In fibroid which is not seen :
Amenorrhoea
Pelvic mass
Infeility
Menstrual irregularity
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.