The ecosystem of factors that leads to higher rates of fibroids in Black women isn’t well understood, but the large-scale Black Women’s Health Study conducted by researchers at Boston University did find a causal relationship between racial discrimination and fibroids.
Fibroids come in a spectrum of sizes
They can be as small as a grain of sand, or “they can get extremely large, sometimes bigger than a grapefruit, and cause bleeding and discomfort,” says Dr. Eilber. They can occur in clusters, or solo. The bigger the fibroid and the more fibroids there are, the more likely you are to have symptoms.
The most common symptom of fibroids is bleeding
Fibroids can be completely asymptomatic. “A lot of women have no problems and don’t even know they have a fibroid until it’s incidentally diagnosed in an imaging test like a CT scan for something else, for example,” says Somi Javaid, M.D., a board-certified OBGYN and founder of HerMD, a women’s health practice in Ohio. You may also discover you have asymptomatic fibroids during a routine pelvic exam, fertility workup, or ultrasound.
When fibroids do cause symptoms, they tend to be “loud and obnoxious,” says Dr. Arumala. The most common fibroid symptom is bleeding, either heavy menstrual bleeding, or bleeding between periods, she explains. “If you are changing a pad or tampon every two hours because it’s saturated, that’s heavy bleeding,” she says. Prolonged heavy bleeding can also lead to anemia—which can cause chronic fatigue, weakness, and shortness of breath. “Any prolonged abdominal pain or vaginal bleeding should prompt a woman to talk to her doctor,” says Dr. Eilber.
Other symptoms of uterine fibroids include:
- Heavy periods
- Bleeding between periods
- Pelvic pain
- Abdominal discomfort, pressure, or feeling of fullness
- Lower back pain
- Frequent urination
- Constipation
- Pain during sex
Fibroids can make sex painful
Certain types of fibroid are more likely to cause pain during sex. “Fibroids causing pain with sex will depend on size and location,” says Dr. Eilber. “Large subserosal fibroids may not cause any symptoms while small submucosal ones might.” Large fibroids in particular can cause a “rocking pain” during sex as the weight of the myoma literally causes the uterus to rock.
Fibroids can impact your ability to get pregnant
Even if your fibroids are asymptomatic, they can still cause issues depending on the location of the fibroids. “Fibroids can be a cause of infertility. In the endometrial cavity, a fibroid can impact the implantation of the fertilized egg, or if the fibroid is situated where it’s blocking the fallopian tube, the egg can’t get to the sperm,” explains Jessica Shepherd, M.D., chief medical officer at Verywell Health and a board-certified OB-GYN and fibroid expert.
This does not mean that if you have fibroids you will have fertility challenges. But if you are struggling with fertility, you may discover you have otherwise asymptomatic fibroids that need treatment.
If you are pregnant, fibroids can cause complications
Once you get pregnant, untreated fibroids can cause more issues. “Pregnancy usually causes fibroids to increase in size,” says Dr. Eilber. “There is an increased risk of C-section for women with fibroids, and women with fibroids who do have C-section have a higher risk of bleeding and needing emergent hysterectomy because of uncontrollable bleeding.” Women with fibroids are also more likely to go into preterm labor, adds Dr. Javaid.
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