- Location, not size, decides the symptom pattern.
- Anaemia from fibroid bleeding is common and treatable.
- Cavity-distorting fibroids reduce fertility and are worth removing.
Heavy menstrual bleeding
Submucosal and intramural fibroids that distort the endometrium cause heavy, prolonged periods, flooding, and passage of clots. Untreated, this leads to iron-deficiency anaemia — fatigue, breathlessness, brain fog. A full blood count and ferritin should be checked whenever bleeding is heavy.
Pressure and bulk symptoms
Larger fibroids press on the bladder (frequency, urgency, incomplete emptying) or bowel (constipation, bloating, back pain). A rapidly enlarging abdomen or a palpable pelvic mass are late signs. These symptoms alone are enough to justify treatment.
Fertility and pregnancy
Fibroids that distort the uterine cavity (submucosal, or intramural fibroids that indent the cavity) reduce implantation and increase miscarriage risk. Their removal — usually by hysteroscopy or laparoscopic myomectomy — reliably improves outcomes. Subserosal fibroids rarely affect fertility.
Frequently asked questions
How much bleeding is 'too much'?
Any bleeding that requires doubling up on protection, causes flooding, or produces clots larger than a 10p coin deserves evaluation.
Can fibroids cause back pain?
Yes — large posterior fibroids can compress nerves and cause lower back or leg discomfort.
Do fibroids cause weight gain?
Large fibroids add measurable weight and abdominal girth, but do not cause true fat gain.
Could a doctor-led plan help you?
A 30-minute video consultation with Dr Berra Önsoy — reviewing your imaging and giving you a clear personalised plan for uterus-sparing fibroid surgery.
Request a video consultation