Uterine Fibroid Symptoms: When to See a Doctor

Most people with a uterus develop at least one uterine fibroid. Fibroids are benign (non-cancerous) tumors that grow in and around the walls of the uterus. They vary in size and may grow as one tumor or clusters of multiple tumors.

“Fibroids don’t always cause symptoms, but when they do, it can severely affect your quality of life. Treatment can help in some cases—you don’t need to write off very heavy or painful periods as just a part of life,” says Mobolaji Ajao, MD, MPH, a Mass General Brigham gynecologic surgeon and division chief of AMC Minimally Invasive Gynecologic Surgery.

Below, Dr. Ajao explains common signs of fibroids and how to know when to see a doctor.

Common signs and symptoms of fibroids

Fibroids don’t always cause symptoms, so you may have them without ever knowing. However, the size, location, and number of fibroids may cause:

• Heavy, longer, painful, or more frequent periods
• Bleeding between periods
• Pain during sex
• Feeling “full” in your lower belly
• Abdominal pain or lower back pain
• Anemia (low red blood cell count) from blood loss
• Urinating frequently or having trouble urinating
• Constipation or rectal pain

Fibroids can also attach to your uterus by a stem. If they twist, this can cause pain, nausea, or fever.

Some fibroids symptoms are similar to those of endometriosis, a condition where pelvic tissue grows outside the uterus. Dr. Ajao advises speaking with your primary care provider (PCP) or obstetrician-gynecologist (OB/GYN) if you experience one or more of the symptoms listed above. They help you understand the cause and if treatment is needed.

What does fibroid pain feel like?

Fibroids may cause pain in your abdomen (belly) or lower back. The pain usually feels dull, heavy, and aching, but it can be sharp. You may experience a feeling of pressure on your bladder or pelvis. Fibroids can also cause painful cramps during your period.

“If your period pain is to the point where it impacts your daily life, where you’re missing school or work, it’s time to talk to your PCP or OB/GYN,” Dr. Ajao advises.

Possible complications from fibroids

Dr. Ajao notes that other issues may point to fibroids, even if you don’t experience specific symptoms. For example, a large fibroid may cause swelling in your abdomen that makes it difficult for your provider to do a pelvic exam or pap smear.

Fibroids can affect pregnancy. They may cause infertility, where you have trouble getting pregnant. They may also cause miscarriage or early (premature) childbirth. However, many people with fibroids have successful pregnancies after treatment.

What does a “fibroid belly” look like?

You may have heard the term “fibroid belly,” where fibroids change the appearance of your lower abdomen. This can happen when fibroid growth causes your uterus to become larger. You may feel a firm, rounded bulge below your belly button that doesn’t go away with diet or exercise.

Your doctor may also be able to feel your fibroids during a routine pelvic exam.

Signs of fibroids breaking down

Fibroids can sometimes break down, or “degenerate.” This happens if a fibroid doesn’t get enough blood, so its cells begin to die. This causes pain that can last a few days or weeks. You may experience:

• Sharp pain in the abdomen
• Pelvic pain that may be acute (in one place)
• Heavy bleeding
• Vaginal discharge
• Fever

Call your provider right away if you have severe bleeding that isn’t normal, even during your period.

When to see a doctor for fibroids diagnosis and treatment

Talk to your PCP or OB/GYN if you experience signs and symptoms of fibroids. They may do an imaging test like an ultrasound exam, magnetic resonance imaging (MRI), or computer tomography (CT) scan to confirm if you have fibroids.

Certain people are at higher risk of having fibroids. They can occur at any age but are most common in people 30 to 40 years old. Black people are more likely to have fibroids than white people, and they also tend to grow more quickly and start at a younger age. Having a family history of fibroids also increases your risk.

Can a fibroid be cancerous?

Fibroids are quite common and benign, meaning they’re non-cancerous. However, a rare cancer of the uterus called a sarcoma can appear similar to a fibroid. Unfortunately, current imaging options (ultrasounds, MRI, and CT scans) or blood tests can’t tell the difference between fibroids and this uterine cancer. There’s ongoing research in this field, and reassuringly, over 99.8% of uterine masses are benign fibroids.

When fibroids may need treatment

Fibroids don’t always need treatment, especially if they’re small, don’t cause symptoms, or occur in someone nearing menopause. Your care team may discuss fibroids treatment if you experience:

• Heavy or painful periods that affect your normal life or cause anemia
• Bleeding between periods
• A fibroid that grows rapidly
• Infertility
• Pelvic pain
• Pelvic pressure, fullness, or the need to urinate more frequently

Dr. Ajao encourages patients to speak up and tell their provider about their symptoms. “If it’s affecting your daily life, we want to know about it,” he says. “We’ll discuss if fibroids treatment may be right for you, and decide what the best options are based on your preferences and goals.”