding between periods, heavy periods sometimes with clots, longer periods, pelvic cramping, frequent urination, a feeling of pressure in the lower abdomen and pain during intercourse. Writing down how many pads or tampons you use, how long periods last and when pain happens gives a provider clear numbers to work from. The abnormal uterine bleeding guide explains what counts as heavy bleeding.

How fibroids are found

Fibroids are often found only when they cause symptoms or during a pelvic exam or imaging test. MedlinePlus lists pelvic ultrasound, MRI, saline infusion sonogram, hysteroscopy and sometimes an endometrial biopsy when bleeding is unusual. The practice does not list pelvic exams or imaging, so these are arranged by referral. At a primary care visit the focus is your history, an abdominal exam and blood work, including the iron checks described in the low iron and anemia guide.

Treatment options

MedlinePlus says no treatment may be needed when fibroids cause no symptoms, and that they sometimes shrink after menopause as hormone levels fall. When treatment is needed it depends on symptoms, age, fibroid size and location, and whether you hope to become pregnant. Options the encyclopedia describes include hormonal intrauterine devices, medicine to reduce bleeding, iron for anemia, hormone-based therapy and procedures such as myomectomy, uterine artery embolization or hysterectomy. These are decided with a gynecology specialist after referral.

Complications worth knowing about

Heavy bleeding can lead to anemia, and a fibroid pressing on the bladder can keep it from emptying fully, which raises the chance of urinary infections. The encyclopedia also lists a twisting fibroid that cuts off its own blood supply and may need surgery, and in rare cases infertility. During pregnancy fibroids may grow, and they can affect delivery. The frequent urination guide describes bladder symptoms, and the pelvic pain in women guide covers other causes of lower belly pain.

When to seek care

MedlinePlus advises seeking care for heavy bleeding, worsening cramps, bleeding between periods or a heavy, full feeling in the lower abdomen that does not go away. The encyclopedia lists severe pain or very heavy bleeding that needs emergency surgery among the possible complications. Call 911 or go to the emergency room for sudden severe pelvic pain, soaking through a pad or tampon every hour, or bleeding with dizziness or fainting. Milder, ongoing symptoms are a reason to schedule a visit.

Sources

• MedlinePlus: Uterine Fibroids (health topic)
• MedlinePlus: Uterine fibroids (encyclopedia)