Symptoms of Uterine Fibroids

With insights into the effect on Black women

This article is part of Uterine Fibroids and Black Women, a destination in our Health Divide series.

Uterine fibroids are benign, non-cancerous tumors that disproportionately impact Black women.

Black women with fibroids often have periods that last longer than the average three to five days—even longer than seven days. Periods can also be very heavy, requiring changing sanitary protection frequently. This can impact everyday life. 

This article discusses the symptoms of uterine fibroids, with particular attention to the effect on Black women.

doctor patient conversation
The Good Brigade / Getty Images

Black Women and Uterine Fibroids

Black women are three times more likely than women of other races to develop fibroids. They are also more likely to get them earlier in life and develop symptoms.

Frequent Symptoms

The location of a fibroid plays a large role in whether or not you will develop symptoms. Some women may experience one or more symptoms, while others may have no symptoms at all.

Common uterine fibroid symptoms include:

  • Abnormal uterine bleeding in the form of periods that are longer, heavier, or more frequent than usual
  • Significant menstrual pain
  • Bleeding between periods
  • Difficulty getting pregnant
  • Pain during intercourse
  • Pelvic, abdominal, or back pain or pressure 
  • Protruding abdominal or belly area
  • Increased menstrual cramping
  • Frequent urination
  • Urinary retention
  • Pain on urination or dyspareunia
  • Constipation
  • Fatigue from anemia
  • Pregnancy complications, such as needing a cesarean section to deliver a baby

Rare Symptoms

If abnormal uterine bleeding is left untreated, severe anemia may occur. This could require treatment with blood transfusions. 

If fibroids change the shape of the uterine cavity, it may lead to:

Complications

Infertility and Black Women

Although fibroids are the cause of only 1 to 2.4% of infertility cases in the United States, infertility disproportionately impacts Black women as they are more likely to undergo hysterectomies, which eliminates the possibility of getting pregnant.

Black women are more likely to have large fibroids that block the fallopian tubes. Of note, many women don’t discover that they have fibroids until their first ultrasound after becoming pregnant.

Fibroids have also been associated with other pregnancy complications, including:

  • Placental abruption
  • Infants who are smaller than average during pregnancy, also called small-for-gestational-age babies

As previously mentioned, excessive uterine bleeding is one of the most common symptoms of uterine fibroids. If left untreated, you may develop severe anemia, which is treated with IV fluid replenishment and blood transfusions

Effect on Black Women

Black women are three times more likely to develop uterine fibroids at an early age, develop symptoms, and respond differently to standard medical treatment, compared to White women.

symptoms of UF in black women
Julie Bang / Verywell

Even further, Black women often experience:

  • More severe symptoms
  • Larger fibroids
  • Lower declines of tumor growth

The above are compared to White women of similar socioeconomic status. 

Black Women and Hysterectomy

Fibroids are the leading reason for hysterectomies, accounting for nearly 40% of all hysterectomies performed annually in the United States.

Black women are 2.4 times more likely to undergo hysterectomy and are nearly seven more times likely to undergo uterine-sparing myomectomy.

When to See a Healthcare Provider

In general, fibroids only need to be treated if they are causing symptoms, affecting your fertility, or impacting your ability to carry a pregnancy.

If fibroids are found incidentally on ultrasound—as is often the case when a woman is pregnant—expectant management is indicated.

Treatment for uterine fibroids should be based on a person’s:

  • Medical history
  • Surgical history
  • Goals of therapy

You Do Not Need to Live in Pain

If you are experiencing heavy menstrual bleeding, persistent pelvic pain or pressure, or recurrent miscarriage, see a healthcare provider.

Fibroids are rarely life threatening, but they can seriously impact your quality of life. Seeing a fibroid specialist can help you get your life back on track and avoid serious complications, like fertility issues and severe anemia, requiring blood transfusions.

Frequently Asked Questions

What do fibroids feel like? 

Most fibroids go unnoticed, but large fibroids may cause a feeling of heaviness or pressure in the lower abdomen or pelvis. The pelvic discomfort experienced by some women can range from sharp, shooting pain to a vague discomfort in the abdomen or pelvis.

If your fibroids are large, you may even experience difficulty lying down, bending over, or exercising.

Do Black women get fibroids more frequently? 

The reasons why Black women get fibroids more frequently than White women are unclear, but new research offers some clues. Fibroids have been associated with the following risk factors:

  • African ancestry
  • Age (development of fibroids increases with age, but symptoms tend to diminish since tumors regress after menopause)
  • Obesity
  • Family history of uterine fibroids
  • High blood pressure
  • No history of pregnancy
  • Higher stress levels
  • Vitamin D deficiency: Women with more melanated skin tones are more likely to experience Vitamin D deficiency, which some studies have associated with an increased risk of uterine fibroid development. 

Is having heavier periods a sign of uterine fibroids?

Heavier periods can be a sign of uterine fibroids, but not always.

If you experience any abnormal uterine bleeding, you should contact a healthcare provider immediately, as this may be a warning sign of a larger problem.

Immediate management of your heavier periods can also help you to avoid serious complications like severe anemia. 

Are cysts and fibroids the same thing? 

No. Cysts are fluid-filled sacs on the ovaries, whereas fibroids are benign, noncancerous growths on or in the uterus.

Do fibroids cause you to gain weight? 

If fibroids grow large enough, they can lead to weight gain, although most fibroids are small in size and don’t lead to weight gain. Weight gain can also worsen with the number of fibroids.

Fibroids may make you feel bloated. They put pressure on your digestive system and bladder, making it more difficult to pass a bowel movement and completely empty your bladder after urination. This can be extremely difficult for women, especially those who are experiencing changes to their body and weight despite no changes to their diet and exercise plan.

A Word From Verywell

Uterine fibroid symptoms don’t have to control your life. While the challenges may disproportionately affect Black women, more inclusive research, better medical technologies, and more awareness of the nuances that play a role in the development and treatment of fibroids provide us with a hopeful outlook for positive outcomes.

Uterine fibroids are extremely common, but their effect on each woman’s life is unique. The different treatment modalities for uterine fibroids are well documented, but remember to take care of your mental health as well. Suffering from the painful experience of fibroids can detract from your quality of life, underscoring the importance of getting the help you need to re-establish normalcy in your day-to-day life.

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