Fibroids are a health concern affecting millions of women around the world, yet they remain widely misunderstood. These (largely) benign uterine growths can vary greatly in size, location, and impact on quality of life. For some women, fibroids are asymptomatic and may go unnoticed; for others, they can lead to significant discomfort and health challenges. Here, we’ll break down what fibroids are, who is most likely to develop them, and how they are detected and managed. Whether you're learning about fibroids for yourself or to support a loved one, understanding these common growths is an important first step.
What are fibroids?
Fibroids are non-cancerous uterine muscle tumors. They’re found outside, inside, and within the walls of the uterus.
You can have one fibroid or many. They can grow fast or slow. Some are the size of a pea, while others are closer to a grapefruit. They can also grow to fill the abdomen.1
Who gets fibroids?
They’re typically found in your 30s or 40s, but they’re found earlier among Black women, who are most likely to get them. This racial disparity could be explained in part by genetics. 2
How common is it?
Roughly 26 million Americans have fibroids—and 15 million have symptoms that are severe enough to interfere with their daily lives. 3
What causes fibroids?
We don’t know for sure. Instead, we can look at the risk factors:
- A family history of fibroids
- Starting your period early
- Being Black
- Obesity
- A lack of Vitamin D
None of these things mean you will get fibroids. They just mean you’re at a greater risk.
What are the symptoms?
It’s common to not have any symptoms. When symptoms do show up, they can include:
- Heavy bleeding
- Painful periods
- Fullness in your stomach
- Needing to pee a lot
- Pain during sex
- Lower back pain
- Constipation
- Rectal pain
- Stomach cramps
How are they found?
Fibroids are often found during routine pelvic exams. Doctors evaluate the size of the fibroids and might make comparisons to the size your uterus would be when pregnant.
For example: “Your fibroids have made your uterus the size it would be if you were two months pregnant.”
Fibroids can be confirmed and examined through ultrasounds and MRIs.
How are fibroids treated?
There are lots of different options for managing fibroid symptoms—from acupuncture to over-the-counter nonsteroidal anti-inflammatory drugs, like ibuprofen. There are several different surgical options, too.
If your symptoms are bothering you, your doctor might prescribe you one of these:
- Gonadotropin-releasing hormone (GnRH) agonists: These stop your period and put you in what’s sometimes called “temporary menopause” in order to shrink your fibroids.
- A progestin-only IUD: It can help decrease heavy bleeding from fibroids but doesn’t shrink your fibroids.
- Tranexamic acid: This is only taken on heavy bleeding days and can help minimize blood loss.
- Hormonal birth control pills: These can help control your bleeding.
Your doctor might also suggest an over-the-counter nonsteroidal anti-inflammatory drug (NSAID) to help with the pain or an iron supplement to handle anemia.4
What can I do at home?
If your symptoms don’t disrupt your day-to-day life, your doctor might suggest just keeping an eye on your fibroids at regular checkups. In the meantime, you can:
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Regularly exercise and maintain a healthy weight to help regulate your hormones.
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Manage any stress caused by your fibroid symptoms through acupuncture, meditation, and time with friends.
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Eat a diet that is low in processed foods and environmental hormones.
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Minimize alcohol, which impacts your hormones.
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Take supplements like chaste tree berry, Vitamin D, and fish oil. Keep in mind: most supplements have not been heavily researched and are not approved by the FDA. 5
What are my surgical options?
It depends on whether you want to get pregnant in the future. If you do, your doctor might suggest:
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Myomectomy: This surgery removes fibroids, either through the vagina or an incision in your abdomen.
- Radio frequency ablation: MRI or ultrasound is used to look at your fibroids and they’re destroyed with radiofrequency or ultrasound waves.
If you don’t ever want to be pregnant, you might be a candidate for:
- Hysterectomy: This major surgery removes the uterus and is the only way to cure uterine fibroids. It’s most often used for folks with large fibroids and heavy bleeding who haven’t had success with other treatments.
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Uterine fibroid embolization: The blood supply to the fibroid is blocked, which makes it shrink.
6
How do I talk about it?
A few things you might say to your doctor:
“I’m nervous that you’re going to find some fibroids during my pelvic exam. Can you narrate everything you’re doing as you’re doing it, just to ease my nerves?”
“I've had heavy periods for years and I'm noticing more fullness in my stomach. Can you do a pelvic exam to check for fibroids?"
“I know you said you didn’t feel any fibroids during my pelvic exam, but I’m wondering if we can do an imaging test to make sure.”
“As a Black woman with a family history of fibroids, I know I’m at an increased risk. Do I need to have more regular pelvic exams?”
Takeaways
Let’s look back at a few key takeaways.
- Fibroids are non-cancerous uterine muscle tumors found outside, inside, and within the walls of the uterus.
- Some are the size of a pea, while others are more like a grapefruit.
- They’re typically found in your 30s or 40s.
- Fibroids are most common among Black women, who get them at younger ages.
- Fibroids are typically found during routine pelvic exams.
- There are lots of different ways to manage fibroid symptoms—from acupuncture to drugs like ibuprofen. Surgery is another option.
Learning about fibroids and how they can affect you is a powerful step toward taking control of your health. Whether you’re dealing with symptoms or just want to stay informed, remember that you're not alone. And if you're struggling with any symptoms, see a doctor.
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This article is for informational purposes only. It is not, nor is it intended to be, a substitute for professional medical advice, diagnosis, or treatment and we recommend that you always consult with your healthcare provider. To the extent that this article features the advice of physicians or medical practitioners, the views expressed are the views of the cited expert and do not necessarily represent the views of Perelel.
References:
- Uterine Fibroids. (n.d.). ACOG.
- Younghans, J. (2020, August 12). Understanding Racial Disparities for Women with Uterine Fibroids. University of Michigan.
- Uterine fibroids | Office on Women’s Health. (n.d.-b).
- Uterine Fibroids: Diagnosis and Treatment. Mayo Clinic.
- Szydłowska I, Nawrocka-Rutkowska J, Brodowska A, Marciniak A, Starczewski A, Szczuko M. (2022, Feb 9.) Dietary Natural Compounds and Vitamins as Potential Cofactors in Uterine Fibroids Growth and Development. Nutrients.
- Uterine Fibroids: What Treatments Are Available. Yale Medicine.
