The most common uterine fibroids symptom is heavy or prolonged periods, felt by around 75% of women with symptomatic fibroids. At Create Health, we speak with women every week who have been living with these symptoms of uterine fibroids for years, told their heavy periods or pelvic pain are simply “normal.”
In many cases, fibroids are the underlying cause, and once identified, there is a great deal we can do. This guide covers everything from recognising the signs and symptoms of uterine fibroids, through to how fibroids are diagnosed and treated in Australia, and what they mean for your fertility and reproductive health.
Uterine Fibroids Symptoms: 14 Signs and Symptoms
Fibroid symptoms depend on the size and location of the fibroids, as well as the number of fibroids present. A small fibroid in the wrong position can cause significant symptoms; a much larger one elsewhere may cause none. Here is what to look for.
1. Heavy or Prolonged Menstrual Bleeding
The most frequently reported symptom of uterine fibroids is heavy or prolonged menstrual bleeding. Signs include soaking through protection within an hour, passing large blood clots, or periods lasting longer than seven days. This is a common symptom of uterine fibroids and is one of the most undertreated symptoms in women’s health, normalised for years before a cause is found.
2. Anaemia and Fatigue
Chronic blood loss from heavy menstrual bleeding depletes iron stores, leading to iron deficiency anaemia. Symptoms of anaemia include persistent exhaustion, breathlessness during light activity, and heart palpitations.
In Australia, this is frequently managed in isolation, iron supplements prescribed without investigation of the underlying cause. If you’ve been on and off iron tablets for years without anyone looking further, please ask for a gynaecological review to see if uterine fibroids could be the cause.
3. Pelvic Pain and Pressure
A persistent dull ache or heaviness in the lower abdomen, often described as constant fullness or the sensation of carrying something heavy in the pelvis, is a classic pelvic symptom of uterine fibroids. This can be present throughout the month, not just during your period. If a fibroid outgrows its blood supply (degeneration), pain can become sudden and severe, warranting urgent attention.
4. Painful Periods (Dysmenorrhoea)
Fibroids, particularly submucosal fibroids and intramural fibroids, cause more severe menstrual cramping as the uterus contracts more forcefully. If period pain is causing you to miss work or daily activities and isn’t controlled by standard pain relief, that is a clinical red flag—not a normal variation. This symptom of uterine fibroids should be evaluated.
5. Frequent Urination or Bladder Problems
The bladder sits just in front of the uterus. Fibroids on the anterior wall of the uterus can press against it, causing frequency, urgency, difficulty fully emptying, or urinary incontinence. This pelvic and urinary symptom is often linked to fibroids pressing on the bladder. An unexplained change in bladder habits always warrants mention to your doctor, as it could be due to fibroids.
6. Lower Back or Leg Pain
Fibroids at the posterior of the uterus can press against spinal nerves or pelvic blood vessels, causing lower back pain or pain radiating into the legs. This is commonly mistaken for a musculoskeletal problem, which is why pelvic symptoms alongside back pain should always prompt a gynaecological assessment. Symptoms such as heavy periods with back pain are often signs of uterine fibroids.
7. Abdominal Swelling or Bloating
Larger fibroids cause visible lower abdominal distension, firm swelling that doesn’t fluctuate with eating. Some women describe clothes no longer fitting around the waist. In significant cases, the uterus can enlarge to a size comparable to several months of pregnancy. This pelvic and abdominal swelling is often a sign of uterine fibroids.
8. Constipation or Bowel Changes
Fibroids pressing against the rectum can cause constipation, rectal pressure, or difficulty with bowel movements. This pelvic symptom is less commonly discussed but it substantially affects quality of life and is absolutely worth raising with your doctor.
9. Pain During Sex
Dyspareunia—pain during or after intercourse is a recognised fibroid symptom, particularly when fibroids are located near the cervix or lower uterus. This symptom is underreported because women feel embarrassed raising it. Please don’t, if you experience pain during sex along with other pelvic symptoms, it deserves investigation. Pelvic pain and symptoms such as heavy bleeding can be linked to fibroids.
10. Spotting or Bleeding Between Periods
Irregular bleeding outside your usual period, particularly associated with submucosal fibroids, is a symptom of uterine fibroids that should always be investigated thoroughly to exclude other causes, including endometrial and cervical pathology. Never assume it’s “just fibroids” without a proper review. This uterine bleeding between periods is a red flag.
11. Recurrent Miscarriage
Submucosal fibroids and intramural fibroids that distort the uterine cavity are associated with recurrent pregnancy loss. The fibroid’s position interferes with implantation or disrupts blood flow to the developing pregnancy. If you have experienced two or more miscarriages, fibroid assessment should be part of your workup, especially if you have plans for pregnancy.
12. Difficulty Conceiving
Some fibroids contribute to fertility difficulties by distorting the uterine cavity, blocking the fallopian tube openings, or disrupting the endometrial environment needed for implantation. Many women with fibroids conceive naturally, but if you have been trying for 12 months (or 6 months if over 35) without success, a pelvic ultrasound is an important first step. Fibroids can cause difficulty getting pregnant, and this symptom should be evaluated.
13. Leg Swelling or Varicose Veins
Less commonly recognised, large fibroids can compress pelvic veins and obstruct venous return from the lower limbs, causing leg swelling, heaviness, or the development of varicose veins in the legs or vulva. This is one of the complications of fibroids that is rarely attributed to fibroids without investigation, and why a gynaecological assessment is important even when presentations seem unrelated.
14. Unexplained Vaginal Discharge or Infection Symptoms
Fibroids that protrude toward the cervix or cause significant uterine enlargement can alter vaginal anatomy and drainage, sometimes leading to recurrent urinary tract infections or abnormal vaginal discharge. Symptoms such as burning, urgency, or recurrent cystitis—even when urine tests are clear, can in some cases be linked to fibroids compressing the bladder or altering local anatomy.
What Are Uterine Fibroids?
Uterine fibroids, also called leiomyomas or myomas, are benign tumours arising from the smooth muscle cells of the uterus. They are almost always non‑cancerous and remarkably common: up to 70–80% of women will develop fibroids at some point – fibroids are common. Their location determines everything about the symptoms they cause.
Intramural fibroids grow within the uterine wall – the most common type. Submucosal fibroids bulge into the cavity and are most strongly linked to heavy bleeding and fertility difficulties. Subserosal fibroids grow on the outer wall and tend to cause pressure rather than bleeding symptoms. Pedunculated fibroids attach via a stalk and can cause sudden severe pain if they twist.
Do fibroids always cause symptoms? No. Many are found incidentally and never cause problems. Whether you develop symptoms depends primarily on location, a small submucosal fibroid can cause significant bleeding, while a much larger subserosal fibroid may be entirely silent. The size and number of fibroids and vary and don’t all cause symptoms.
Can Uterine Fibroids Be Prevented?
There is no guaranteed way to prevent fibroids, but certain lifestyle factors appear to influence risk. Maintaining a healthy weight helps keep oestrogen levels in check, as excess adipose tissue is a known source of additional oestrogen.
A diet rich in green vegetables, fruit, and wholegrains, and lower in red and processed meat—has been associated with modestly reduced fibroid risk in research literature.
Given that vitamin D deficiency is common across many population groups in Australia—including women with darker skin, those who work indoors, or those who consistently use high‑SPF sunscreen, checking and maintaining adequate vitamin D levels is a straightforward, low‑risk measure that may carry a modest protective benefit.
None of these measures will eliminate risk entirely, particularly with a strong family history. But they are all worthwhile investments in your broader reproductive and general health.
What Causes Uterine Fibroids?
Oestrogen and progesterone promote fibroid growth, which is why fibroids develop during the reproductive years, may enlarge during pregnancy, and typically shrink after menopause.
Key risk factors include family history, ethnicity (women of African descent develop fibroids more frequently and with more severe symptoms), obesity (which raises oestrogen levels), early menarche, and vitamin D deficiency – particularly relevant in Australia, where deficiency is common despite high sun exposure.
Fibroids can grow within the wall of the uterus in response to hormonal changes. The symptoms and causes of uterine fibroids are closely linked to these hormonal influences. Fibroids may grow during the reproductive years, and fibroids can get quite large in some cases, affecting the shape of the uterus.
How Are Uterine Fibroids Treated and Diagnosed in Australia?
Transvaginal ultrasound is the gold standard first‑line investigation, widely available with Medicare rebates on valid referral. MRI is used for complex cases and surgical planning. Hysteroscopy allows direct visualisation—and often same‑session treatment—of submucosal fibroids.
Not all fibroids need treatment. When treatment is required, options range from the Mirena IUD (reduces bleeding without surgery), GnRH agonists (shrink fibroids before surgery), and tranexamic acid/NSAIDs (cycle‑by‑cycle symptom control), through to myomectomy (surgical removal preserving the uterus—preferred for women wanting fertility), UAE (minimally invasive; generally not recommended if planning pregnancy), HIFU (non‑invasive; available at selected Australian centres), and hysterectomy (definitive cure; only when family is complete and other options have failed).
| Treatment | Preserves Fertility? | Key Consideration |
| Myomectomy | Yes | Fibroids can recur |
| UAE | Generally not recommended | Minimally invasive; fibroids shrink not removed |
| HIFU | Potentially | Non-invasive; not suitable for all types |
| Endometrial ablation | No | Reduces bleeding only |
| Hysterectomy | No | Permanent; family should be complete |
Fibroids can be treated with a range of treatment options for uterine fibroids, from medical management to surgical removal of the fibroids. The best treatment plan depends on your symptoms, fertility goals, and overall health. Uterine fibroid embolization is one option that shrinks fibroids by blocking the uterine artery, but it is not recommended if you plan to get pregnant.
Fibroids During Pregnancy: What to Expect
If you’re already pregnant and have fibroids, or are planning a pregnancy – this section is specifically for you, because it’s an area that no one explains clearly enough.
Most women with fibroids have normal pregnancies. However, there are some specific things to be aware of clinically.
Fibroids can grow during pregnancy. Under the influence of elevated oestrogen and progesterone in the first trimester, some fibroids enlarge, occasionally quite significantly. This growth usually stabilises in the second trimester. The majority of fibroids, however, remain stable or actually shrink as the pregnancy progresses. Fibroids can shrink after menopause in some women.
Fibroid degeneration is common and painful. When a fibroid grows rapidly and outpaces its blood supply, it undergoes a process called red degeneration, where the central tissue breaks down. This most commonly occurs in the second trimester and causes localised, sometimes severe pelvic pain, fever, and nausea. It is one of the most frequent causes of non‑obstetric abdominal pain in pregnancy.
It is managed conservatively with rest and analgesia; it is not dangerous to the pregnancy in most cases, but it is distressing and often leads to hospital admission. Knowing about this possibility beforehand helps women understand what is happening if it occurs.
Location still determines risk during pregnancy. A fibroid in the lower uterine segment can obstruct labour and increase the likelihood of caesarean delivery. Submucosal fibroids carry the highest risk of miscarriage and early pregnancy loss. Subserosal fibroids, by contrast, rarely cause pregnancy complications directly.
Myomectomy during pregnancy is rarely recommended. If a fibroid is identified during pregnancy, surgical removal is almost never the right course of action, the risks to the pregnancy outweigh the benefits in nearly all circumstances.
The exception is the rare pedunculated fibroid with a narrow stalk that twists during pregnancy, causing intractable pain. Management is almost always supportive and expectant.
At Create Health, we counsel all patients with known fibroids before they begin trying to conceive—because understanding your fibroid’s location and size before pregnancy is far better than managing uncertainty during one. If you have fibroids and are planning a pregnancy, we would encourage you to have this conversation with your gynaecologist early.
Fibroids vs Adenomyosis
These two conditions are frequently confused – they share near‑identical symptoms and often coexist. Adenomyosis occurs when endometrial tissue grows into the uterine muscle wall, causing a diffusely enlarged, tender uterus and progressively worsening period pain. Fibroids cause more focal pressure symptoms; the uterus may feel irregular rather than uniformly enlarged.
The critical clinical point: myomectomy treats fibroids but does nothing for adenomyosis. MRI is the most accurate way to distinguish them, and at Create Health, we investigate for both before recommending any treatment, because treating only half the picture is not good enough.
When Should You See a Doctor?
Seek prompt attention if you experience periods so heavy you soak through protection within an hour, severe or worsening pelvic pain, persistent fatigue alongside heavy bleeding, difficulty conceiving, recurrent miscarriage, or unexplained bleeding between periods or after sex.
We also want to acknowledge what rarely appears in medical articles: the emotional toll of living with these symptoms. Years of being told your periods are “just heavy,” of cancelling plans around pain, of feeling exhausted without explanation—these experiences leave a mark. Many women come to us having internalised the idea that they are overreacting, when in fact they have been significantly under‑supported. What you have been experiencing is real, it has a name, and there is help available. You deserve to feel well.
Frequently Asked Questions
Can fibroids shrink on their own?
Some fibroids remain stable or shrink after menopause as oestrogen declines. During reproductive years, resolution without treatment is unreliable. Watchful waiting with monitoring is appropriate in many cases.
Are fibroids the same as endometriosis?
No, distinct conditions, though they can coexist. Endometriosis involves tissue similar to the uterine lining growing outside the uterus. Both can cause pain and affect fertility, but require completely different treatment approaches.
Does Medicare cover fibroid treatment in Australia?
Yes, rebates apply to ultrasounds, specialist consultations, hysteroscopy, myomectomy, and UAE with a valid referral. Our team at Create Health will walk you through costs before you proceed with anything.
How Create Health Can Help
At Create Health, our specialist gynaecology and fertility team takes the time to listen carefully, investigate thoroughly, and build a management plan around your circumstances and goals, whether that’s watchful waiting, medical management, minimally invasive surgery, or fertility‑preserving intervention.
You don’t have to navigate this alone. Contact our team today to arrange a consultation for treatment options for uterine fibroids or to discuss your symptoms of fibroids and fertility plans.
Sources
Mayo Clinic. “Uterine fibroids – Symptoms and causes.” Accessed via Mayo Clinic
Summary: Describes heavy menstrual bleeding, pelvic pressure or pain, frequent urination, abdominal swelling, constipation, back pain, pain during sex, anaemia, and fibroid‑related fertility issues as common symptoms of uterine fibroids.MedlinePlus / U.S. National Library of Medicine
“Uterine Fibroids – Topic Overview” and “Uterine Fibroids – Medical Encyclopedia”
Summary: Lists heavy or prolonged periods, bleeding between periods, pelvic pressure, frequent urination, pain during sex, lower back pain, constipation, and fertility problems as typical symptoms of uterine fibroids.MSD Manuals / Merck Manual
“Uterine Fibroids – Gynecology and Obstetrics”
Summary: Explains symptom patterns based on fibroid location, size, and number, and details how fibroids can cause anaemia, pelvic pain, urinary and bowel symptoms, and complications in pregnancy.Cleveland Clinic. “Uterine Fibroids: Causes, Symptoms & Treatment.”
Summary: Describes heavy or painful periods, bleeding between periods, pelvic fullness or bloating, frequent urination, pain during sex, lower back pain, constipation, abdominal distension, and chronic vaginal discharge as symptoms of uterine fibroids.PMC (NIH‑affiliated review)
“Complications of Uterine Fibroids and Their Management”
Summary: Discusses how fibroids can cause abnormal bleeding, pelvic pain, bladder and bowel compression, and infertility, and reviews how these symptoms and complications are managed.
