Can you have uterine fibroids without any symptoms?

You’d be surprised how many of my patients didn’t realize they have uterine fibroids. The thing is, about half of people with fibroids don’t experience any symptoms, and many never need treatment.

Some people with uterine fibroids do experience symptoms on occasion, including heavy periods, pain or discomfort during sex, and feeling like they need to pee all the time. For some people, the symptoms are totally manageable with over-the-counter treatments like pain medication or switching to a different kind of birth control.

Regular checkups can help spot lots of different conditions early — including uterine fibroids. Spotting an issue early can mean it’s easier to treat, so it’s smart to pay attention to your body’s signals and keep track of any symptoms.

Uterine fibroids – what are they?

The words “uterine fibroids” might sound scary, but it’s actually a common condition that only causes symptoms about half of the time. When my patients come in for their regular OB-GYN appointment, I’ll check to see if their uterus is enlarged, which could indicate fibroids.

Uterine fibroids are super common! More than 70 percent of women develop them by the time they’re 45, says research published in the International Journal of Gynecology & Obstetrics in 2020. We don’t know exactly why fibroids grow, but hormones like estrogen and progesterone as well as growth hormones and prolactin could be to blame.

Fibroids can’t be prevented, but about half don’t cause any symptoms, and most don’t need treatment.

So what can you do? My best advice is to learn more about what uterine fibroids are and get regular checkups to keep an eye out for changes or issues.

What makes fibroids more likely to grow?

There are a few different factors that can increase your risk of developing fibroids. If you fall into one of these groups, just make sure you get regular checkups and become familiar with the signs of fibroids so you can talk about them with your health care provider.

Race and genes

Black and Hispanic women are statistically more likely to develop uterine fibroids than white women. In fact, a 2006 study published in the medical journal Fertility and Sterility found that black women are almost 10 times more likely to develop fibroids than white women.

A study from 2020 in the Journal of Obstetrics and Gynecology Canada found that East Asian women are more likely to have larger, longer-lasting fibroids than white women, but they report their symptoms as less severe.

There also seems to be a genetic component. If someone in your family has had fibroids, you’re more likely to get them too.

Age

As we get older, our risk of developing fibroids increases (it’s highest just as we reach menopause and then declines). In fact, women in their 40s and 50s are 10 times more likely to have uterine fibroids than those who are in their early 30s and younger.

Periods and pregnancies

The age you were when you got your first period is also a factor. A 2013 study in the American Journal of Epidemiology found that people who started getting periods before they were 11 were more likely to develop multiple fibroids.

Another interesting tidbit: the more times you’ve been pregnant, the less likely you are to develop fibroids. Also, according to research published in Fertility and Sterility \n 2010, about 79 percent of the uterine fibroids that are found in the first-trimester shrink in size during the postpartum period, and about a third go away entirely.

How can I decrease my risk?

Although fibroids can’t be prevented, there are some things you can do to help decrease your risk.

• Maintain a healthy weight – Obesity can increase the risk of developing fibroids by two to three times.
• Choose alcohol-free drinks — Alcohol (especially beer!) can interfere with the chemicals in your body that affects fibroid development.
• Switch to decaf – Caffeine can stress out your liver and make it harder to balance estrogen levels. Try swapping your coffee for decaf or herbal tea.
• Eat a healthy, balanced diet – Cut back on red meat, heap your plate with lots of fruit and veggies, and add in plenty of dairy and vitamin D.

Finally, if you do have fibroids, it’s important to keep an eye on them. While lots of people with fibroids don’t have any symptoms and never require treatment, as fibroids grow, they can cause pain and bleeding.

How do health care providers diagnose uterine fibroids?

A lot of uterine fibroids are first discovered during a pelvic exam. I might notice that my patient’s uterus seems enlarged or feels rough. Next, I’ll order an ultrasound to get a closer look and a blood test to check for anemia (heavy periods can mean your body loses blood cells and more iron than normal).

Sometimes, I might use other imaging tests to confirm uterine fibroids. If my patient is over 35 and hasn’t been able to get pregnant after a year of trying, I might use X-ray imaging or something called hysterosalpingography (a special kind of X-ray for your uterus) to see if the uterine tubes are clear or if something (fibroids) might be blocking them.

If you have a fibroid and have been having heavy periods, your health care provider might suggest a procedure called hysteroscopy. This is when they insert a tiny camera into the uterus to see the uterine walls and remove any fibroid nodes they can find inside the uterine cavity.

If there are lots of fibroids or we aren’t exactly sure what’s causing your symptoms, we might recommend magnetic resonance imaging (aka an MRI).

What if I have uterine fibroids?

First, you’re not alone! More than 70 percent of women will develop fibroids at some point in their life, a study published in the International Journal of Gynecology & Obstetrics in 2020 found. Fibroids are very common and usually benign (meaning that they won’t become cancerous). Especially if they’re small and you catch them early, you might not even notice they’re there.

If you need treatment, there are lots of options, including medication, noninvasive procedures, and surgery. Your health care provider will go over all the risks, benefits, and what it might mean for your chances of getting pregnant in the future.

Here are some questions to ask your health care provider:

• How many fibroids do I have? How big are they? Where are they?
• Will I need more tests?
• Can I treat my fibroids with medication?
• Is there medication I can take for my symptoms?
• Are there any side effects?
• Is surgery an option for me?
•  If I choose surgery, how long will it take me to recover?
• Will I still be able to get pregnant?
• Will it be easier to get pregnant after I treat my fibroids?

 

If you’re not experiencing any symptoms and your health care provider says you have fibroids, there’s usually nothing to worry about or do. Most likely, they will recommend coming in for regular checkups to see if the fibroids are growing or spreading.

Signs that your fibroids might be causing you trouble include heavier periods than usual, painful sex, feeling like you need to pee all the time, and pressure in your belly or back. If you do develop symptoms, remember that there are lots of treatment options to remove the fibroids and/or manage your symptoms. You can work with your health care provider to find the right one for you.