Increased menstrual bleeding tends to be the most common problem associated with fibroids. It is thought the fibroids distort the uterine architecture and affect blood flow and thereby cause increased bleeding.
When the fibroids are big, they can press on the bowels at the back of the uterus or the bladder at the front of the uterus and cause bowel habit changes such as constipation or urinary symptoms such as needing to urinate frequently. Occasionally, the fibroids may be so big that the woman may feel it herself by rubbing her own abdomen. Pain can occur as a result of fibroid enlargement or pressure effect on surrounding organs. However, fibroids are generally painless.
Fibroids rarely cause infertility. Even very big fibroids do not cause infertility. Occasionally, fibroids may contribute to miscarriages or presumed implantation failure if they protrude into the uterine cavity (submucous fibroids). Even this is a may be. Most women with fibroids go through their pregnancies without any problems.
Therefore, although fibroids are very common, they do not always need to be treated. The location rather than the size of the fibroids are more predictive of the likelihood of fibroids requiring treatment. The fibroids with a large portion protruding into the uterine cavity (submucous) are more likely to cause problems such as heavy periods and miscarriages and thus requiring treatment.
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