The Causes and Symptoms of Fibroids
Dr. Eric DePopas, MD
PainTheory Chief Medical Officer
Vascular & Interventional Radiologist
When it comes to fibroids, accessing factual, clear information is essential. An estimated 26 million Americans have fibroids, and between 70-80% of women will develop them by the time they’re 50. For such a prevalent condition, many women are surprisingly ill-equipped with the correct knowledge to even express concerns about fibroids to their doctors.
We’ve put together this guide to help you understand the causes and symptoms of fibroids, so you can learn more about the condition and recognize potential signs.
Table of Contents
What are fibroids?
Fibroids are growths made up of muscle and fibrous tissue found in or around the uterus. They are sometimes referred to as leiomyomas, myomas, uterine myomas, or fibromas. Despite the worries of some patients, fibroids do not heighten the risk of uterine cancer and are rarely cancerous themselves.
The severity of fibroid symptoms varies per woman. Some fibroids may be more uncomfortable depending on factors like:
- Your age
- Location of your fibroids
- The number and size of your fibroids
The four types of fibroids
Intramural Fibroids
Intramural fibroids develop on the muscle wall of the uterus and are the most common type of fibroid. Particularly large intramural fibroids can stretch the uterus and cause pain. Additionally, intramural fibroids can cause symptoms such as heavy or irregular menstrual bleeding, cramping, and bloating.
Subserosal Fibroids
Subserosal fibroids grow on the outside of the uterus and can sometimes become quite large, causing what is often referred to as a “fibroid belly.”
Submucosal Fibroids
Submucosal fibroids grow near the inner layer of the uterus. Submucosal fibroids can often cause heavy menstrual bleeding.
Pedunculated Fibroids
Pedunculated fibroids can grow on the inside layer or outside layer of the uterus. They are usually connected to the uterus by a thin stalk or stem. Pedunculated fibroids can press on other structures in the belly and cause symptoms such as pain, bloating, urinary urgency, and constipation. If pedunculated fibroids are located on the inside layer of the uterus, they can cause heavy, irregular menstrual bleeding.
Fibroid Symptoms
Fibroid can cause a range of symptoms as they grow, including both “bleeding” and “bulk” symptoms. When fibroids become symptomatic and begin to affect your daily life, it might be time to seek treatment. Symptoms may include include:
- Painful or heavy periods
- Abdominal pain, swelling, or bloating
- A frequent need to urinate
- Pain or discomfort during sex
- Back pain
- Constipation
- Difficulty conceiving
We understand that the list above can be intimidating, but we encourage our patients not to worry because these symptoms are often treatable. There are both prescription and over-the-counter medications that can help provide relief for many of the discomforts caused by fibroids.
Unfortunately, when medications are stopped, fibroid symptoms usually return. Medications lessen the symptoms of fibroids but do not actually treat the underlying fibroid(s). If you’re looking for permanent fibroid treatment, there are minimally invasive procedures, like uterine fibroid embolization, which can alleviate fibroid growth, discomfort, and more serious symptoms. There are also surgical therapies like hysterectomy and myomectomy to treat fibroids.
To find out if you’re a candidate for uterine fibroid embolization, take our fibroid assessment.
What are the signs of fibroids in the uterus?
Symptoms like back pain, constipation, pelvic discomfort, and stomach aches are uncomfortable, but individually they don’t necessarily mean you have fibroids. If, however, you experience these symptoms simultaneously or chronically, we suggest talking to your doctor.
There are other symptoms that are stronger indicators of uterine fibroid development.
If you are experiencing excessively heavy menstrual bleeding we suggest you talk to your physician as this can be a sign of fibroid development or other serious abnormalities of the uterus. Heavy menstrual bleeding can lead to anemia (where you have insufficient red blood cells to carry oxygen to your body’s tissues). Anemia can be treated with iron supplements and dietary changes, but in some cases may require prescription medication. While fibroids themselves are rarely life-threatening, anemia is a serious medical condition. If you’ve noticed increased blood loss during menstruation, consult your doctor.
In other instances, large fibroids can press on the bladder and ureter (which transports urine from the kidney to the bladder). Such pressure can result in the sensation of needing to frequently use the bathroom.
Fibroid symptoms can also lead to a range of negative social implications. For example, many patients report an increase in social anxiety stemming from their fibroids. The feeling of constantly needing to urinate as well as the possibility of bleeding through a tampon are common concerns. If your fibroids ever cause this type of stress, it is highly recommended that you speak to a medical specialist to find relief.
In extreme circumstances, fibroids can also cause difficulties with fertility and increase the chances of miscarriage.
Fibroid risk factors
While anyone with a uterus can develop fibroids, some women are more susceptible to developing them. These risk factors include:
Women of African or Caribbean descent
Studies show that African-American women are 2 to 3 times more likely to develop fibroids than women of other ethnicities.
Obesity
Research shows that women who are obese are more susceptible to fibroids.
High red meat intake
According to Johns Hopkins University, women who consume a high amount of red meat or have high blood pressure are also at a higher risk of developing fibroids.
How do you know if you have fibroids?
Although many women have fibroids, not everyone who has fibroids is symptomatic — which is why fibroids commonly go undetected. Since fibroids do not always present with symptoms, many women find out they have fibroids by chance during routine gynecology check-ups.
However, many patients who seek medical help because of fibroid symptoms are diagnosed by their doctor using one of two techniques:
Ultrasound
Ultrasound technology uses high-frequency sound waves to detect if fibroids are present. In some instances, doctors will use a transvaginal ultrasound to produce clearer images of the uterus.
Pelvic MRI
A Pelvic MRI uses magnets and radio waves to produce images of the ovaries, uterus, and other organs in the pelvic region. MRI is an effective way of discovering fibroids.
What causes fibroids?
Medical professionals are still conducting research on the exact reason why fibroids form, however, they appear to grow in response to the female sex hormones estrogen and progesterone. Women’s estrogen levels are highest between the ages of 16 to 50, which is also the time when fibroids are most likely to develop. During menopause, when estrogen levels are low, fibroids tend to shrink and are unlikely to develop.
PHYSICIAN INSIGHT
Family history is also linked to fibroid development. If your relatives have experienced fibroids, there’s a higher possibility that you will too.
Symptoms like back pain, constipation, pelvic discomfort, and stomach aches are uncomfortable, but individually they don’t necessarily mean you have fibroids. If, however, you experience these symptoms simultaneously or chronically, we suggest talking to your doctor. There are other symptoms that are stronger indicators of uterine fibroid development.
If you are experiencing excessively heavy menstrual bleeding we suggest you talk to your physician as this can be a sign of fibroid development or other serious abnormalities of the uterus. Heavy menstrual bleeding can lead to anemia (where you have insufficient red blood cells to carry oxygen to your body’s tissues). Anemia can be treated with iron supplements and dietary changes, but in some cases may require prescription medication. While fibroids themselves are rarely life-threatening, anemia is a serious medical condition. If you’ve noticed increased blood loss during menstruation, consult your doctor.
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