Uterine Fibroids – Symptoms and Diagnosis

04:48 19th June 2013 | Fibroids

Menstrual Disturbance Menstrual Bleeding Bleeding Symptoms Pregnancy Clinical Examination Transvaginal Ultrasound Scan MRI

The majority of fibroids are small and do not cause any symptoms but few women may have symptoms which affect their lives significantly and would require treatment. The different symptoms may be caused by the position of the fibroid, its size or the number of fibroids in the womb.

Menstrual disturbances
Fibroids may cause the menstrual bleeding to be heavier or increase in duration of bleeding or may cause bleeding in between periods. Some women may have a combination of bleeding symptoms. The presence and degree of bleeding is determined mainly by location. Women with fibroids that protrude into the uterus are more likely to have significant increases in bleeding

Pressure symptoms and pain
These symptoms depend on the size of the fibroids. They can range from microscopic to the size of a football and sometimes larger. Larger fibroids may cause a feeling of fullness and pressure in the abdomen. It is because of this symptom that some women think they are carrying a pregnancy for longer than the normal duration. Those compressing on the urinary bladder may cause frequent urination. Those compressing on the rectum may cause constipation or a painful urge to stool, and those compressing the cervix may cause painful intercourse.

Pregnancy related symptoms:
Though a vast majority of women with fibroids have normal uncomplicated pregnancies and deliveries, some may have fibroid-related complications. Fibroids may cause
miscarriages especially where they are multiple and distorting the womb. Where there are large fibroids present, they may disturb the way the baby lies and cause it to lie abnormally. They may also cause premature rupture of membranes and premature separation of the placenta. There may also be difficulty during labour.

Most doctors can suspect that a woman has fibroids by a simple clinical examination of her lower abdomen and pelvis which will reveal an enlarged irregular mass. The diagnosis however will usually be backed up with a transvaginal ultrasound scan which can detect even small fibroids. Studies have shown that ultrasound scans are highly effective, in sensitivity and specificity, in detecting the presence of fibroids. Magnetic resonance imaging (MRI) has similar accuracy in detecting fibroids as well as enabling mapping of the fibroids in women with multiple fibroids. Sometimes a special Xray called hysterosalpingogram (HSG), done by women to check for blockage in their womb or fallopian tubes, may also suggest the presence of fibroids. A less frequently used procedure called hysteroscopy where the doctor uses a special telescope to look into the cavity of the uterus can be used to detect small fibroids within the cavity of the uterus; to assess the relation of the fibroids to the endometrial cavity and the regularity of the endometrium. The benefits of imaging are to objectively determine the number of fibroids, their sizes, location and relation to the endometrial cavity.