Fibroids begin as single or multiple seedlings in the myometrium and grow gradually over a long period. They may cause pressure in the pelvis resulting in pain, urinary frequency, urgency and constipation. The intramural fibroids may also interfere with uterine contraction resulting in abnormal bleeding during menstruation. This could be menorrhagia, hypermenorrhoea and metrorrhagia. This may also lead to anaemia and an inability to to conceive. Pain may be due to torsion in pedunculated fibroids, or degeneration thereof. In fibroids located in the uterine cavity, the risk of infertility, placenta abruptio and premature labour are high.