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1. Bleeding
most common symptom and usually presents as menorrhagia
tumors are thought to exert pressure and impinge on the uterine
venous system, which causes venous dilatation within the myometrium
and endometrium
When engorged venules are disrupted at the time of menstrual
sloughing, bleeding from these markedly dilated venules overwhelms
the usual hemostatic mechanisms
2. Pelvic Discomfort and Dysmenorrhea
sufficiently enlarged uterus can cause pressure sensation, urinary
frequency, incontinence, or constipation.
Rarely, leiomyomas extend laterally to compress the ureter and lead to
obstruction and hydronephrosis.
3. Acute Pelvic Pain
a less frequent complaint but is most often seen with a degenerating
or prolapsing leiomyoma
leiomyomas may degenerate, and such tissue necrosis can be
associated with acute pain, fever, and leukocytosis.
4. Infertility And Pregnancy Wastage
effects include occlusion of tubal ostia and disruption of the normal
uterine contractions that propel sperm or ova.
Distortion of the endometrial cavity may also diminish implantation
and sperm transport. Importantly, leiomyomas are associated with
endometrial inflammation and vascular changes that may disrupt