Uterine fibroids are benign growths made of smooth muscle cells and fibrous connective tissue that vary in location and size. As women age, the incidence of fibroids increases, typically starting in their 30s or 40s. While fibroid growth usually does not pose a significant threat to a woman’s health, it can sometimes have a serious impact on fertility.

The exact cause of uterine fibroids remains unknown, but they generally appear after a woman begins ovulating and shrink after menopause. Therefore, doctors believe that sex hormones—particularly estrogen and progesterone—play a role in their growth.

Some women may have fibroids without feeling any symptoms or may only experience mild discomfort. However, others may experience more noticeable symptoms. The main symptoms include:

  • Heavy and prolonged menstrual bleeding: Heavy and prolonged periods may indicate uterine fibroids, especially submucosal fibroids, which can increase the surface area of the uterine lining, leading to more bleeding. Another reason for heavy bleeding is that fibroids can cause hormonal imbalances, weakening the uterine muscles and leading to more bleeding.
  • Abnormal bleeding between periods: In addition to heavy and prolonged periods, fibroids can cause abnormal bleeding at any time during the menstrual cycle.
  • Pelvic and lower back pain: If fibroids grow large, they can cause abdominal bloating and pelvic pain. In severe cases, larger fibroids can exert pressure on the lower back and bladder, leading to back pain and frequent urination.
  • Pain during intercourse: Discomfort or pain during intercourse can also be a symptom of uterine fibroids.

Depending on the size and location of uterine fibroids, they can affect fertility to varying degrees. After fertilization, the embryo implants, develops, and grows in the uterus until birth. If fibroids are present, the embryo may attempt to implant on top of a fibroid, or the fibroid may alter the normal shape of the uterus, making implantation difficult. This can result in difficulties in becoming pregnant. However, if the fibroids do not affect the uterine lining, they may not have a significant impact on fertility.