Complications of uterine fibroids: What you need to know

The article was professionally consulted by BSCK II Bui Minh Phuc - Department of Obstetrics and Gynecology, Vinmec Ha Long International Hospital.

Uterine fibroids are a common disease in women, some of the complications of uterine fibroids can have a profound effect on a woman's quality of life. So what are the symptoms and ways to prevent complications of uterine fibroids? Find out through the article below.

Uterine fibroids are benign tumors of the smooth muscle of the uterus, they vary in size and number in each patient. Fibroids affect about 30% of women by age 35 and between 20 and 80% of women by age 50. The disease is most common in women between the ages of 16 and 50. This is the reproductive period of women, so the cause of the disease is often explained by an increase in the level of the hormone estrogen in the female body.

Common signs in patients with uterine fibroids are:
Abnormal vaginal bleeding Symptoms of anemia: Patients often have pale skin and are often tired. Severe anemia causes dizziness and possibly fainting. Discomfort, dull pain in the lower abdomen, especially when the tumor is large. Air is as thin as water. Urinate frequently. Pain during sex. Feel the tumor in the hypogastrium (abdomen below the navel).

There are also some women who discover fibroids after years of not getting pregnant or having consecutive miscarriages. Once a fibroid is discovered, it may continue to grow until menopause. As estrogen levels drop during menopause, fibroids may shrink.

If fibroids are small in size, they usually cause no symptoms and may disappear with menopause. However, if complications of uterine fibroids occur, they can be serious and life-threatening.

Anemia Symptoms of anemia are both a manifestation and a complication of uterine fibroids. Patients often have pale skin, less rosy face, often tired, feeling no energy to perform daily tasks.

Acute anemia due to hypermenorrhoea, blood loss in a large amount in a short time can cause anemia to the patient's brain, causing dizziness, fainting, even death if the blood loss is too large.
Persistent anemia, if not detected and treated, will progress to the chronic stage of anemia. Patients may lose weight, lack health to work, feel short of breath, dizzy when doing heavy work.
Large tumor causing pressure on surrounding organs When the tumor size is growing, the tumor presses on neighboring organs, causing complications of uterine fibroids with the following manifestations:
Compression on the bladder causing difficulty urinating, frequent urination, urinary urgency, urinating many times a day. Compression of the ureter causes stagnation of urine in the renal pelvis, which can cause kidney stones or pyelonephritis,... Compression of the rectum causes frequent constipation, solid stools, and pain during defecation. Venous compression causes lower extremity edema. Subperitoneal tumor torsion The patient presented with sudden onset of severe right iliac fossa pain accompanied by vomiting, bowel obstruction, shock, and pain-induced syncope. If not treated promptly, the patient can develop peritonitis, which rapidly deteriorates and can lead to death.

Complications of infection Infection can be in the tumor or spread to the surrounding organs or the whole body:
Infection right at the tumor is a complication of uterine fibroids in the form of polyps, protruding outside the uterus. Patients often have abdominal pain, fever, increased white blood cell count, and general collapse. On gynecological examination, the doctor can observe dark brown, soft, necrotic mass. Endometritis: Patients may have purulent discharge, bad odor, fever, and lower abdominal pain. Acute or chronic tubal inflammation: vaginal bleeding, pelvic pain, fever. This complication can cause delayed pregnancy. Taking up a very small percentage but with a very poor prognosis, cancer is a complication of uterine fibroids that is difficult to diagnose. Patients usually have no characteristic symptoms; There may be fever, weight loss, abnormal vaginal bleeding for a long time, general weakness, ...

Infertility or infertility Some cases of uterine fibroids are discovered after going to the doctor because they have not been pregnant for a long time even without using any contraception. This is one of the complications of uterine fibroids.

There are several causes of infertility in patients with uterine fibroids:
Anovulatory menstrual cycle: One of the menstrual cycles in which there are no mature ovarian follicles, so ovulation does not occur. like any other menstrual cycle. So, even if you have sex, you can't conceive. The patient's body has too high levels of estrogen hormone, which is relatively unfavorable for pregnancy. Large uterine fibroids disrupt the contraction of the smooth muscle of the uterus, making it difficult for sperm to reach the egg. Or when sperm and fertilized eggs also make it difficult for the zygote to move and not attach to the lining of the uterus to develop. Abnormal uterine lining: It is detrimental to the zygote, causing the zygote to not attach to the uterus to develop. Fibroids located in the waist or interstitium of the uterus also make it difficult to get pregnant. Miscarriage In pregnant women with uterine fibroids, uterine muscles are often less elastic, contractile disorders due to hormonal imbalance. Therefore, these women are at high risk of miscarriage.

During pregnancy, fibroids can limit the growth of the fetus, increasing the likelihood of a cesarean delivery compared to women without fibroids.
Affects the normality of the fetal position: Due to the abnormal shape of the uterine cavity, the fetus may not be able to turn to the right side for vaginal delivery. Placental abruption: This occurs when the placenta breaks free from the wall of the uterus because it is blocked by a fibroid. It causes hypoxia to the fetus and can be dangerous for the life of the fetus. During labor: Uterine fibroids disrupt the contractions of the smooth muscles of the uterus, making it difficult during labor. Uterine fibroids can turn into prostate tumors, obstructing the outflow of the fetus.
In the period of placental abruption: Due to fibroids causing abnormal uterine lining, after placental delivery, the patient may have retained placenta, uterine bleeding that does not stop or the uterus does not contract tightly into a safe mass. after placental abruption (uterine lethargy).
Postpartum period: The patient has a high risk of endometritis.

When presenting, complications of uterine fibroids affect the patient's life, which can be treated with drugs or surgery. The location of the fibroids, the severity of your symptoms, and any future plans to have children can all influence your doctor's treatment decisions.

Treating fibroids before getting pregnant can improve your fertility. The most common treatments for complications of uterine fibroids to preserve fertility include:
Surgery The patient will have the tumor removed and fertility preserved. This may increase the need for a cesarean section, and you will likely have to wait about 3 months after the procedure before trying to get pregnant.
Hormonal birth control pills While you are taking the pill, you will not be able to get pregnant. These birth control methods can help ease the symptoms of this condition, such as heavy and painful bleeding.
IUD or IUD Like the birth control pill, the IUD will prevent pregnancy while you're using it. However, it can help eliminate some of the symptoms of fibroids while preserving fertility.
Gonadotropin-releasing hormone (Gn-RH) agonist This medicine blocks the production of the hormones that lead to ovulation and menstruation, so you will not be able to get pregnant while taking this medicine. It can help shrink fibroids.
Embolization of tumors This method uses an electric current, laser or radiofrequency energy beam to shrink the blood vessels that feed the fibroids.
Each treatment method has its own risks and complications, so listen to your doctor's advice to make your choice. Likewise, ask your doctor how long you will have to wait before trying to get pregnant after treatment. With some treatments, such as birth control pills, you can try to get pregnant as soon as you stop using them.

Despite being a benign disease, complications of uterine fibroids are still possible and have serious consequences for women's health. Therefore, periodic reproductive health examination is very necessary, both to help detect early and reduce the likelihood of complications of uterine fibroids, and also to protect women from other gynecological diseases. Vinmec International General Hospital offers a package of gynecological examination and screening for female customers, with no age limit.
When registering for the Basic Gynecological Examination and Screening Package, customers will receive:
Specialized gynecological examination Transvaginal Uterine Ovarian Ultrasound Vaginal Bilateral Breast Ultrasound Tests such as: Treponema pallidum rapid test, Chlamydia rapid test, take samples for cervical-vaginal cytology, bacterioscopic staining (female vaginal fluid), HPV genotype PCR automated system, Total urinalysis by automatic machine .