When to See a Doctor: Recognizing Serious Fibroid Symptoms

1. Fibroid Symptoms:Heavy or Prolonged Menstrual Bleeding

When It’s a Concern

• Soaking through one or more pads or tampons every hour for several hours.
• Periods lasting longer than seven days.
• Passing large blood clots (larger than a quarter).
• Feeling dizzy, weak, or fatigued, which could indicate anemia.  

Why It’s Important:

• Heavy bleeding can lead to iron deficiency anemia, causing extreme fatigue and weakness.
• May indicate submucosal fibroids, which grow inside the uterine cavity and disrupt the endometrial lining.  

2. Fibroid Symptoms: Severe Pelvic Pain or Pressure

When It’s a Concern

• Chronic, dull pelvic pain that does not go away.
• Sharp, stabbing pain that occurs suddenly.
• Lower back pain that worsens over time.  

Why It’s Important:

• Large fibroids can press on nearby organs, causing pelvic pressure and discomfort.
• Sudden, severe pain could indicate fibroid degeneration, where a fibroid outgrows its blood supply and starts breaking down.  

3.Fibroid Symptoms: Frequent Urination or Difficulty Emptying the Bladder

When It’s a Concern

• Needing to urinate often (even at night).
• Feeling the urge to urinate but passing only a small amount.
• Difficulty fully emptying the bladder.  

Why It’s Important:

• Fibroids located near the bladder can compress the urinary tract, leading to urinary issues or infections.
• Severe cases may cause kidney damage if the urine flow is blocked.  

4.Fibroid Symptoms:Bloating or Constipation

When It’s a Concern

• Persistent bloating or a feeling of fullness in the abdomen.
• Difficulty passing stool or experiencing constipation that lasts for days.
• Hemorrhoids or pain during bowel movements.  

Why It’s Important:

• Fibroids near the rectum can press on the intestines, causing bowel issues.
• Severe constipation may lead to digestive complications if untreated.  

5.Fibroid Symptoms: Pain During Intercourse (Dyspareunia)

When It’s a Concern

• Deep, persistent pain during or after intercourse.
• Pain that worsens over time.  

Why It’s Important:

• Fibroids located in the cervix or near the vaginal wall can cause discomfort or pain during intercourse.
• This can also lead to emotional distress and relationship difficulties if left unaddressed.  

6.Fibroid Symptoms: Difficulty Getting Pregnant or Recurrent Miscarriages

When It’s a Concern

• Trying to conceive for over a year without success.
• Multiple miscarriages without a known cause.  

Why It’s Important:

• Fibroids in certain locations, such as inside the uterine cavity (submucosal fibroids), can interfere with implantation and pregnancy.
• Removing fibroids in select cases has been shown to improve pregnancy rates.  

7.Fibroid Symptoms: Sudden, Severe Abdominal Pain

When It’s a Concern

• Intense, sharp pain that does not subside.
• Nausea, fever, or vomiting accompanying abdominal pain.
• Swelling or tenderness in the lower abdomen.  

Why It’s Important:

• Could indicate fibroid torsion, where a fibroid on a stalk (pedunculated fibroid) twists, cutting off its blood supply.
• This is a medical emergency requiring immediate treatment.  

8.Fibroid Symptoms: Rapidly Growing Fibroids or Enlarged Abdomen

When It’s a Concern

• Noticeable increase in abdominal size (similar to pregnancy).
• Sudden growth of fibroids over a short period.  

Why It’s Important:

• While fibroids grow slowly, rapid growth may require further testing to rule out other conditions.
• Fibroids larger than 10 cm may require surgical intervention.  

When to Seek Emergency Care:

Go to the doctor or emergency room if you experience:

• Severe, sudden pelvic pain.
• Uncontrolled heavy bleeding.
• Signs of anemia (extreme fatigue, dizziness, pale skin).
• Severe constipation with abdominal swelling.  

What to Expect at the Doctor’s Office

A doctor may perform:

• Pelvic exam to check for enlarged uterus.
• Ultrasound or MRI to assess fibroid size and location.
• Blood tests to check for anemia or hormonal imbalances.  

Fibroid Symptoms: Treatment Options

Treatment depends on severity of symptoms and future pregnancy plans:

1. Medications – Hormonal treatments (e.g., GnRH antagonists like Relugolix) to shrink fibroids.
2. Minimally invasive procedures – Uterine artery embolization (UAE) or MRI-guided focused ultrasound (FUS).
3. Surgery – Myomectomy for women wanting to conceive; hysterectomy for severe cases.  

Conclusion

Uterine fibroids do not always require treatment, but serious symptoms should never be ignored. If you experience persistent pain, excessive bleeding, or fertility issues, consult a doctor for proper evaluation and treatment options.

References

References

1. Micić, J. et al. Currently Available Treatment Modalities for Uterine Fibroids. Medicina, 2024, 60(868). Available at: https://doi.org/10.3390/medicina60060868.
2. Krzyżanowski, J.; Paszkowski, T.; Woźniak, S. The role of nutrition in pathogenesis of uterine fibroids. Nutrients, 2023, 15(23): 4984. Available at: https://doi.org/10.3390/nu15234984.
3. Wang, Y. et al. Minimally invasive surgery for uterine fibroids. Ginekologia Polska, 2020, 91(3): 149-157. Available at: https://doi.org/10.5603/GP.a2020.0034.
4. Donnez, J.; Dolmans, M. M. GnRH antagonists with or without add-back therapy: A new alternative in the management of endometriosis? International Journal of Molecular Sciences, 2021, 22(21): 11342. Available at: https://doi.org/10.3390/ijms222111342.
5. Memon, S. I.; Acharya, N. S.; Potdar, J. Spontaneous Expulsion of a Huge Cervical Fibroid After Uterine Artery Embolization. Cureus, 2022, 14(10): e30163. Available at: https://doi.org/10.7759/cureus.30163.