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Home > Women's Health > Menstrual Health > Fibroids: Signs, Possible Causes, and Complications

Fibroids: Signs, Possible Causes, and Complications

Updated on September 28, 2022
7 min read
By Shiza Khan, M.Sc. – Clinical Nutrition & Dietetics | Dietitian/Nutritionist

In this article:

  • What Are Fibroids?
  • Signs of Fibroids
  • Causes of Fibroids
  • Complications of Fibroids
  • Most-Asked Questions About Fibroids
  • Final Word

Fibroids are becoming more and more common all around the world. They affect around 50% of women worldwide.

warning signs associated with fibroids

They occur during middle age, which is when women are in their mid-30s or early 40s, although they may occur earlier or later as well.

Fibroids can have a genetic link as women with a family history of fibroids are more prone to developing them later. (1)

What Are Fibroids?

Fibroids can be defined as growths that are round in shape and almost like a tumor but are benign, or noncancerous. (1) They develop in the uterus and can be of different sizes, from very small, almost like a pea, to extremely large, like a melon (1 mm to 20 cm in diameter).

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Sometimes, they aren’t visible to the naked eye and sit in the uterus; other times, they can grow in huge masses that end up causing uterine distortion and enlargement.

Fibroids are also known as myomas or leiomyomas in the scientific language. Their growth is steady, which means that they develop gradually during puberty or the reproductive phase. However, some may stay the same size without any significant growth.

Most myomas have no symptoms in over half of women and stop growing after menopause. (2) If they don’t, then immediate medical attention is required.

Signs of Fibroids

warning signs that can indicate fibroids

Because fibroids are generally asymptomatic, (3) it may be hard to pinpoint the condition. But they do present some signs at times. (4)

If you experience the following symptoms or signs, take into account fibroids as a causal option.

1. Heavy vaginal bleeding

Experiencing prolonged or heavy bleeding during periods is a common sign of fibroids. (5)

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Women may pass blood clots and develop anemia due to the heavy period flow. This can further lead to:

  • Fatigue
  • Light-headedness
  • Headache
  • Diffuse pain

2. Pelvic discomfort

If your fibroids grow into huge masses, they may exert increased pressure on the lower abdominal region, causing discomfort in the pelvic area. This may further lead to pain. (5)

Due to this uterine enlargement, you may have trouble:

  • Lying face down
  • Bending over
  • Exercising
  • Running

3. Pelvic pain

Pelvic pain is very rare as it happens only when a fibroid starts to degenerate. The pain occurs in a single spot only and resolves within a month.

The pain can be chronic at times and persist in the same region, for which you can take a painkiller. (5)

4. Bladder problems

People suffering from fibroids have a hard time controlling their bladder. This leads to issues such as:

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  • Frequent urination
  • Nocturia (urge to urinate at night)
  • Constant urge to urinate

These symptoms are due to the pressure on the bladder applied by growing fibroids that reduce the bladder’s capacity to hold urine. (5)(6)

5. Back pain

back pain in women could be indicative of fibroids

Back pain is also a rare symptom that occurs when fibroids start to press the muscles and nerves in your lower back. (7)

6. Irregular bowel movements

Fibroids sometimes tend to put pressure on your rectum, causing difficulty in bowel movements and leading to constipation.

You may also experience pain while having a bowel movement. In rare cases, this can cause hemorrhoids. (8)

7. Pain during sexual intercourse

Having fibroids may cause a woman to experience pain while having sexual intercourse. (9) This is because fibroids create a pressure sensation that interferes with sexual enjoyment.

If the fibroids are closer to the cervix, they not only cause pain but also bleeding. They can also cause hormonal imbalance that lowers your libido.

Causes of Fibroids

what causes fibroids?

It has not been scientifically proven yet what causes fibroids to grow and develop in the uterus. Many studies suggest that the development of these fibroids is mainly due to hormonal imbalance. (5)

Hormones such as progesterone and estrogen cause them to grow. During pregnancy, when these hormones are on a rise, the fibroids grow in size. This is why, after menopause, the fibroids stop growing due to decreased hormone secretion.

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Here are the possible causes of fibroids:

1. Genetics

Fibroids may develop due to faulty genes that differ from the normal genes present in uterine muscle cells. (10)

2. Hormones

Estrogen and progesterone cause thickening of the uterine wall as part of the menstrual cycle, which may be responsible for fibroid development. (11)

Fibroids contain an increased amount of estrogen and progesterone receptors than normal muscle cells of the uterus, causing them to grow when hormones are secreted. (12)

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3. Growth factors

These are chemicals that help your body maintain the tissues, and they may also promote fibroid development. (13) These include:

  • Insulin-like growth factors
  • Epidermal growth factor
  • Transforming growth factor beta

Complications of Fibroids

Fibroids are considered to be not too dangerous. They don’t usually cause serious conditions. However, they can cause discomfort and loss of blood during menstruation, leading to anemia.

Opposite to common belief, fibroids don’t really hinder your chance of getting pregnant. They can, however, increase the risk of pregnancy complications such as delivery before 9 months or restricted fetal growth. (14)

Most-Asked Questions About Fibroids

Can fibroids turn cancerous?

can fibroids turn cancerous?

Usually, fibroids will cause no symptoms whatsoever and don’t even require any kind of treatment. Escalations to the doctor are needed if symptoms are seen.

They appear during childbearing years and are never associated with cancer. They don’t increase the risk of uterine cancer, nor do they develop into cancer themselves. (15) (16)

What are fibroids made of?

Leiomyomas are generally nothing but masses of muscle and connective tissue that arise from the uterine wall.

When do women know they have fibroids?

A lot of women who have fibroids don’t even know they have them until they are accidentally discovered because of an ultrasound during pregnancy or during a pelvic exam. 

How are fibroids treated?

There is no one treatment for fibroids. The location of fibroids in the uterus or outside of it plays a major role in deciding how to tackle the issue. The number of fibroids also is important to figure out the best treatment for fibroids.

Final Word

Fibroids don’t require any kind of treatment until they cause serious symptoms, and prevention of them is difficult due to lack of research. But, by making healthier life choices with timely interventions, you can decrease your chances of suffering from fibroids.

References
  1. Williams ARW. Uterine fibroids – what’s new?. F1000Res. 2017;6:2109. Published 2017 Dec 7. doi:10.12688/f1000research.12172.1.
  2. Ulin M, Ali M, Chaudhry ZT, Al-Hendy A, Yang Q. Uterine fibroids in menopause and perimenopause. Menopause. 2020;27(2):238-242. doi:10.1097/GME.0000000000001438.
  3. Al-Hendy A, Myers ER, Stewart E. Uterine Fibroids: Burden and Unmet Medical Need. Semin Reprod Med. 2017;35(6):473-480. doi:10.1055/s-0037-1607264.
  4. Marsh EE, Al-Hendy A, Kappus D, Galitsky A, Stewart EA, Kerolous M. Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women. J Womens Health (Larchmt). 2018;27(11):1359-1367. doi:10.1089/jwh.2018.7076.
  5. Barjon K, Mikhail LN. Uterine Leiomyomata. [Updated 2021 Aug 11]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK546680/.
  6. Houlihan S, Koenig N, Friedman B, Lee T, Geoffrion R. Fibroid surgery and improvement in bladder symptoms: The FAB study. Neurourol Urodyn. 2018;37(6):1965-1970. doi:10.1002/nau.23541.
  7. Jensen AM, Bewketu B, Sanford D. Intermittent low back pain referred from a uterine adenomyosis: a case report. J Chiropr Med. 2011;10(1):64-69. doi:10.1016/j.jcm.2010.08.004.
  8. Fuldeore MJ, Soliman AM. Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis. Int J Womens Health. 2017;9:403-411. Published 2017 Jun 7. doi:10.2147/IJWH.S133212.
  9. Moshesh M, Olshan AF, Saldana T, Baird D. Examining the relationship between uterine fibroids and dyspareunia among premenopausal women in the United States. J Sex Med. 2014;11(3):800-808. doi:10.1111/jsm.12425.
  10. Medikare V, Kandukuri LR, Ananthapur V, Deenadayal M, Nallari P. The genetic bases of uterine fibroids; a review. J Reprod Infertil. 2011;12(3):181-191.
  11. Wong JY, Gold EB, Johnson WO, Lee JS. Circulating Sex Hormones and Risk of Uterine Fibroids: Study of Women’s Health Across the Nation (SWAN). J Clin Endocrinol Metab. 2016;101(1):123-130. doi:10.1210/jc.2015-2935.
  12. Borahay MA, Asoglu MR, Mas A, Adam S, Kilic GS, Al-Hendy A. Estrogen Receptors and Signaling in Fibroids: Role in Pathobiology and Therapeutic Implications. Reprod Sci. 2017;24(9):1235-1244. doi:10.1177/1933719116678686.
  13. Ciarmela P, Islam MS, Reis FM, et al. Growth factors and myometrium: biological effects in uterine fibroid and possible clinical implications. Hum Reprod Update. 2011;17(6):772-790. doi:10.1093/humupd/dmr031.
  14. Lee HJ, Norwitz ER, Shaw J. Contemporary management of fibroids in pregnancy. Rev Obstet Gynecol. 2010;3(1):20-27.
  15. Chen I, Firth B, Hopkins L, Bougie O, Xie RH, Singh S. Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids. JSLS. 2018;22(1):e2017.00066. doi:10.4293/JSLS.2017.00066.
  16. Sakin Ö, Denizli R, Pirimoğlu ZM, Anğın AD, Çıkman MS, Gülyaşar G. The effects of menopausal uterine fibroids on the prognosis of endometrium cancer. Turk J Obstet Gynecol. 2020;17(2):128-132. doi:10.4274/tjod.galenos.2020.70104.
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