Fibroids Symptoms
Why This Matters
Fibroids don't affect every woman in the same way.
Some women have no symptoms at all and only discover they have fibroids during a routine scan or pregnancy ultrasound. Others experience symptoms that can have a significant impact on their daily lives, relationships and emotional wellbeing.
If you've been struggling with heavy periods, pelvic pain or needing to visit the toilet more often, you may have wondered whether these symptoms are "normal."
They aren't something you should simply have to put up with.
Recognising the symptoms of fibroids is the first step towards getting the right advice and treatment.
Quick Summary
Many fibroids cause no symptoms.
Heavy menstrual bleeding is one of the most common symptoms.
Symptoms depend on the size, number and location of the fibroids.
Fibroids can cause pelvic pressure, pain and frequent urination.
Some women experience fertility problems or pregnancy complications.
If symptoms are affecting your quality of life, speak to your healthcare provider.
Why Do Fibroids Cause Symptoms?
Fibroids vary enormously in size.
Some are no larger than a pea, while others can grow large enough to expand the uterus significantly.
The symptoms you experience usually depend on:
where the fibroids are located
how large they are
how many fibroids you have
Interestingly, a small fibroid in the wrong place can sometimes cause more symptoms than a much larger one elsewhere.
Heavy Menstrual Bleeding
Heavy periods are one of the most common symptoms of fibroids.
You may notice:
periods lasting longer than seven days
soaking through sanitary products quickly
needing to use both pads and tampons together
passing large blood clots
bleeding through clothes or bedding
needing to change protection during the night
Heavy bleeding can interfere with work, family life and social activities.
Over time, it may also lead to iron deficiency anaemia.
Anaemia
If heavy bleeding continues month after month, your body may struggle to replace the iron it loses.
Symptoms of anaemia include:
tiredness
weakness
dizziness
shortness of breath
headaches
pale skin
difficulty concentrating
If you have very heavy periods and feel constantly exhausted, your doctor may recommend a blood test to check your iron levels.
Pelvic Pressure
Larger fibroids can create a feeling of pressure in the pelvis.
Some women describe it as:
heaviness
fullness
bloating
feeling as though something is pressing down inside the pelvis
This pressure may become more noticeable as fibroids increase in size.
Pelvic Pain
Although many fibroids are painless, some women experience:
aching pain
lower abdominal discomfort
backache
pain during menstruation
pain during sexual intercourse
Pain can also occur if a fibroid outgrows its blood supply and begins to break down, a process known as degeneration.
Frequent Urination
Fibroids growing towards the front of the uterus may press on the bladder.
This can cause:
needing to pass urine more often
difficulty emptying the bladder completely
waking during the night to urinate
urgency
These symptoms often improve if the fibroid becomes smaller or is treated.
Constipation
Fibroids growing towards the back of the uterus may press against the bowel.
This may lead to:
constipation
difficulty opening your bowels
a feeling that your bowel doesn't empty completely
Pain During Sex
Some women experience discomfort or pain during sexual intercourse.
This depends largely on where the fibroid is located.
If sex has become painful, it's important to mention this to your healthcare provider, as there may be several possible causes.
Abdominal Swelling
Very large fibroids can cause the abdomen to become noticeably larger.
Some women describe looking several months pregnant despite not being pregnant.
This usually develops gradually over time.
Fertility Problems
Most women with fibroids have no difficulty becoming pregnant.
However, some fibroids—particularly those that distort the inside of the uterus—may:
make it harder to conceive
increase the risk of miscarriage
reduce the success of IVF treatment
If you're trying for a baby, your doctor can advise whether your fibroids are likely to be contributing.
Pregnancy Symptoms
During pregnancy, fibroids may sometimes cause:
pelvic pain
degeneration
changes in the baby's position
a slightly increased risk of premature birth
Most women with fibroids still have healthy pregnancies.
When Should You See a Doctor?
Arrange an appointment if you experience:
very heavy periods
bleeding between periods
pelvic pain
persistent pelvic pressure
difficulty emptying your bladder
constipation that doesn't improve
pain during sex
symptoms of anaemia
difficulty becoming pregnant
Getting an early assessment can help identify the cause and allow you to discuss the most appropriate treatment options.
What Does This Mean for You?
Not everyone with fibroids experiences symptoms.
For those who do, the effects can range from mild inconvenience to symptoms that have a significant impact on everyday life.
You don't have to simply accept heavy bleeding, pain or constant fatigue as "just part of being a woman."
If your symptoms are affecting your work, relationships, family life or emotional wellbeing, speak to your healthcare provider. Effective treatments are available, and the best option will depend on your individual circumstances.
You Are Not Alone
Many women spend years believing their symptoms are normal.
Perhaps you've always had heavy periods, or you've gradually adapted your life around needing to know where the nearest toilet is or carrying spare clothes "just in case."
If this sounds familiar, you're not alone.
Too many women dismiss symptoms that deserve medical attention because they've been told that heavy or painful periods are simply something to put up with.
You deserve to be listened to, taken seriously and offered appropriate care.
Questions to Ask Your Doctor
Could my symptoms be caused by fibroids, or might there be another explanation?
Do I need an ultrasound or any other tests?
Are my symptoms likely to get worse over time?
Am I becoming anaemic because of my heavy bleeding?
What treatment options are available for my symptoms?
Could my fibroids affect my fertility or future pregnancies?
When should I come back if my symptoms change?
Myth vs Fact
Myth
Fact
Heavy periods are just something women have to live with.
Heavy bleeding is not normal and should always be assessed if it's affecting your life.
All fibroids cause pain.
Many fibroids cause no symptoms at all.
Bigger fibroids always cause worse symptoms.
A small fibroid in the wrong place can sometimes cause more problems than a larger one elsewhere.
If I have fibroids, I'll definitely need surgery.
Many women never need treatment, and several non-surgical options are available.
Your Next Step
If you've recognised some of these symptoms, it can be helpful to keep a symptom diary before your appointment.
Write down:
When your periods start and finish.
How heavy the bleeding is.
Whether you pass clots.
Any pain or pressure you experience.
How often you need to pass urine.
How your symptoms affect your work, sleep or daily activities.
Having this information can help your healthcare provider understand what you're experiencing and recommend the most appropriate next steps.
Key Takeaways
Many fibroids cause no symptoms.
Heavy menstrual bleeding is the most common symptom.
Symptoms depend on the size, number and location of the fibroids.
Fibroids can cause pain, pelvic pressure, bladder and bowel symptoms.
Heavy bleeding may lead to iron deficiency anaemia.
You should seek medical advice if your symptoms are affecting your quality of life.
Frequently Asked Questions
Can you have fibroids without knowing it?
Yes. Many women have fibroids that cause no symptoms and are only discovered during an ultrasound or routine examination.
Are heavy periods always caused by fibroids?
No. Heavy periods can have many causes, including adenomyosis, endometriosis, hormonal changes, polyps and bleeding disorders. An assessment is needed to determine the cause.
Can fibroids make you look pregnant?
Yes. Large fibroids can sometimes cause noticeable enlargement of the abdomen.
Can fibroids cause back pain?
Yes. Depending on their size and location, fibroids can cause lower back pain or pelvic discomfort.
Do fibroids always get worse?
Not necessarily. Some remain the same size for years, some grow slowly, and many shrink after the menopause.
Related Articles
Fibroids Explained
What Causes Fibroids?
How Are Fibroids Diagnosed?
Treatment Options for Fibroids
Fibroids and Fertility
Can You Get Pregnant with Fibroids?
Fibroids During Pregnancy
Heavy Periods: When Should You Seek Help?
References
National Institute for Health and Care Excellence (NICE). Heavy Menstrual Bleeding: Assessment and Management (NG88).
Royal College of Obstetricians and Gynaecologists (RCOG). Fibroids: Information for You.
American College of Obstetricians and Gynecologists (ACOG). Uterine Fibroids.
Stewart EA, et al. Uterine Fibroids. Nature Reviews Disease Primers.
Bulun SE. Uterine Fibroids. New England Journal of Medicine.
World Health Organization (WHO). Women's reproductive health resources.