Uterine fibroids are common in women today. They’re so common that many women go undiagnosed for years, thinking that heavy, clotted period flow is normal.
By age 50, about 80% of black women and 70% of white women experience uterine fibroids. From unwanted symptoms to long-term side effects to medical disparities, fibroids are a topic of concern among women and health professionals today.
What is a Uterine Fibroid?
Uterine fibroids are benign (noncancerous) tumors that grow in the muscular wall of the uterus. Although there is no known cause, these fibroids are very common in women. There are many clinical, social, and economic impacts of uterine fibroids.
According to Juan Camilo Arjona Ferreira, a gynecologist and the Chief Medical Officer at Myovant Sciences: “All symptoms associated with menstruation tend to be normalized.” Because heavy bleeding and period pain— two major signs of fibroids— are assumed “normal” in much of society, few women realize their symptoms are cause for concern.
Uterine Fibroid Symptoms
The main symptom of fibroids in women is heavy menstrual bleeding, or “menorrhagia”. Heavy bleeding affects up to 54% of menstruating women and can lead to other conditions like anemia, pregnancy complications, and hormone imbalances.
What is considered “heavy” menstrual bleeding? The key indicators are:
Period bleeding that occurs for more than seven days
Regularly needing to change your super pad or tampon every 1-2 hours
Passing large clots in your menses (larger than the size of a nickel or quarter)
Bleeding that negatively impacts your quality of life
Typically, heavy period bleeding means you bleed more than 80 mLs of menses during a cycle. For reference, one regular tampon holds about 4mL.
Other symptoms of uterine fibroids can be:
Menstrual periods lasting more than a week
Pelvic pressure or pain
Lower back pain
Pain during sexual intercourse
Swelling of the lower abdomen
Difficulty emptying the bladder
Backache or leg pains
If the fibroids are large, they can compress the bowel or bladder, causing some women to frequently use the bathroom.
How do Uterine Fibroids Affect Women?
Fibroids can take a toll on a woman’s physical and reproductive wellness. It can also greatly impact her quality of life.
People with fibroids and heavy bleeding are 15 times more likely to be admitted to the ER. They’re also more likely to have anemia, which is an iron deficiency. Many women miss work due to painful periods and uncontrollable bleeding caused by fibroids, leaving them with financial loss.
Uterine fibroids are a leading cause of hysterectomy— many of which could’ve been avoided with better treatment options and patient advocacy. The medical, economic, and psychological cost of diagnosis and treatment for uterine fibroids costs billions of dollars per year on the healthcare system, posing a significant impact on women and society.
Diagnosis and Treatment
How are uterine fibroids diagnosed? Diagnosis is achieved through pelvic exams and uterine imaging. Ultrasound, MRI, and X-ray scans can determine uterine fibroids. More invasive diagnostic methods, like hysteroscopy and laparoscopy, are also helpful in diagnosis.
A hysteroscopy is used to see inside the vagina and cervix using a long scope with a light. This allows doctors to locate intruding fibroids.
A laparoscopy is when a doctor cuts into the abdomen to insert a long scope so they can see inside the uterus, ovaries, and overall womb area. This can reveal fibroids that don’t show up on other tests.
When it comes to uterine fibroids treatment, there are several options:
Hormonal medication (addresses hormonal imbalances and mitigates symptoms)
Myomectomy (surgical removal of uterine fibroids, preserving the uterus)
Uterine artery embolization (a cut-off of blood flow that shrinks fibroids)
RF ablation (heating of fibroids to shrink and soften fibroids)
Hysterectomy (surgical removal of the uterus)
Every type of treatment has its side effects and risks, which should be discussed with your doctors. Not every treatment option is suitable for every patient.
Different women have different preferences about their reproductive wants, needs, and goals. Depending on the severity of fibroids, it’s important to discuss options with a healthcare professional who encourages patient-informed options.
A growing concern in women’s healthcare is the fact that uterine fibroid treatment is the #1 cause of hysterectomy. Know that there may be alternative treatments than hysterectomy if you or a woman you know is diagnosed with fibroids.
Learn more about uterine fibroid treatment from a doctor’s perspective on the Fempower Health podcast episode with Dr. Opoku-Anane.
“We normalize pain and discomfort in women. It has been normalized that women go through pain, perhaps because of childbirth. Some women believe there is normality to this. We go by what our moms and sisters say. I didn’t even know painful periods weren’t normal until residency.” - Dr Jessica Opoku-Anane
What Can Women Do to Confront Uterine Fibroids?
Whether you want to prevent, treat, or recover from the many effects of uterine fibroids, it starts with navigating women’s health. Here are some ideas.
Track your cycle. What’s normal and abnormal for you? It’s important to be aware of your body. Monitor your period, fertility, and sexual health using a period tracking app or calendar with details of what you experience. This information is valuable when you seek treatment.
Do your research. Continually learn about women’s health topics. If you have a concern, be prepared with questions before going to your doctor. Check out this episode on "How to Talk to Your Doctor" to help you approach your doctor with vital information.
Get involved with women’s health advocacy. Join a community that educates and provides resources for women to take charge of their health. Learn about menstrual health equity. Listen and ask questions to various medical experts.
Be aware of medical gaslighting. Healthcare providers want the best for their patients, but sometimes patient experience is dismissed. With a well-informed perspective, you can notice the signs of medical gaslighting and better advocate for yourself (and others).
Stay updated on women’s health. Read books and listen to podcasts that address medical discoveries, research breakthroughs, and revised standards of care.
Share this episode with other women. If you know someone who values reproductive advocacy, women’s health, or informed decision-making, share this with them!