In addition to heavy vaginal bleeding and pelvic pain, as the fibroid uterus enlarges it creates mass effect upon adjacent structures and causes a variety of bulk-type symptoms:
• Fibroids extending from the front of the uterus can compress the bladder and cause urinary frequency. Less commonly stress incontinence (leakage of urine when laughing or exercising) or bladder outlet obstruction occurs.
• Fibroids extending from the back of the uterus can compress the colon and cause constipation or bloating.
• Nerves that exit the lower spinal canal can be compressed causing low back and leg pain (sciatica).
• When the uterus enlarges enough it can push outward on the abdominal wall, causing abdominal distortion and in some cases give the appearance of being pregnant.
• Fibroids that compress and distort the vagina can cause pain during sexual intercourse (dyspareunia).