Many women with uterine fibroids have no symptoms at all, even when the fibroids are large. The condition is often discovered incidentally during routine pelvic examinations or imaging tests. The classic symptoms are heavy menstrual bleeding and secondary anemia, which largely depend on the location and size of the fibroids.
(1) Intramural Fibroids
These fibroids develop within the uterine wall. They commonly cause heavy menstrual flow, prolonged menstrual periods, and a dragging pelvic sensation during menstruation.
(2) Subserosal Fibroids
These grow outward beneath the outer uterine lining and usually produce no symptoms. However, large fibroids on the anterior uterine wall may compress the bladder, leading to frequent urination.
(3) Submucosal Fibroids
These grow just beneath the endometrium and project into the uterine cavity. Heavy menstrual bleeding is the main symptom, which gradually worsens as the fibroid enlarges, leading to prolonged periods and significant secondary anemia. They may also cause infertility or an increased risk of miscarriage after conception.
Pedunculated submucosal fibroids can stimulate uterine contractions, causing paroxysmal abdominal pain or a heavy dragging sensation. If infection or necrosis occurs, they may produce large amounts of bloody or foul-smelling purulent vaginal discharge.