Abstract
Purpose How many women assume that they have fibroids but are found not to have fibroids
on ultrasound examination? How severe are the physical symptoms reported by these
women compared to the symptoms reported by women with actual uterine fibroids? Are
the symptoms more severe if the patient believes that she has at least one relatively
large (dominant) fibroid or more than 3 fibroids?
Material and Methods A total of 1548 patients completed an anonymous questionnaire in which they were
asked about the number of their fibroids, dysmenorrhea and premenstrual symptoms,
dyspareunia and bleeding disorders (using a numerical analog scale between 0 – 10).
The questionnaire was administered in a hospital-based fibroid clinic. The information
provided by the patients was then compared with transvaginal or abdominal ultrasound
findings. The symptoms reported by women with and without fibroid(s) were compared.
Results 1045 out of 1548 patients fulfilled the studyʼs inclusion criteria. Contrary to the
information they provided, no fibroid(s) were detected in 6% (62 of 1045 patients)
of patients on ultrasound examination. Of these women, 87% had dysmenorrhea, 79% had
premenstrual pain and 57% reported dyspareunia. The severity of the symptoms was found
not to be associated with the assumed size or number of fibroid(s). There was no significant
difference in the pain reported by women without and by women with fibroids. Reporting
a feeling of strong pressure on the bladder (OR: 1.18) or abdomen (OR: 1.12) or constipation
(OR: 1.16) increased the likelihood of detecting a fibroid on ultrasound investigation.
Conclusions The presence of manifest symptoms (dysmenorrhea, dyspareunia, premenstrual pain,
bleeding disorders) does not allow conclusions to be made about the number or size
of fibroids or about which therapy is indicated. Even an erroneous assumption about
the presence of fibroids may result in patients experiencing symptoms.
Key words
fibroids - sonography - dysmenorrhea - dyspareunia - premenstrual pain
