Uterine Fibroids: Symptoms, Causes, and Treatment Options

Uterine fibroids are common — but that doesn't mean you have to suffer.

You have heavy periods. So heavy that you dread leaving the house for days each month. Your belly feels bloated and full. Maybe you feel pressure in your pelvis, or pain during sex.

And you might be wondering: is this normal? Or is something else going on?

For millions of women, the answer is uterine fibroids. Let's talk about what they are, what they feel like, and what you can do about them.

What Are Uterine Fibroids?

Uterine fibroids (also called leiomyomas) are non-cancerous growths that develop in or on the uterus. They're made of muscle and fibrous tissue, and they can range in size — from as small as a pea to as large as a grapefruit or even bigger.

Here's the surprising part: up to 70-80% of women will develop fibroids by age 50. Most don't even know they have them because they cause no symptoms.

But for those who do have symptoms, fibroids can be a major quality-of-life issue.

Types of Fibroids

Intramural fibroids: The most common type. They grow within the uterine wall and can cause heavy bleeding and pain.

Subserosal fibroids: Grow on the outside of the uterus. They can press on nearby organs, causing bloating and pressure.

Submucosal fibroids: Grow just under the uterine lining. These often cause the heaviest bleeding and fertility issues.

Pedunculated fibroids: Grow on a stalk, inside or outside the uterus.

🌺 Start here: "Womb Health 101: How to Keep Your Uterus Happy and Healthy" — your foundation guide.

Common Symptoms

Not everyone with fibroids has symptoms. But when they do, here's what it can look like:

• Heavy, prolonged periods: Soaking through pads or tampons every hour, passing large clots
• Pelvic pressure or pain: A feeling of fullness or heaviness in the lower belly
• Bloating: Looking several months pregnant even when you're not
• Frequent urination: Fibroids pressing on your bladder
• Constipation or rectal pressure: From fibroids pressing on your bowel
• Pain during sex: Deep pain that makes intimacy uncomfortable
• Lower back pain: That doesn't seem to have another cause
• Infertility or pregnancy complications: Depending on fibroid location

What Causes Fibroids?

Honestly? Doctors don't know exactly what causes them. But research suggests several factors play a role:

• Hormones: Estrogen and progesterone stimulate fibroid growth. They shrink after menopause.
• Genetics: If your mom or sister had them, you're more likely to have them.
• Race: Black women are more likely to develop fibroids, at younger ages, and with more severe symptoms.
• Age: Most common in the 30s and 40s.
• Lifestyle factors: Diet, weight, and vitamin D levels may play a role.

How Are Fibroids Diagnosed?

Pelvic exam: Your doctor may feel an irregularly shaped uterus.

Ultrasound: The most common way to confirm fibroids. Can be done abdominally or transvaginally.

Other imaging: MRI, hysteroscopy, or sonohysterography for more detail.

Treatment Options: From "Watch and Wait" to Surgery

Watchful waiting: If fibroids aren't causing symptoms, many women just monitor them.

Medications:

• Birth control pills or IUDs can help with heavy bleeding
• Tranexamic acid reduces bleeding during periods
• GnRH agonists temporarily shrink fibroids (often before surgery)

Minimally invasive procedures:

• Uterine artery embolization (UAE) — blocks blood flow to fibroids
• Radiofrequency ablation — uses heat to shrink fibroids
• Myomectomy — surgical removal of fibroids while keeping the uterus

Surgery:

• Hysterectomy — removal of the uterus. The only "cure," but major surgery with significant implications

Fibroids and Fertility

Fibroids can affect fertility depending on their size and location. Submucosal fibroids (those inside the uterine cavity) are most likely to cause problems with implantation or pregnancy.

If you're trying to conceive and have fibroids, talk to a reproductive specialist about whether removal might help.

🌺 Related condition: "Endometriosis: What You Need to Know" — another common cause of pelvic pain.

Living with Fibroids

If you have symptomatic fibroids, you know how much they can take over your life. The heavy bleeding, the planning around your period, the pain.

What helps day-to-day:

• Heat packs for pain
• Iron supplements if you're anemic from heavy bleeding
• Period underwear or heavy-duty products for peace of mind
• Tracking symptoms to see patterns
• Advocating for yourself with doctors

The Bottom Line

Uterine fibroids are common — but that doesn't mean you have to suffer in silence. There are options, from watchful waiting to medication to surgery.

The right treatment depends on your symptoms, your age, and whether you want to have children. Talk to a doctor who listens. And if one doesn't listen, find another.

You deserve to feel good in your body.

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🌺 Womb health series:
👉 Womb Health 101
👉 Endometriosis
👉 You are here: Uterine Fibroids
👉 Coming next: PCOS and Your Womb

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🌺 Real talk about fibroids: they're common, but your symptoms matter. And tired moms (and future moms) sound the same in every language.
Have you been diagnosed with fibroids? What helped you? Drop it in the comments.