Uterine Fibroids and Hysterectomy - Symptoms

Complications

Effect on Fertility

Most fibroids appear to have only a small effect on a woman’s fertility. Female infertility is usually due to other factors than fibroids.

Effect on Pregnancy

Fibroids may increase pregnancy complications and delivery risks. These may include:

• Cesarean section delivery
• Breech presentation (baby enters the birth canal upside down with feet or buttocks emerging first)
• Preterm birth
• Placenta previa (placenta covers the cervix)
• Excessive bleeding after giving birth (postpartum hemorrhage)

Anemia

Anemia due to iron deficiency can develop if fibroids cause excessive bleeding. Oddly enough, smaller fibroids, usually submucosal, are more likely to cause abnormally heavy bleeding than larger ones.

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Most cases of anemia are mild and can be treated with dietary changes and iron supplements. However, prolonged and severe anemia that is not treated can cause heart problems. [For more information, see In-Depth Report #57: Anemia.]

Urinary Tract Infection

Large fibroids that press against the bladder occasionally result in urinary tract infections. Pressure on the ureters may cause urinary obstruction and kidney damage.

Uterine Cancer

Fibroids are nearly always noncancerous, even if they have abnormal cell shapes. Cancer of the uterus usually develops in the lining of the uterus (endometrial cancer). Only in rare cases (less than 0.1%) does cancer develop from a malignant change in a fibroid (called leiomyosarcoma). Nevertheless, rapidly enlarging fibroids in a premenopausal woman or even slowly enlarging fibroids in a postmenopausal woman need evaluation to rule out cancer.

Click the icon to see an image of uterine cancer.

Review Date: 07/26/2010
Reviewed By: Reviewed by Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).