A missed period can be a significant cause for concern, often leading to immediate thoughts of pregnancy. However, the menstrual cycle is a complex biological process influenced by numerous factors, and variations are not uncommon. Beyond pregnancy, various other elements can disrupt the regularity of a woman’s cycle, leading to delayed or absent menstruation.
Understanding Uterine Fibroids
Uterine fibroids are non-cancerous growths that develop within or on the muscular wall of the uterus. These growths are common, affecting between 20% and 80% of women by the age of 50. Fibroids can range in size from microscopic to masses large enough to fill the entire abdominal cavity.
Fibroids are classified based on their location within the uterus. Intramural fibroids grow within the uterine muscular wall and are the most common type. Subserosal fibroids develop on the outer surface of the uterus, while submucosal fibroids grow just beneath the uterine lining and protrude into the uterine cavity. Some fibroids, whether subserosal or submucosal, can also grow on a stalk, known as pedunculated fibroids.
Fibroids and Menstrual Irregularities
Uterine fibroids can impact the menstrual cycle, though a completely missed period is less common than other irregularities. They are more frequently associated with changes like heavy bleeding. Large fibroids may, in rare cases, distort the uterine lining or affect the uterus’s ability to contract, potentially contributing to an irregular or delayed period.
More often, fibroids cause heavy menstrual bleeding or prolonged periods lasting longer than seven days. This can occur because fibroids, especially submucosal ones, increase the surface area of the uterine lining, leading to greater blood loss. Fibroids can also interfere with the normal contraction and relaxation of the uterine muscles, which are necessary to regulate blood flow, resulting in extended bleeding. Increased menstrual pain is also a common symptom, as fibroids can exert pressure on the uterine walls and surrounding organs.
Other Signs of Uterine Fibroids
Beyond changes in menstrual patterns, uterine fibroids can manifest through various other symptoms depending on their size, number, and location. Many women with fibroids experience pelvic pressure or pain, which can be a constant feeling of fullness or a dull ache in the lower abdomen. Large fibroids can also press on nearby organs, leading to frequent urination or difficulty completely emptying the bladder.
Pressure on the rectum can cause constipation. Some individuals may also experience lower back pain or leg pain if fibroids press on nerves and blood vessels extending to the legs. Pain during sexual intercourse is another potential symptom, particularly if fibroids are located in a position that causes discomfort during activity. In some instances, fibroids can grow significantly, causing an enlarged abdomen that may resemble pregnancy.
When to Consult a Doctor
It is advisable to consult a healthcare professional if you experience persistent missed periods, unusually heavy or prolonged menstrual bleeding, or severe pelvic pain. Any new or worsening symptoms that interfere with daily life, such as frequent urination, constipation, or discomfort during sexual intercourse, also warrant medical attention. These symptoms could indicate the presence of uterine fibroids or other gynecological conditions that require evaluation.
A healthcare provider will typically begin with a pelvic exam to check for any abnormalities, including masses that might be fibroids. If fibroids are suspected, imaging tests such as an ultrasound are commonly used to confirm the diagnosis and determine their size and location. A diagnosis is necessary to understand the cause of your symptoms and discuss appropriate management or treatment options, if needed.