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Signs & Symptoms Uterine Fibroids
Fibroids, even large ones, can be present without any symptoms.
However, they can also cause a variety of symptoms depending on their size, location and the absence or presence of complications such as torsion (twisting) or degeneration (fibroid grows to an extent that it starts running out of its blood supply).
The most common symptoms are heavy cyclical menstrual bleeding (menorrhagia) accompanied by menstrual pain (dysmenorrhea).
Sometimes, especially when a fibroid protrudes into the uterine cavity, it can cause erosion of the endometrial lining and produce irregular or continuous bleeding (meno-metrorrhagia).
Other possible symptoms include pain with deep penetration during intercourse (dyspareunia), bladder irritability, rectal pressure, constipation and painful bowel movements (dyschezia).
Effects Of Uterine Fibroids On Reproduction
Those fibroids that impinge upon the endometrial cavity (submucosal) or multiple fibroids in the muscle layer without a direct impact may adversely affect fertility.
Large intramural fibroids that block the openings of the fallopian tubes into the uterus, and where multiple fibroids cause abnormal uterine contraction patterns.
Surgery to treat fibroids can also affect fertility in several ways. If the endometrial cavity is entered during the surgery, there is a possibility of postoperative adhesion formation within the uterine cavity.
This should always be checked by a hysteroscopy or fluid ultrasound (hydrosonography) prior to beginning fertility treatment.
Because myomectomy can be bloody, there is a high likelihood of abdominal adhesion formation, which could encase the ovaries, preventing the release of the eggs or blocking the ends of the fallopian tubes.
It is important that experienced surgeons or reproductive endocrinologists, who are familiar with surgical techniques to limit blood loss and prevent adhesion formation, perform myomectomy.
In some cases multiple uterine fibroids may also deprive the endometrium of blood flow, that the delivery of estrogen to the uterine lining (endometrium) is curtailed to the point that it cannot thicken enough to support a pregnancy. This results in early 1st trimester miscarriages (prior to the 13th week of pregnancy).
Large or multiple fibroids, by curtailing the ability of the uterus to stretch in order to accommodate the spatial needs of a rapidly growing pregnancy, may precipitate recurrent 2nd trimester miscarriages (beyond the 13th week) and/or trigger the onset of premature labor.