Uterine Fibroids: What Every Woman Needs to Know

Asele Team
4 days ago
5 min read

If you've been told you have fibroids, or you're dealing with heavy, painful periods and wondering what's going on, this post is for you.

Uterine fibroids are one of the most common health conditions women face, yet many women know very little about them. Let's change that.

What Are Fibroids?

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

The key thing to know: fibroids are almost never cancerous. Less than 1 in 1,000 fibroids turn out to be cancerous.

How Common Are They?

Very common. Studies estimate that fibroids affect more than 70% of women by the time they reach 50. Many women have them without even knowing it, because fibroids don't always cause symptoms.

Why Black Women Are Disproportionately Affected

Research consistently shows that Black women — including women of African descent in Nigeria, Kenya, South Africa, the UK, and the US — are:

2 to 3 times more likely to develop fibroids compared to white women
More likely to develop them at a younger age
More likely to have larger and more numerous fibroids
More likely to experience severe symptoms like heavy bleeding and anemia (a shortage of healthy red blood cells)

The reasons aren't fully understood, but factors like genetics, vitamin D deficiency, and higher rates of certain risk factors may play a role. Importantly, fibroids in Black women remain seriously under-researched.

What Are the Symptoms?

Not all fibroids cause problems. But when they do, symptoms can include:

Heavy menstrual bleeding — Soaking through pads or tampons quickly, passing large blood clots, or periods lasting more than 7 days. (See our post on heavy periods.)
Pelvic pain or pressure — A feeling of fullness or heaviness in your lower belly
Frequent urination — If a fibroid presses on your bladder
Constipation — If a fibroid presses on your rectum
Lower back pain
Pain during sex
Difficulty getting pregnant — Fibroids can sometimes block the fallopian tubes or affect how an embryo implants. (Learn more about fertility and fibroids.)
Enlarged abdomen — Large fibroids can make your belly grow, sometimes causing people to ask if you're pregnant

What Causes Fibroids?

The exact cause isn't known, but several factors increase your risk:

Hormones — Estrogen and progesterone (the hormones that regulate your menstrual cycle) appear to promote fibroid growth. This is why fibroids tend to shrink after menopause (when these hormone levels drop).
Family history — If your mother or sister has fibroids, you're more likely to develop them too.
Race — As mentioned above, Black women are at significantly higher risk.
Age — Fibroids are most common in women in their 30s and 40s.
Vitamin D deficiency — Some research suggests a link between low vitamin D levels and fibroid development.
Diet — Diets high in red meat and low in fruits, vegetables, and dairy may increase risk.
Obesity — Women who are overweight have a higher risk of fibroids.

How Are Fibroids Diagnosed?

Fibroids are often discovered during a routine pelvic exam. Your doctor might feel irregularities in the shape of your uterus. To confirm, they may order:

Ultrasound — The most common imaging test for fibroids
MRI (Magnetic Resonance Imaging) — Provides more detailed images, especially useful before planning treatment
Hysteroscopy — A thin, lighted scope is inserted through the vagina to look inside the uterus

Treatment Options

Treatment depends on your symptoms, the size and location of your fibroids, your age, and whether you want to have children in the future.

Watchful Waiting

If your fibroids aren't causing symptoms, your doctor may suggest monitoring them with regular check-ups and ultrasounds. Many fibroids stay the same size or even shrink on their own, especially after menopause.

Medications

Hormonal birth control — Pills, IUDs (like the Mirena), or injections can help control heavy bleeding. (See our contraception guide.)
GnRH agonists — These medications temporarily shrink fibroids by lowering estrogen levels. They're often used before surgery to make fibroids smaller.
Tranexamic acid — A non-hormonal medication that helps reduce heavy menstrual bleeding.
Iron supplements — To treat anemia caused by heavy bleeding.

Minimally Invasive Procedures

Uterine Fibroid Embolization (UFE) — A procedure where tiny particles are injected into the blood vessels feeding the fibroid, cutting off its blood supply and causing it to shrink. No major surgery required.
Radiofrequency ablation — Uses heat to destroy fibroid tissue.
MRI-guided focused ultrasound — Uses sound waves to heat and destroy the fibroid.

Surgical Options

Myomectomy — Surgical removal of fibroids while keeping the uterus intact. This is often preferred by women who want to have children in the future.
Hysterectomy — Removal of the uterus entirely. This is the only treatment that guarantees fibroids won't come back. It's a major decision and should be a last resort.

Living with Fibroids: Practical Tips

Track your symptoms — Keep a record of your periods, pain levels, and any other symptoms. This helps your doctor make better treatment decisions.
Eat well — A diet rich in fruits, vegetables, and whole grains may help. Some research suggests that green tea extract and vitamin D may have benefits, though more studies are needed.
Stay active — Regular exercise can help manage weight and may reduce fibroid risk.
Get your vitamin D checked — Especially if you have darker skin, as melanin reduces your body's ability to produce vitamin D from sunlight.
Don't suffer in silence — Heavy periods and pelvic pain are not "normal." If your symptoms affect your quality of life, seek medical help.

Fibroids and PCOS: Is There a Link?

Research suggests that women with PCOS may have a higher risk of developing fibroids. A landmark study found that among Black women, the incidence of fibroids was 65% higher in those with

PCOS compared to those without. The hormonal imbalances in PCOS — particularly the disruption of estrogen and progesterone — may encourage fibroid growth. If you have PCOS, it's worth discussing fibroid screening with your doctor. (Read our full guide to PCOS.)

The Bottom Line

Fibroids are common, they're not cancer, and there are many treatment options available. You don't have to live with debilitating symptoms. Talk to your doctor about what's right for you, and know that you have choices.

References

PMC. "Comprehensive Review of Uterine Fibroids: Developmental Origin, Pathogenesis, and Treatment." pmc.ncbi.nlm.nih.gov
PMC. "The Health Disparities of Uterine Fibroids for African American Women." pmc.ncbi.nlm.nih.gov
PMC. "Uterine Fibroids — Causes, Impact, Treatment, and Lens to the African Perspective." pmc.ncbi.nlm.nih.gov
Office on Women's Health. "Uterine Fibroids." womenshealth.gov
Cleveland Clinic. "Uterine Fibroids." clevelandclinic.org