The impact of UF on the patient’s quality of life is commonly underestimated. These symptoms include menstrual abnormalities, feelings of pelvic pain or pressure, urinary difficulties, sexual dysfunction, infertility, and complications of pregnancy. These are summarised below.
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Menorrhagia (excessive bleeding) and metrorrhagia (prolonged bleeding) are commonly reported symptoms of UF among pre-menopausal women. Compared to women without fibroids, women with fibroids are 1.4 times more likely to report excessive bleeding. In a prospective cohort study of 418 women undergoing hysterectomy for non-malignant conditions, 43% reported prolonged bleeding lasting more than eight days per month and 38% reported heavy bleeding lasting more than four days per month.
Pelvic pain or pressure
Pelvic pain or pressure, which can be either cyclic (dysmenorrhoea) or non-cyclic (primarily symptoms associated with pressure from an enlarging uterus), is the second most common symptom of UF patients. Pelvic pain is related to the size and position of the fibroid. Of 146 women with UF undergoing hysterectomy, 45% reported pelvic pain for more than 8 days per month and 74% reported discomfort. Women with UF are 2.6 times more likely to report moderate or severe non-cyclic pelvic pain than women without UF.
UF have been associated with urinary complications (frequency, urgency, difficulty initiating urination, and difficulty voiding). Urinary urgency and frequency were reported by 73% of women being treated for symptomatic fibroids
Non-care-seeking women who had UF diagnosed on ultrasound were found to be 2.8 times more likely to report moderate or severe dyspareunia (recurrent or persistent genital pain associated with sexual intercourse) than women without UF. Studies reporting results from a widely used and validated questionnaire for assessing the quality of life [UFS-QoL] find that the most commonly reported reason for dissatisfaction with sexual function is that many women avoid sexual relations because of menorrhagia related to UF.
Complications of pregnancy/infertility
UF is also associated with infertility and complications of pregnancy.
Reduction in quality of life
As a result of the symptoms associated with UF, women with uterine fibroids experience significantly higher levels of symptom distress and lower health related quality of life [QoL] than women without uterine fibroids. Iin a comparison of quality of life measures between cohorts of women with and without uterine leiomyomas, there was a statistically significant difference in their rating of different quality of life measures in:
- symptom severity;
- energy and mood;
Productivity losses due to UF
Since UF are most common among women during their prime working years, the impact of UF on productivity is large. In the US it has been estimated that 9.9 million employed women suffer from clinically diagnosed uterine fibroids. It has been suggested that 2-4 million work days are lost before surgery and 3-7 million work days after surgery in the USA each year. Work absences are reported by 40% of women with symptomatic UF.