What are the early symptoms of uterine fibroids?

Uterine fibroids seriously affect women's reproductive health, so it is important to pay attention to the symptoms of uterine fibroids. Common manifestations include uterine bleeding and abdominal masses, or compression symptoms, as well as increased leucorrhea and enlarged uterine cavity.

(1) Uterine bleeding is the most common symptom of uterine fibroids, occurring in more than half of patients. Among them, cyclical bleeding is the most common, which can manifest as increased menstrual volume, prolonged menstrual period or shortened cycle. It may also present as irregular vaginal bleeding that is not related to the menstrual cycle. Uterine bleeding is more common with submucosal fibroids and intramural fibroids, while subserosal fibroids rarely cause uterine bleeding.

(2) Abdominal masses and compression symptoms When the fibroids gradually grow and cause the uterus to enlarge to more than the size of a 3-month pregnant uterus or become a large subserosal fibroid located at the fundus of the uterus, a mass can often be felt in the abdomen, which is more obvious in the early morning when the bladder is full. The mass was solid, movable, and non-tender. When the fibroids grow to a certain size, they can cause compression symptoms of surrounding organs. Fibroids on the anterior wall of the uterus close to the bladder can cause frequent urination and urgency; giant cervical fibroids compressing the bladder can cause difficulty in urination or even urinary retention; fibroids on the posterior wall of the uterus, especially those in the isthmus or posterior lip of the cervix, can compress the rectum, causing difficulty in defecation and discomfort after defecation; giant broad ligament fibroids can compress the ureter and even cause hydronephrosis.

(3) Pain: Uterine fibroids generally do not cause pain, but many patients may complain of a feeling of heaviness in the lower abdomen and pain in the waist and back. When the pedicle of subserosal fibroids is twisted or uterine fibroids undergo red degeneration, acute abdominal pain may occur. It is not uncommon for fibroids to be combined with endometriosis or adenomyosis, which may cause dysmenorrhea.

(4) Increased vaginal discharge. Enlargement of the uterine cavity, increase in endometrial glands, and pelvic congestion can cause increased vaginal discharge. When submucosal fibroids of the uterus or cervix ulcerate, become infected, or necrotic, bloody or purulent leucorrhea will be produced.

(5) Infertility and miscarriage Some patients with uterine fibroids are infertile or prone to miscarriage. The impact on conception and pregnancy outcomes may be related to the growth location, size and number of the fibroids. Giant uterine fibroids can cause deformation of the uterine cavity, hindering the implantation of the gestational sac and the growth and development of the embryo; fibroids compressing the fallopian tubes can lead to obstruction of the lumen; submucosal fibroids can hinder the implantation of the gestational sac or affect the entry of sperm into the uterine cavity. The spontaneous abortion rate in patients with fibroids is higher than that in the normal population, with a ratio of about 4:1.

(6) Anemia: Long-term menorrhagia or irregular vaginal bleeding can cause hemorrhagic anemia. More severe anemia is more common in patients with submucosal fibroids.

(7) A very small number of patients with uterine fibroids may develop polycythemia and hypoglycemia, which are generally believed to be related to the production of ectopic hormones by the tumor.