Fibroids can be found in 70% of all women (and nearly 85% of black women), and roughly one in four women will experience clinical symptoms as a result of uterine fibroids, says Elizabeth Stewart, MD, a professor of obstetrics and gynecology at Mayo Clinic in Rochester, Minnesota.
What are fibroids, exactly?
“They’re benign growths in the uterine wall composed of smooth muscle and fibrous tissue,” explains Dr. Stewart, who has researched fibroids extensively. Note again the word “benign.” While many of us associate any kind of internal growth with the C-word, fibroids are almost never cancerous. “That’s very rare—only one out of about 350 cases,” says Linda Bradley, MD, director of the Center for Menstrual Disorders, Fibroids & Hysteroscopic Services at Cleveland Clinic.
What are the symptoms of fibroids?
While fibroids are usually not cancerous, they can cause a range of symptoms that tend to appear during a women’s late 20s, 30s, or 40s. (Progesterone and estrogen promote the growth of fibroids, and so symptoms tend to resolve once a woman reaches menopause.)
Your period is super-heavy
The most common symptom of fibroids is heavy menstrual bleeding, Dr. Bradley says. “There could be bleeding where women are saturating through pads, or require double or triple protection,” she says. “Menstrual bleeding could also be prolonged or all the time.” She says this heavier-than-normal bleeding could result from “changes to the uterus’s architecture” caused by the fibroids, which in some cases can grow to the size of a grapefruit. But size isn’t as big of a factor as placement, Dr. Stewart says. Fibroids that push into the uterus’s “endometrial cavity” are most likely to cause bleeding, she says.
Your cycle is all over the map
Apart from heavy bleeds, any changes to a woman’s menstrual bleeding—spotting, erratic periods, etc.—could be the result of fibroids, Dr. Bradley says. “It’s not just heavy bleeding, but anything irregular or different from what a woman is used to,” she adds. Again, she says fibroid-related changes to the structure of the uterus could explain this bleeding.
You feel uncomfortable pressure down there
Pain, pressure, and discomfort are all common fibroid symptoms, Dr. Bradley says. “This pain could be during intercourse or her period,” she says. Depending on the size and position of the growth, some women may have trouble lying on their stomach or in certain positions. They may even look mildly pregnant, she says. Some women also experience an uncomfortable sensation of pressure—either all the time, or when sitting or lying in certain positions.
Your knees and back are killing you
Depending on their size and placement, it’s possible for fibroids to pinch or press on nerves running to a woman’s lower body or spine, Dr. Bradley says. In these cases, women may feel pain or discomfort in her legs or back.
You’re having trouble getting pregnant
In some cases, fibroids can interfere with a woman’s ability to conceive or maintain pregnancy, Dr. Stewart says. This is certainly not always the case. But if a woman has repeated miscarriages, fibroids may be a possible cause, she says. Fibroids can also increase a woman’s risk for premature labor and pain during pregnancy, she says.
Bathroom difficulties
Just as they can put pressure on nerves, fibroids can press against the bladder or urinary tract, Dr. Bradley says. “This can cause straining or difficult [bowel] movements,” she says. Some women may have to go to the bathroom more frequently, or they may not be able to go easily, she adds. Constipation is also a symptom.
What fibroid treatment options are available?
All symptoms of fibroids can be categorized as minimal, mild, moderate, and severe, Dr. Bradley says. Depending on a woman’s age, her symptom severity, and her plans for reproduction, treatments can vary widely. “In the past, the common treatment was hysterectomy,” she says. While that procedure is still performed in some cases, “it’s important to balance quality of life with fertility plans,” she adds. Both she and Dr. Stewart say medications—including some administered via IUD—as well as a range of invasive and non-invasive surgical options are possible for women whose quality of life is affected by fibroid-related symptoms. “I often say fibroids are like snowflakes or thumbprints in that each one is unique,” Dr. Bradley says. “Because the size and placement and number can be different, each patient needs different treatment.” Talk to your doctor, and there’s a good chance he or she can relieve your fibroid-related symptoms.
