Most women who develop fibroids may not even notice them. Its only when they become symptomatic that they need evaluation with possible treatment. There are however issues that can arise when you have fibroids. These can greatly alter the quality of life. Heavy bleeding: Is the most serious symptoms. Excessive bleeding during and/or between periods can cause anemia. Anemia in turn can cause lack of oxygen delivery to the entire body. This in turn pushes the heart into overdrive which on the long run can weaken the heart and cause palpitations. Significant anemia in this context is also responsible for a constant state of feeling tired, weak and winded. Some patients we see in our practice do require iron infusions and/or blood transfusions. Pelvic pain: Can be cyclical or constant. It is quite debilitating. Bulk symptoms: When fibroids reach a certain size, they will start putting pressure on surrounding organs, notably the bladder where it causes urinary frequency /frequent trips to the bathroom, the intestines where it can cause constipation, the lower back where it can cause back and leg pain. Bulk symptoms may also cause bloating and increased belly size (Abdominal girth). Infertility: When symptoms reach a certain size or number or are in parts of the uterus needed for conception, they may compromise the anatomy of the uterus and thus be responsible for the inability to conceive and the possibility of miscarriage. Note that fibroids do grow at a faster rate during pregnancy which makes for increased risk of complications. Other symptoms: Pain during intercourse can cause relationship issues. All the symptoms above can create a great deal of stress and have a negative impact on quality of life.