Uterine fibroids are far more common than many women realize. By age 50, it is estimated that up to 70% to 80% of women will have developed these benign growths within or on the uterus. For some, these fibroids remain small and asymptomatic, discovered only incidentally during a routine pelvic exam or ultrasound. For others, however, they are a source of chronic pain, disruption, and significant health concerns.
Despite their prevalence, many women endure the symptoms of fibroids for years before seeking treatment. It is common to dismiss heavy periods as "just a part of life" or to attribute pelvic pressure to general bloating or aging. But living with pain or discomfort should never be your baseline. Understanding the signals your body is sending is the first step toward reclaiming your health and quality of life.
Uterine fibroids, clinically known as leiomyomas, are noncancerous growths of the uterus that often appear during childbearing years. They develop from the smooth muscular tissue of the uterus (myometrium). A single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue.
Fibroids can range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight.
While the word "tumor" or "growth" can be frightening, it is important to remember that fibroids are almost always benign (noncancerous). They are not associated with an increased risk of uterine cancer and almost never develop into cancer. However, their benign nature does not mean they are harmless; their impact on your daily life can be substantial.
Symptoms can vary greatly depending on the size, location, and number of fibroids you have. Here are the primary warning signs that warrant a conversation with a specialist.
Menorrhagia, the medical term for menstrual periods with abnormally heavy or prolonged bleeding, is the most common symptom associated with fibroids.
If you find yourself soaking through sanitary protection every hour for several consecutive hours, passing blood clots larger than a quarter, or waking up during the night to change protection, your flow is heavier than normal. Prolonged periods that last longer than a week are also a key indicator.
This excessive blood loss is not just an inconvenience; it is a medical concern. Over time, heavy bleeding can lead to anemia, a condition where your body lacks enough healthy red blood cells to carry adequate oxygen to your tissues. This often results in profound fatigue, weakness, and shortness of breath.
As fibroids grow, they take up space. Large fibroids can cause a sensation of heaviness or pressure in the lower abdomen or pelvis. This is often described not as a sharp pain, but as a vague, constant sense of fullness—similar to the feeling of being pregnant.
Sometimes, this pressure can manifest as acute, severe pain. This usually happens when a fibroid outgrows its blood supply and begins to die (degenerate). If you experience sudden, sharp pelvic pain, it requires immediate medical assessment.
Anatomically, the uterus sits directly next to the bladder. When fibroids grow on the front wall of the uterus, they can press against the bladder, reducing its capacity.
You may feel the need to urinate frequently, even if your bladder isn't full. In some cases, the pressure can obstruct the urethra, making it difficult to fully empty your bladder despite the urge to go. This can be frustrating and disruptive, often waking women multiple times during the night.
Just as fibroids on the front of the uterus press on the bladder, fibroids located on the back wall of the uterus can press against the rectum. This pressure can cause difficulty with bowel movements, leading to chronic constipation. In some cases, it can cause discomfort or pain during bowel movements. Because constipation is a common issue with many causes, this symptom is often overlooked as a sign of a gynecological issue.
It might seem unrelated, but spinal and leg pain can stem directly from uterine health. Large fibroids can press against the nerves that extend from the pelvis to the legs and back. This compression can cause radiating pain in the lower back, usually dull and aching, or shooting pains down the back of the legs (sciatica). If you have treated back pain with physical therapy or medication without relief, it may be time to consider a pelvic ultrasound.
Fibroids can make sexual intercourse uncomfortable or painful (dyspareunia). This pain can occur specifically during deep penetration or in certain positions depending on where the fibroids are located within the uterus. We understand this is a sensitive topic, but it is a vital aspect of your overall well-being and relationship health that deserves professional attention.
In some cases, large fibroids can cause the abdomen to swell or look distended. You might feel like you are bloated, or you may even look pregnant. If you have noticed an increase in your waistline that doesn't correlate with weight gain elsewhere on your body, specifically a firm mass in the central lower abdomen, this could be a sign of significant fibroid growth.
Not all fibroids behave the same way. Their classification is based on where they are located in the uterus, which directly influences the symptoms you experience.
For many of our patients hoping to conceive, this is a primary concern. While many women with fibroids have successful pregnancies, certain types—particularly submucosal fibroids—can distort the uterine cavity. This distortion can prevent a fertilized egg from implanting or may increase the risk of miscarriage.
During pregnancy, fibroids can also increase the risk of complications such as placental abruption, fetal growth restriction, and preterm delivery. If you are planning to become pregnant and suspect you have fibroids, a preconception evaluation can help you understand your options and risks.
Uterine fibroids are a medical condition, not a life sentence of discomfort. You do not have to plan your life around your menstrual cycle or live with chronic pelvic pressure.
If you recognize any of these signs or symptoms, we encourage you to schedule a consultation. A simple pelvic exam and ultrasound can often confirm the diagnosis. From there, we can discuss a personalized treatment plan that aligns with your health goals, whether that involves preserving fertility, eliminating symptoms, or simply gaining peace of mind. Your health is a priority, and you deserve care that is as compassionate as it is expert.
