Surprising Things Women Should Know About Fibroids
Uterine fibroids are an extremely common reproductive condition, but odds are you’ve never heard much about them. Up to 80% of women will develop at least one fibroid by age 50 (and sometimes many more), though they’re most common in women between 30 and 40 years old. Read on to learn more about these smooth muscle growths in the uterus, their symptoms and risk factors, and the different medical options for treatment or removal. We promise you’ll learn something new along the way.
Fibroids Are Not Cancer
“Fibroids are benign, smooth muscle tumors of the uterus, and they can grow in different parts of the uterus,” says Karen Wang, M.D., assistant professor of gynecology and obstetrics at the Johns Hopkins University School of Medicine in Baltimore. Technically, all fibroids are benign, and they can either grow as a single tumor or as many as 30 at once. They also range in size—some can be very small, and some can be as large as a grapefruit.
There’s No Definitive Cause
Experts don’t know the cause of fibroids, but there’s definitely a genetic component. “We do know that mothers and sisters more commonly will have fibroids if one family member already has it,” Dr. Wang says. There are several risk factors for fibroids you should know: Family history, eating habits, older premenopausal age, weight, and ethnicity can all affect your chances of getting fibroids. But none of these have a clear black-and-white connection to fibroid growth—and ultimately, there’s nothing you can do to diminish your risk entirely.
Women May Ignore Symptoms
Generally, most people with fibroids don't notice any symptoms, but some women may experience heavy bleeding or painful periods, bloating in the abdominal area, pain during sex, lower back pain, or problems with infertility. It is also not unheard of to experience bladder dysfunction. “If you have small fibroids and don’t really have symptoms, it’s just something you need to monitor,” says Kathy Huang, M.D., OB/GYN and assistant professor of obstetrics and gynecology at NYU Langone Health in New York City. You don’t need to get treatment unless the fibroid is bothering you.
Symptoms Can Mirror Menstrual Bleeding
Another reason fibroids can go undiagnosed (besides being asymptomatic) is that some women will chalk up their heavy bleeding to a regular menstrual cycle. “A lot of women think their periods are normal, or for them it is their normal because they don’t know any differently,” Dr. Wang says. In general, if you bleed for more than seven days or need to change your tampon or pad after less than two hours, that’s considered heavy bleeding that might be worth a doctor’s visit.
Since there’s no clear cause of fibroids, researchers aren’t totally sure why some racial groups are at higher risk. But the numbers don’t lie—"African American women more commonly will have fibroids compared to white and Asian women,” Dr. Wang explains. Black women develop fibroids more often and at an earlier age then their white counterparts, and they are more likely to report debilitating symptoms. Women of color also experience bias in the healthcare system, making it harder for them to seek treatment and be taken seriously by physicians.
Fibroids Can Affect Fertility
Many women go on to have uneventful pregnancies despite fibroids, while some studies show an increased risk of miscarriage, preterm labor, malpositioned babies, and other complications. Large fibroids can block the fallopian tubes or overcrowd the uterus so that the body cannot successfully carry a pregnancy to term. Luckily, there are things you can do to increase your chances of getting pregnant with fibroids, depending on which treatment you choose (more on that later).
Your Gyno Can Detect Fibroids
If you aren’t having symptoms, you may be diagnosed during your annual visit or during a routine ultrasound in pregnancy. Your practitioner may be able to feel the fibroid with their fingers during an ordinary pelvic exam. If you’re having uncomfortable symptoms and want to get checked for fibroids, your healthcare provider can do imaging tests like an ultrasound or MRI. “If you’re having bleeding, pain, or fertility issues, getting radiologic imaging will be very helpful to understand if there is a problem,” Dr. Huang suggests.
Treatment Options Vary
If you have fibroids and have mild symptoms, your doctor may suggest taking medication like birth control to manage your heavy bleeding. If you have fibroids with moderate or severe symptoms, surgery may be the best way to treat them—and that can range from a minimally invasive radiography procedure to a myomectomy (fibroid removal). “Every patient is different—some patients will have one fibroid, and some patients will have 30 fibroids,” Dr. Wang says. “Those are very different in how you manage them.”
Hysterectomy Is Not the Only Option
“I hear from a lot of women who have only been given the option of a hysterectomy,” Dr. Huang says. “That is not something we want to see—we want to see patients and doctors having a discussion about other options.” Hysterectomy is effective, but it takes fertility off the table. For women who still want to get pregnant, this feels like a really dire option. Dr. Huang encourages patients to ask probing questions before deciding on a treatment. “Don’t shy away from asking questions and being thoughtful,” she suggests.
Fibroid Risk Is Linked to D Deficiency
There’s really not much you can do to prevent fibroids, with one notable exception: Research shows a potential link between vitamin D deficiency and fibroids. “For African American women who are vitamin D deficient, if they have fibroids, then correcting the vitamin D deficiency with a supplement can help slow down recurrence,” Dr. Wang says. This is a topic of continued interest for researchers, with the hope that it may lead to new treatment options down the road.
Fibroids Are Common
It’s easy to feel isolated when you’re struggling with symptoms and not getting the answers you need. But Dr. Huang, who has fibroids herself, encourages women to trust themselves and what their bodies are telling them. “I felt isolated and alone in my journey,” she says. I’m a doctor, and I knew this was not my fault, but somehow I still felt like I was responsible for this condition.” She hopes to help normalize this condition and make women feel empowered to get the answers they need.
- Uterine Fibroids: (1): U.S. Department of Health & Human Services, Office on Women’s Health. (n.d.) “Uterine fibroids.” https://www.womenshealth.gov/a-z-topics/uterine-fibroids
- Uterine Fibroids: (2): American College of Obstetricians and Gynecologists. (n.d.) “Uterine Fibroids.” https://www.acog.org/womens-health/faqs/uterine-fibroids
- Racial Disparities: Journal of Women’s Health. (2013.) “The Burden of Uterine Fibroids for African-American Women: Results of a National Survey.” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3787340/
- Heavy Menstrual Bleeding: Centers for Disease Control and Prevention. (n.d.) “Heavy Menstrual Bleeding.” https://www.cdc.gov/ncbddd/blooddisorders/women/menorrhagia.html
- Fibroids & Vitamin D Deficiency: International Journal of Molecular Sciences. (2018.) “Vitamin D and Uterine Fibroids—Review of the Literature and Novel Concepts.” https://www.nichd.nih.gov/newsroom/releases/030112-vitaminD-fibroids