For people with uteruses, sudden cramping, sharp abdominal pains, heavy bleeding, and urgent bathroom trips can be a mystery game: Are my stomach woes from that shrimp salad at lunch or is my period on the way? Are the pangs in my bladder a sign of a urinary tract infection (UTI), a yeast infection, or something else entirely? A lot of these symptoms are common among many gastrointestinal and pelvic-area conditions, which makes determining their causes a little challenging.
If you’re experiencing heavy, longer-than-usual periods on top of abdominal discomfort, consider looking into uterine fibroids. According to the Mayo Clinic, the condition occurs when noncancerous growths form in a person’s uterus, leading to symptoms like heavy, prolonged menstruation, abdominal pain, pressure in your bladder or rectum, and a frequent urge to use the bathroom (for both number one and number two), to name a few.
You could experience only one of these issues, some of them, or none—roughly half of all people with uterine fibroids don’t have symptoms at all.1 You’ll also likely have uterine fibroids at some point if you don’t already have them now, as most people with uteruses will experience fibroids before they reach menopause.1 (Remember: Though uterine fibroids are technically tumors, they almost always aren’t cancerous.)
Since asymptomatic fibroids can become symptomatic at any point, it’s important to know what to watch for. Here are six signs you might have uterine fibroids.
1. Your periods are particularly heavy or erratic.
Heavy menstrual bleeding can happen for a lot of reasons—say, you’re on a new birth control pill or you know certain days of your cycle tend to come with a stronger flow. But if your period lasts longer than seven days, you need to change your tampon, pad, or menstrual cup every two hours or more, or your periods are just super uncomfortable, uterine fibroids could be at play.
“Fibroids are one of the most common causes of abnormal bleeding [from the uterus] that we see in gynecology,” Sara Kim, MD, ob-gyn and clinical assistant professor at Stony Brook Medicine, tells SELF.2 Fibroids can generate period-like symptoms outside of your cycle, Dr. Kim explains, like bleeding and cramping even when you’re not menstruating. “Someone may have a period and then, a week later, have days of bleeding again due to the fibroid,” she says.
Specific changes to your cycle can vary depending on the number of fibroids, where they are in your uterus, as well as their size, Terry Huynh, MD, a gynecologic surgeon at Yale medicine and assistant professor of obstetrics, gynecology, and reproductive sciences at Yale school of medicine, tells SELF. For example, larger (and more plentiful) fibroids typically mean heavier periods. For the most part, the larger the fibroids are (and the more you have of them), the higher likelihood you’ll have heavy bleeding or other uncomfortable symptoms.
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How much a fibroid, or fibroids, causes you to bleed is also often tied to its type. For example, fibroids that bulge into the uterine cavity—called submucosal fibroids—are often associated with the most significant bleeding changes, regardless of the fibroid’s size. “It can be a small fibroid, but if it’s in the [uterine] cavity, you may notice symptoms earlier than if the same size fibroid were not in the [uterine] cavity,” Dr. Huynh says. The other two types are subserosal (which protrudes on the outside, or surface, of the uterus) and intramural (these grow within the muscle layer). If intramural and subserosal fibroids are large enough, both can lead to heavy bleeding and infertility.
2. You feel cramping and experience bloating when you’re not on your period.
Uterine fibroids can push against surrounding organs, leading to bloating and cramping, Dr. Huynh says: “Usually, the pain, cramping, and discomfort is located in the lower abdomen [or] pelvis because of the location of the fibroids,” she explains, noting that it’s similar to what you might feel on your period—even though you’re not. The discomfort can range in severity and sensation. Large uterine fibroids, for example, can cause a person to experience “bulk” symptoms—meaning, the fibroid’s sheer size takes up space in the uterus, leading to a bloated or “full” feeling, Dr. Huynh says. That bloated feeling can cause some bathroom issues, too; John Hopkins Medicine says that bulking is sometimes associated with increased urination and constipation.
Other times, the pain is less “all over,” and is more isolated (and maybe harsher). One rare example of this are pedunculated fibroids, which attach to the uterus with a long, stem-like growth, causing sudden, strong abdominal pain that goes in and out—similar to really bad period cramps. In other rare cases, a fibroid may grow faster than its blood supply, which can also cause similarly intense sensations.
3. Bathroom trips are a burden.
Dr. Huynh says that when a uterine fibroid puts pressure on the bladder or bowel, it might feel harder—or even painful—to poop or pee. “The sheer force of the fibroids pushing and compressing against the rectum [causes people to] push against that force to have a bowel movement,” she adds. Similarly, if the fibroid is pushing against the bladder, the organ doesn’t have as much space as it would if the fibroid wasn’t there. You may feel like you have to pee more frequently or are unable to empty your bladder completely.
4. Sex is painful.
In a study of 21,746 people diagnosed with uterine fibroids,3 nearly one quarter of participants reported that they often experienced pain and pressure during sex. Dr. Huynh explains that this can happen when a uterus that is enlarged by uterine fibroids shifts, moves, and presses on different areas during the act. You might feel mild discomfort or sharp pain, Dr. Kim says: “Depending on [the fibroid’s] location, just the act of intercourse can be uncomfortable, or [pain] only occurs [during] deep penetration.”
5. You feel pressure or pain in your lower back.
An enlarged uterus from uterine fibroids may press against surrounding nerves, organs, muscles, and the spine, which can lead to lower back pain. This might feel like a dull ache, cramp, sharp sting, or pain that might travel down the leg. Lower back pain is most common when the fibroid is located toward the back of the uterus, Dr. Kim says.
6. You have trouble getting pregnant.
Many people with uterine fibroids, whether or not they’re symptomatic, can get pregnant, but the condition can sometimes contribute to infertility in 2 to 3% of cases.4 This usually happens for one of two reasons, Dr. Kim explains: Either the fibroid is so large that a fertilized egg is unable to implant on the wall of the uterus or the fibroid blocks the fallopian tubes.
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If you’ve been trying to get pregnant for a year or longer or are over 35 and have been trying for at least six months, your medical team can do an exam to see if fibroids may be involved, the Mayo Clinic notes. People who visit health care providers with fertility complaints are usually scanned via ultrasound or other imaging to assess for fibroids or other masses, Dr. Kim notes.
When to see a doctor about possible uterine fibroid symptoms
Though any of the symptoms noted above would warrant a call to your ob-gyn, one of the most telling uterine fibroid signs is often heavy, abnormal periods. So if your cycle feels off, no matter the reason, it’s best to schedule an appointment. And if you don’t have an annual ob-gyn appointment on the books, it’s time to set one up. According to Cleveland Clinic, many uterine fibroids are discovered during routine pelvic exams.
Landing on a diagnosis—and eventual treatment—could take time. Don’t be afraid to speak up: If an ob-gyn (or anyone on your care team) isn’t taking your pain or symptoms seriously, keep pressing for answers. “When someone comes in for bleeding, I often ask about other symptoms,” Dr. Kim says. “If someone has heavy menstrual bleeding, constant back pain, [and] constipation, I may have a suspicion for a large uterine fibroid.”
If a doctor thinks you might have uterine fibroids, they’ll typically perform a pelvic ultrasound, MRI, or other type of test. Though there are solid treatments available (including various hormonal medications, noninvasive and minimally invasive procedures, and surgeries for some severe cases), depending on your symptoms and how many uterine fibroids you have, they’re not always necessary if you’re not in pain, Dr. Huynh says.
Whether your abdominal cramps and heavy periods are related to uterine fibroids or something else, one thing’s certain: You don’t have to carry on with frustrating symptoms without help. Once you have the answers, you can get on track to feeling better.
Sources:
- Journal of Women’s Health, Burden, Prevalence, and Treatment of Uterine Fibroids: A Survey of U.S. Women
- Frontiers in Reproductive Health, Uterine Fibroids (Leiomyomata) and Heavy Menstrual Bleeding
- BMC Women’s Health, Prevalence, Symptoms, and Management of Uterine Fibroids: An International Internet-Based Survey of 21,746 Women
- Diagnostics Multidisciplinary Digital Publishing Institute, Uterine Fibroids and Infertility
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