In fibroid which is not seen :
Ans. is a i.e. Amenorrhea Symptoms of Fibroid Most common symptom - Menstrual disturbancesdeg 1. Most common Menstrual Disturbance - Progressive Menorrhagiadeg (seen in 30% cases ). Causes : a. Increased surface areadeg Increased vascularity of uterusdeg Associated endometrial hyperplasiadeg Hyperestrogenismdeg Congestion of Venous plexusdeg Abnormal uterine contractilitydeg Other Menstrual Symptoms : Metrorrhagiadeg - (Continuous and irregular bleeding)deg Causes : a. Ulceration of submucous fibroid or polyp.deg Sarcomatous change in Leiomyoma.deg Coincidental pregnancy state.deg Coincidental Ca endometrium or Endometrial Polyp.deg 2. Pressure Symptoms 1! Feeling of presence Veins & Lymphatics Alimentary tract Nerves of sacral Bladder of mass plexus or obturator Oedema & varicositydeg Dyspepsiadeg (v rare) Diurnal frequency Rarely Constipation l anterior cervical Pain in pelvic regiondeg fibroiddeg can cause Urinary retention Dysmenorrhea - congestivedeg as well as spasmodicdeg type seen. 3. Infeility : As a sole cause fibroid is responsible for < 3% cases of infeiliy. Causes : a. Fibroid hinders the ascent of the sperm.deg b. Interferes with implantation of feilised ovum.deg c. Can cause associated disturbance in ovulationdeg 4. Pain : A fibroid usually does not cause pain. Causes : * Malignancydeg It is being extruded from body as a polypdeg Associated Endometriosisdeg Torsion of a pedunculated fibroma.deg Degenerationdeg Mnemonic :My PET Dog. Other rare features of Fibroid : 5. Polycythemia - (Interesting as fibroids generally cause Anemia due to blood loss. Polycythemia is seen in Broad ligament fibroids).deg 6. Hypoglycemia and Hypokalemia. A woman with leiomyomas never has amenorrhoea. Every woman suffering from fibroid who has continuous bleeding or irregular bleeding should be subjected to endometrial aspiration before her treatment is planned.
Amenorrhoea
Pelvic mass
Infeility
Menstrual irregularity