For women, the reality of living with uterine fibroids (or knowing a sister, mother or aunt who does) is overwhelmingly common. It often feels like an unwelcome family heirloom, quietly passed down through generations. But is this just a coincidence, or is your family history a powerful predictor of your own fibroid risk? While environmental factors and lifestyle play a role, research confirms there is a strong genetic link to these non-cancerous tumors. If fibroids are a feature of your family tree, it’s time to understand the inheritance factor, take proactive steps and break the cycle of generational pain.
What are fibroids?
Uterine fibroids, also called leiomyomas, are abnormal growths within the uterus. These growths usually appear in the years a woman can get pregnant and give birth, as noted by the Mayo Clinic. It is important to note that fibroids are not cancerous, and there is a zero percent chance of them turning into cancer.
These growths vary in size. From as small as a seed to as large as a melon, they can grow within, outside or inside the wall of the uterus. While the majority of women may experience no symptoms, some may have heavy or painful periods, pelvic pain or frequent urination. The symptoms of these growths usually depend on their size and location.
About 20% to 50% of women have these growths. Mostly, the growths occur in women in their early 30s and late 50s. However, the condition is less common in women who have entered menopause, per Hopkins Medicine.
What’s happening in your body?
Fibroid growth can press on surrounding organs, affect normal hormone levels and alter the shape and function of your uterus. This can make you experience symptoms like painful periods, constipation, an enlarged abdomen and frequent urination. Additionally, these growths can sometimes cause anemia due to blood loss as a result of heavy menstrual bleeding. A study shared in Experimental and Therapeutic Medicine notes that, in rare occurrences, fibroids can lead to serious complications like infertility or problems with pregnancy.
Additionally, Anne Kamwila, Healthcare Policy Analyst for the African Health Economics & Policy Association, explains, “Studies have shown that submucosal fibroids have been linked with advanced risks of miscarriage and lower rates of clinical pregnancy.”
While some of these growths remain small and asymptomatic, others grow large and cause noticeable discomfort. This is due to the influence of hormone levels, primarily estrogen and progesterone.
Causes of fibroids
While the exact cause remains unclear, several factors are known to contribute to their growth. One significant contributor is gene changes; many fibroid growths contain genetic alterations that differ distinctly from those in normal uterine muscle cells. Hormones, specifically estrogen and progesterone, also play a crucial role. These cause the uterus lining to thicken during the menstrual cycle in preparation for pregnancy, and fibroid growths have more cells that these hormones bind to than do normal uterine muscle cells. This hormonal dependence explains why the growths typically decrease in size after menopause when hormone levels drop.
Furthermore, the extracellular matrix (ECM), the material that makes cells bind together, is increased in fibroids, giving them their characteristic fibrous appearance. The ECM also stores growth factors, which lead to biological changes within the fibroid cells, as reported by Human Reproduction Update.
Healthcare professionals believe that uterine growth likely develops from a stem cell within the smooth muscular tissue of the uterus. This single cell divides repeatedly until it forms a solid, rubber-like lump that is distinct from the surrounding tissue. Uterine fibroids can grow in varying ways – some may grow slowly, others rapidly and some remain unchanged. While some growths can become quite significant, others may decrease naturally. Fibroids that appear during pregnancy often shrink or disappear after delivery as the uterus returns to its standard size.
Health risks and complications
Uterine fibroids are generally not dangerous, but they can cause complications including menstrual bleeding leading to anemia, back pain, infertility or pregnancy complications, miscarriages and an enlarged uterus.
Menstrual bleeding can lead to a drop in red blood cells, hence contributing to anemia. The condition can cause fatigue from heavy blood loss. If you experience severe bleeding during your period, your healthcare professional may tell you to take an iron supplement to help manage anemia. In case you have experienced severe anemia, your medical expert may recommend that you undergo a blood transfusion to compensate for the blood lost.
What to do about fibroids
Managing fibroids is highly individualized and depends on several key factors, including the severity of your symptoms, your age and your future fertility goals. For individuals experiencing mild or entirely absent symptoms that do not interfere with their daily life, the best approach may be watchful waiting.
When symptoms like heavy bleeding or pain need to be addressed, medication is a common option. Medicines for fibroids often target the hormones that control the menstrual cycle to help manage specific symptoms such as heavy menstrual bleeding and pelvic pressure. One of the most commonly used medicines is Gonadotropin-releasing hormone (GnRH) agonists. These medicines work by blocking the production of the hormones estrogen and progesterone, effectively putting the body into a temporary menopause-like state. This process stops the menstrual period, causes the fibroids to shrink and often improves anemia, according to the Mayo Clinic.
Beyond medication, there are non-invasive procedures available. One such procedure utilizes an MRI scanner, which helps healthcare professionals obtain a clear image of the uterine fibroids. They can then target the growth by focusing sound waves into the fibroid to heat and destroy small areas of the fibroid tissue, as noted in a PubMed study.
When to see a doctor
While small fibroids can be asymptomatic, you must see a doctor if they start impacting your quality of life. Seek immediate care for heavy, prolonged bleeding (soaking pads/tampons hourly), bleeding between periods or pelvic pain that is sharp and sudden. Don’t wait until you develop anemia (extreme fatigue and weakness) from blood loss. Also, mention pelvic pressure that causes frequent urination or constipation. Advocate for yourself: if your symptoms are disruptive, it’s time to demand testing and explore treatment options.
Who is prone to fibroids?
Studies have shown that the prevalence of uterine fibroids is much higher in Black women compared to white women, with varying differences depending on population and case definition. You are more likely to develop fibroids if you:
- Are between 30 and 50 years old.
- Have a family history of fibroids.
- Have not given birth.
- Started menstruating early.
Can fibroids cause thrush?
Fibroids do not directly cause thrush, which is a fungal infection caused by the abnormal growth of Candida yeast, per the Cleveland Clinic. Thrush primarily affects young children, but it can occur in individuals of all ages.
The causes of thrush include particular medications and some health conditions, such as dry mouth and diabetes. Thrush treatment usually involves antifungal medications. If you have a healthy immune system, your thrush is a minor problem that typically resolves within a few weeks of your initial treatment.
Bottom line
Fibroids are non-cancerous growths that can cause a range of symptoms from mild to severe. While many women live with fibroids without any issues, others may require immediate medical attention. Recognizing symptoms early and seeking medical advice can help you manage fibroids effectively and avoid complications.
Frequently Asked Questions
Do fibroids give you an odor?
Not directly. However, they can cause heavy bleeding, which may lead to hygiene challenges that can contribute to odor.
Can fibroids cause leg swelling?
In rare cases, fibroids can press on the blood vessels in the pelvis, possibly leading to swellings in the leg or pain. This condition is relatively uncommon and typically occurs in association with significantly enlarged fibroids.
Are gynecological problems hereditary?
Yes, many gynecological problems are hereditary. Such conditions include fibroids, endometriosis and ovarian cysts, which can run in families. If your mother or sister had fibroids, you are at a higher risk of having the condition.
Citations
Mayo Clinic. Uterine Fibroids. Mayoclinic.org. Published September 15, 2023. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
John Hopkins Medicine. Uterine Fibroids. John Hopkins Medicine. Published 2019. https://www.hopkinsmedicine.org/health/conditions-and-diseases/uterine-fibroids
Kawano M, Okamoto M, Yano M, Kawano Y. Life-threatening anemia due to uterine fibroids: A case series. Experimental and Therapeutic Medicine. 2022;24(5). doi:https://doi.org/10.3892/etm.2022.11605
Datir SG, Bhake A. Management of Uterine Fibroids and Its Complications During Pregnancy: A Review of Literature. Cureus. 2022;14(11). doi:https://doi.org/10.7759/cureus.31080
Islam MS, Ciavattini A, Petraglia F, Castellucci M, Ciarmela P. Extracellular matrix in uterine leiomyoma pathogenesis: a potential target for future therapeutics. Human Reproduction Update. 2017;24(1):59-85. doi:https://doi.org/10.1093/humupd/dmx032
Mayo Clinic. Uterine fibroids – Diagnosis and treatment – Mayo Clinic. Mayoclinic.org. Published 2019. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294
Amit Kumar Shrivastava, Jindal G, Arun Kalpdev, et al. Role of MRI and FIGO Staging in Evaluation of Fibroids – A Pictorial Review. PubMed. 2023;18(1):121-126. doi:https://doi.org/10.26574/maedica.2023.18.1.121
Katon JG, Plowden TC, Marsh EE. Racial Disparities in Uterine Fibroids and Endometriosis: A Systematic Review and Application of social, structural, and political context. Fertility and Sterility. 2023;119(3). doi:https://doi.org/10.1016/j.fertnstert.2023.01.022
Cleveland Clinic. Thrush. Cleveland Clinic. Published 2018. https://my.clevelandclinic.org/health/diseases/10956-thrush