Uterine Fibroids: Experts Share 6 Signs Every Woman Should Know & How To Get A Diagnosis If You’re Dealing With One Or More Of Them
Uterine fibroids are benign tumors that originate in the uterus/womb. They are made up of the same smooth muscle fibers that the uterus wall is made of (myometrium), however they are much rounder than the uterus muscle and they can appear anywhere in the womb.
According to the U.S. Department of Health & Human Services, up to 80 percent of women will develop uterine fibroids by the time they reach age 50. While many women don’t realize they have them, about half will experience significant symptoms, making it crucial to understand these tumors and their telltale signals.
Fibroids get their name from the fact that they tend to be more firm, or fibrous, than the normal muscle of the uterus, says Elizabeth Stewart, MD, director of the division of reproductive endocrinology at the Mayo Clinic.
“Think of every cell as if it’s a brick; there’s something called the extra-cellular matrix that holds those bricks together,” she says.
Fibroids have excessive and varying amounts of extra-cellular matrix, says Dr. Stewart, which helps explain why they range in size—from a growth the size of a pea to as big as a basketball—and grow at different rates.
It’s also important to know that these are non-cancerous uterine growths and almost always benign. Dr. Stewart added:
“A fibroid diagnosis can feel scary because you may hear the terms ‘tumor’ and ‘neoplasm,’ which most of us associate with cancer. But ‘neoplasm’ just means new growth, and a tumor can be either malignant or benign.”
Scientists are still trying to understand what causes fibroids to develop in the first place, but there are a few known risk factors, including race (nearly 25 percent of Black women between 18 and 30 have fibroids versus 6 percent of white women), heredity (your risk is greater if your mom or sister has fibroids), and menstruating at an early age (estrogen and progesterone, the hormones that stimulate growth of the uterine lining during your cycle, appear to promote the growth of fibroids).
Below are six signs linked to fibroids, and how to get a diagnosis if you’re dealing with one or more of them.
1. Your period is heavy and/or long.
One of the most common indicators of uterine fibroids are heavy periods or a prolonged cycle, says Dr. Stewart (read: you need to change your pad or tampon after less than two hours, you pass clots the size of a quarter or larger, and/or you have more than seven days of bleeding).
That’s because fibroids can increase blood flow to the uterus and even the size of the uterus itself, resulting in more menstrual flow and the formation of blood clots, says Dr. Stewart.
The catch: Many women don’t realize that heavy periods and bleeding for a week or longer is something they should flag. She says:
“If you talk to your mom, sister, or best friend to get a sense of what their periods are like, you might think your abnormal symptoms are normal because those women may also have fibroids.”
In fact, misconceptions about what constitutes a “normal” menstrual cycle explains why many women delay treatment for uterine fibroids, according to research published in the International Journal of Gynecology & Obstetrics.
2. You’re tired all the time, short of breath, dizzy, and/or dealing with insomnia.
These are all signs you might have anemia, a condition where you don’t have enough red blood cells to carry oxygen from your lungs to the rest of your body. If you’re experiencing heavy, prolonged periods—or bleeding between cycles—you may be losing so much blood that your body has to dip into its iron stores to make more blood, causing an iron shortage (a.k.a. anemia) as a result.
“When I see a patient who is severely anemic, it’s often a clue that she may have uterine fibroids,” says Dr. Stewart. “If you have heavy menstrual bleeding, ask your doctor for a complete blood count to check for anemia.”
3. You’re constipated or feel like you have to urinate all the time.
Depending on the size and shape of a uterine fibroid and where it’s growing, there’s a chance it will push up against your bladder or bowels and cause bathroom problems, says Dr. Stewart.
Some women report feeling constipated, or experience straining or difficulty having bowel movements. Others say they have to urinate frequently. The expert says:
“The trouble with these symptoms is that constipation and frequent urination are pretty common in general. So, I’ll see a woman with significant fibroids resting on her bladder that are contributing to urinary frequency, but she thinks she has to urinate all the time because she drinks a lot of water.”
4. Sex is painful.
While there can be a number of reasons for pain during intercourse, discomfort during deep penetration is one sign of uterine fibroids, says Dr. Stewart.
“Just like fibroids can press on your bowel or bladder and cause problems, they can also push on the vagina, which can cause pain during sex,” she says.
5. You feel “full” or pressure in your lower belly.
Depending on the size of a fibroid and where it’s growing, women can experience any number of pain sensations—from occasional pressure and cramping to a near-constant feeling of discomfort.
While you might assume that the more pain you’re in, the bigger your fibroids (and the more of them you have), Dr. Stewart says that’s not always the case.
“Fibroids the size of a penny can cause significant pain or other symptoms,” she says. “They can also grow and regress in a short period of time, meaning your symptoms may come and go.”
6. You’re having trouble getting—or staying—pregnant.
While fibroids don’t generally interfere with fertility and pregnancy, they can cause reproductive complications for some women, says Dr. Stewart.
For example, submucosal fibroids—which grow on the inside of the uterine lining—may cause infertility or miscarriage if they interfere with an embryo’s ability to implant in the uterine lining wall.
In late pregnancy, fibroids can cause preterm labor and placenta previa, a condition where the baby’s placenta partially or totally covers the mother’s cervix and triggers bleeding.
What You Can Do
If you have one or more of the above symptoms, it’s a good idea to schedule an appointment with your doctor or OB-GYN, says Dr. Stewart. For many women, fibroids can be found during an abdominal or pelvic exam.
“If fibroids are on the outside of the uterus, your doctor may feel a lumpy, bumpy, enlarged uterus,” says Dr. Stewart. Fibroids growing inside the uterus are harder to detect, and require an ultrasound or MRI for a definitive diagnosis.
If you do have uterine fibroids, there are a number of treatment options available, says Dr. Stewart. If your symptoms are mild, the best course of action may be to do nothing. In many cases, fibroids shrink after menopause, when reproductive hormone levels drop.
Your doctor may also prescribe a medication to help regulate your cycle and treat symptoms like heavy bleeding and pelvic pain. And while a hysterectomy (removal of the uterus) used to be the go-to procedure for many women with painful fibroids, there are a number of less invasive treatments that doctors now try first, says Dr. Stewart, including high-intensity ultrasound therapy, laparoscopic removal of the fibroids, and others. Work with your physician to find the best solution for you.