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Clinical features

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

The majority are asymptomatic or are noticed by the patient as a non-tender, non-painful abdominal swelling.

Common symptoms include:

  • abnormal uterine bleeding (AUB)
    • most common symptom of uterine fibroid
    • heavy menstrual bleeding
      • associated with intramural and submucous fibroids
      • may lead to iron deficiency anaemia
    • intermenstrual bleeding is unusual
  • abdominal bloating, and a sense of heaviness in the lower abdomen, due to the abdominal swelling
  • pelvic pressure symptoms
    • urinary frequency, urgency
    • urinary incontinence
    • difficulty with urination
    • hydronephrosis
    • constipation
    • tenesmus
  • pelvic pain
    • is not generally a feature
    • severe pain may occur during red degeneration, especially during pregnancy, or with torsion of a pedunculated subserous fibroid
    • colicky pain may occur from extrusion of a subserous fibroid through the cervix.
  • infertility - submucous tumours may interfere with implantation of the blastocyst, or cause early abortion
  • dystocia - tumours in the lower uterine segment may obstruct labour (1,2,3)


  • very large fibroids may be palpated abdominally
  • vaginal examination usually reveals - a firm, irregularly enlarged uterus that is non-tender; an exception is one undergoing red degeneration which may be very tender
  • consistency is variable - from rock hard in the calcified postmenopausal fibroid, to soft, even to cystic if degenerative changes have occurred
  • most fibroids move with the cervix - except if subserous, detached and parasitic
  • bruits may be heard during auscultation of large tumours; they are similar to the uterine souffle of pregnancy


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