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Me and My Fibroid: Eruption of A Silent Volcano

For the past 2 years, G, 31, had been enduring menstrual pain and heavy bleeding with clots. She had become accustomed to the “stormy time of the month”.

“I did not seek medical help as I thought it was normal to have some discomfort or clots during menses after childbirth, ” she recalled.

After the birth of her son 4 years ago, her periods had become increasingly heavier and longer. There were clots on the first 3 to 4 days. About 2 year ago, she began to experience abdominal cramps on the first few days of menses as well. The pain was relieved by applying a hot pack to the lower abdomen and by taking painkillers. She also felt weak and exhausted during menstruation.

One morning, she was brought to the emergency department in the hospital when she collapsed and passed out in her office. It was the second day of her menstruation. She looked pale with a fast pulse rate of 110 beats per minute. Her blood pressure was low at 90/60mm Hg. Her uterus was enlarged and palpable in the lower abdomen, corresponding to about 14 weeks of pregnancy. A large amount of blood clot was noted in her vagina. Ultrasound examination revealed a large uterine mass about 8 cm in diameter, protruding into the uterine cavity. Her hemoglobin was low at 9.2 gm/dl. She was transfused with blood. Her bleeding was stopped with medication. G was having heavy bleeding and severe anemia due to a huge uterine fibroid.

What are uterine fibroids?

Uterine fibroids are common muscle growths of the womb. About 20 to 70 percent of women will have fibroids during their childbearing years. They are usually non-cancerous.

Fibroids can range in size from tiny seedlings to huge masses that can distort and enlarge the uterus. They can present either as a single lump or multiple ones. They are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids protrude outside the uterus.

What are the symptoms?

Majority of the fibroids do not present with any symptoms. If symptoms are present, they are dependent on the location, size and number of fibroids. Common symptoms include:

  • Heavy menstrual bleeding

  • Prolonged or painful periods

  • Spotting or bleeding between periods

  • Pelvic pressure or pain

  • Frequent urination

  • Difficul