Uterine fibroids (leiomyomas) are common, non-cancerous growths that develop from the muscle tissue of the uterus. Although fibroids are localized to the pelvis, their presence can cause systemic symptoms that leave a person feeling generally unwell or “sick.” The severity of these whole-body effects depends on the fibroid’s size, number, and exact location within the uterus.
The Primary Symptoms of Uterine Fibroids
The most common symptoms of uterine fibroids arise directly from their physical presence in the pelvis. Fibroids often cause prolonged and heavy menstrual bleeding (menorrhagia). Excessive flow is indicated by a period lasting longer than seven days or requiring sanitary protection changes every hour for several consecutive hours. This heavy bleeding is particularly common with submucosal fibroids, which grow just beneath the uterine lining.
The sheer bulk of fibroids can also lead to pressure-related discomfort in the lower abdomen. This manifests as a feeling of fullness, heaviness, or constant generalized pelvic pressure. Pelvic pain, including painful menstrual cramps (dysmenorrhea) and discomfort during sexual intercourse (dyspareunia), is also a frequent complaint. The physical displacement of the uterus by large fibroids is the direct cause of these localized pressure issues.
How Fibroids Cause Systemic Sickness
The feeling of being generally unwell largely stems from severe blood loss caused by heavy menstrual bleeding, which depletes the body’s iron stores. This blood loss leads to iron deficiency anemia, as the body cannot replace blood fast enough. Iron is necessary for producing hemoglobin, the protein in red blood cells that transports oxygen throughout the body.
A lack of sufficient oxygen-carrying capacity leads to profound and persistent fatigue and weakness. Other systemic signs of anemia include lightheadedness, pale skin, cold hands and feet, and shortness of breath. Chronic anemia can also place strain on the heart, potentially leading to an irregular heartbeat or palpitations in more advanced cases.
The physical size of the fibroids also creates systemic effects by pressing on neighboring organs. Large fibroids growing on the back of the uterus can press against the colon and rectum, interfering with normal bowel movements. This compression slows the passage of waste and frequently results in chronic constipation and abdominal bloating.
Fibroid growth can also significantly reduce the bladder’s capacity due to the uterus’s proximity. Pressure on the bladder causes urinary symptoms, such as an increased urge to urinate and frequency, even with minimal urine volume. In rare instances, extremely large fibroids may compress the ureters, potentially leading to a backup of urine and kidney dysfunction.
Recognizing Symptom Severity and Next Steps
The degree to which fibroids cause systemic sickness varies greatly based on their location, number, and size. While a small fibroid may cause no symptoms, others may result in severe, life-altering bleeding. It is important to seek medical evaluation if symptoms are persistent or worsening.
Specific signs that warrant immediate medical attention include severe fatigue, fainting, or dizziness, which can indicate serious anemia. Uncontrolled, heavy bleeding or acute, sharp pelvic pain unrelieved by over-the-counter medication also requires prompt care. Diagnosis typically begins with a pelvic exam, followed by imaging tests, such as a pelvic ultrasound, to confirm the size and location of the fibroids.
Initial management focuses on addressing the systemic consequences, often starting with iron supplementation to counteract anemia caused by blood loss. Medications designed to reduce menstrual bleeding, such as hormonal birth control or other therapies, may also be used to manage symptoms. Addressing the underlying fibroids is necessary to prevent the systemic sickness from recurring, as iron supplements alone do not stop the source of the bleeding.