4 Signs You May Have Uterine Fibroids: A Gynecologist Explains

As a practicing gynecologist in New York City, I have seen tens of thousands of patients with a condition called uterine fibroids, or noncancerous tumors of the uterus. These women come to me because fibroids affect fertility and cause heavy and unpredictable bleeding and pain. Here are the answers to some common questions about fibroids, four signs you may have them, and exactly how to handle it.

The downside? This can cause significant uterine pain. Fibroids can also block natural delivery, and women with fibroids have a much higher chance of needing a cesarean section. Large fibroids can take up the baby's growing space and cause abnormalities of growth in the fetus. Finally, if the fetus' placenta has formed over a fibroid, it can increase the risk of it coming detached prematurely before delivery. This is called an abruption and requires an emergency cesarean section.

Fibroids are not more common in women with endometriosis. Women with endometriosis often have a similar condition called adenomyosis, which is essentially endometriosis within the uterine wall. This condition can cause similar symptoms as fibroids: increased bleeding and pain. Since it also increases the size of the uterus, it is often mistakenly diagnosed as fibroids.

Here are some telltale signs and symptoms that fibroids could be affecting you and your health:

A common symptom of fibroids is heavier periods—even if only occasionally—as fibroids can be near the uterine lining and interfere with the blood flow. Heavier bleeding will result in the need to change a pad or tampon more often and even lead to bleeding through or around them. There will be more clotting of blood, which looks like globs of brown/purple tissue often compared to liver. Fibroids can also cause bleeding between regular periods and make the periods longer as well. Heavier periods can cause a drop in the level of blood in your body, which in turn can make you feel tired and have less energy.

Occasionally, fibroid tumors can degenerate—which means they grow faster than the body can supply blood to them and parts of the fibroids begin to die—and cause pain. This pain is usually felt right along the midline above your pubic bone, the bone between your vagina and your abdomen, and it’s not necessarily associated with your period or ovulation. While small parts of the insides of the fibroids can die, the fibroids actually will continue to get larger as the outer layers continue to grow and cause further problems.

Fibroids that sit on your bladder can cause the need to urinate more frequently. You might also experience a persistent feeling of fullness in the area above your pubic bone, but this differs from the occasional bloating as it is typically constant. In women with very large fibroids, the fullness can actually lead to constipation as well.

Most people who have fibroids have several, and often more than a dozen. Whether there is one large fibroid or 20, they can feel like a firm mass right above your pubic bone. Anytime a woman feels something that she does not believe should be there, she should be examined by a doctor as soon as possible. In this area, the most common cause of a mass is fibroids, which, although they can cause all of these problems, are seldom cancer and can almost always be removed. So don't panic, but do see a doctor to be sure of the diagnosis and learn about possible treatments.

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