Uterine fibroids (medically known as leiomyomas) are non-cancerous growths that develop within the muscular walls of the uterus. While the word “growth” can sound intimidating, these are almost always benign; however, they are far from harmless for quality of life.
The impact is not felt equally across all demographics. Research from the Mayo Clinic shows that Black women are disproportionately affected. They are more likely to develop fibroids at a significantly younger age, experience larger and more numerous growths and endure more severe symptoms. Understanding what fibroids are, why they happen and what to do can help women take control of their health.
What are fibroids?
Fibroids can be as small as a seed or as large as a melon. Some people have just one, while others have many. According to the National Library of Medicine, a part of the National Institute of Health (NIH), fibroids are very common during childbearing years. The National Institute of Child Health and Human Development (NICHD) reports that by age 50, up to 70-80% of women will develop them.
Doctors don’t fully understand why fibroids are more common and more severe in Black women. However, studies suggest that genetics, hormones and environmental factors may all play a role.
What’s happening in your body
Although fibroids are benign, their presence can cause significant structural changes in the pelvic cavity. As they expand, they may distort the uterine wall, leading to an enlarged or asymmetrical uterus. Depending on their size and location – whether they are intramural (within the wall), submucosal (under the lining) or subserosal (on the outer surface) – they can exert significant pressure on neighboring organs.
Large fibroids can press against the bladder, causing frequent urination or against the rectum, leading to constipation or pelvic discomfort. They also often interfere with the uterine lining’s ability to shed efficiently, resulting in menorrhagia (excessively heavy or prolonged bleeding) and painful cramping. In some cases, fibroids can block the fallopian tubes or interfere with embryo implantation. They may also increase the risk of certain pregnancy complications, such as placental abruption or preterm labor.
Causes of fibroids
There is no single cause of fibroids. Instead, several factors can increase a woman’s risk of developing them. Estrogen and progesterone, which control the menstrual cycle, can promote fibroids. This is also why they are more prevalent during the reproductive years and may shrink after menopause when hormone levels drop. The Cleveland Clinic explains that fibroids contain more hormone receptors than normal uterine muscle cells, which may explain why they grow.
Family history can also play a major role. If other female relatives have a history, a woman is more likely to be diagnosed. The Office on Women’s Health notes that Black women are two to three times more likely to have fibroids compared to white women. Other factors that might increase the risk include starting a period at a young age, being overweight and eating a diet high in red meat but low in fruits and vegetables.
Health risks and complications
Many fibroids are asymptomatic. However, when they do cause problems, the Centers for Disease Control and Prevention (CDC) lists heavy menstrual bleeding and pelvic pain as common symptoms. Heavy bleeding can lead to anemia, a condition where the body doesn’t have enough healthy red blood cells. Common symptoms include feeling tired, weak or short of breath. The National Heart, Lung, and Blood Institute (NHLBI) explains that heavy menstrual bleeding is a common cause of iron-deficiency anemia.
Fibroids can also affect fertility. The American College of Obstetricians and Gynecologists (ACOG) states that fibroids may sometimes cause trouble getting pregnant or increase the risk of certain complications, depending on their size and location. However, this isn’t the case for everyone as many people with fibroids have healthy pregnancies.
Dr. Diana Rangaves explains, “Damage or blockage in the fallopian tubes, often caused by pelvic inflammatory disease or endometriosis, can prevent the egg from meeting the sperm. Surgery can address issues like blocked fallopian tubes or uterine fibroids that might be hindering fertility. Consult your healthcare provider to discuss the risks and benefits if this is your case.”
What to do about fibroids
Fibroids can often be managed with medication, procedures or surgery. The best option depends on a woman’s symptoms, age and whether they want to have children in the future. Always talk to a qualified healthcare provider to determine the right treatment plan. For women with asymptomatic or minor fibroid symptoms, regular check-ups for monitoring might be all that’s needed. The Mayo Clinic notes that treatment is not always needed if fibroids are not causing problems.
Hormonal birth control, such as pills, patches or IUDs, can help reduce heavy bleeding and pain but may not shrink fibroids. Some people might be prescribed gonadotropin-releasing hormone (GnRH) agonists, a medication that lowers estrogen levels and temporarily shrinks fibroids. GnRH agonists are often used as a pre-surgical treatment to reduce size. They are usually used for short periods because of side effects.
Tranexamic acid is a non-hormonal medicine designed to treat fibroid symptoms. It’s taken during periods to reduce heavy bleeding. Uterine artery embolization (UAE) is a procedure that blocks blood flow to fibroids, causing them to shrink. The NIH NLM describes UAE as a minimally invasive treatment option, offering quicker recovery times than traditional open surgeries.
Other surgical options also exist. This includes a myomectomy, which removes fibroids while keeping the uterus in place. This option is ideal for women who want to have children in the future. Meanwhile, a hysterectomy removes the uterus and is the only permanent cure for fibroids. Hysterectomies are usually reserved as a last resort option when other treatments have failed or when symptoms are severe. After a hysterectomy, pregnancy is no longer possible.
When to see a doctor
Women should see a doctor if they routinely have very heavy periods, bleeding between periods, pelvic pain that doesn’t go away or trouble getting pregnant. Also seek care if there are persistent feelings of being tired or weak from heavy bleeding, as this might signal anemia.
Anyone experiencing a sudden severe pain, fever or very heavy bleeding that soaks through one or more pads or tampons every hour for several hours should seek medical care right away. These could be signs of a serious problem.
Are fibroids cancerous?
Almost all fibroids are benign and do not increase your risk of developing uterine cancer. According to ACOG, fewer than 1 in 1,000 fibroids are cancerous. Since most fibroids don’t turn into cancer, doctors usually take a “watchful waiting” approach if you aren’t experiencing symptoms.
If they do cause discomfort, treatments range from hormonal medications to minimally invasive procedures. The takeaway? A fibroid diagnosis is rarely a cause for panic, but it is a great reason to stay in close communication with your gynecologist to ensure your symptoms (if any) stay manageable.
Can diet affect fibroids?
While diet alone is not a “cure-all” for uterine fibroids, the National Library of Medicine presents growing evidence that what you eat can play a significant role in managing symptoms and potentially slowing their growth. Because fibroids are estrogen-dependent, dietary choices that help balance hormones or reduce inflammation can be incredibly beneficial.
Clinical studies have shown a correlation between high intakes of red meat (such as beef and ham) and an increased risk of developing fibroids. This may be due to the saturated fats or the presence of growth hormones in certain meat products. Conversely, the NIH notes that diets rich in green leafy vegetables and fruits (especially citrus) are associated with a lower risk. These foods are high in fiber, which helps the body process and eliminate excess estrogen.
Bottom line
Fibroids are common and can be frustrating, especially for Black women who are more likely to experience severe symptoms because of developing them at a younger age. The good news is that fibroids are not cancerous and there are many proven treatment options available. Women experiencing fibroid symptoms should talk to a trusted healthcare provider to develop a treatment plan together.
Frequently Asked Questions
How to get rid of a fibroid belly?
A “fibroid belly” happens when large fibroids make the lower abdomen look swollen. The only proven way to reduce this is through medical treatment such as medication, uterine artery embolization, myomectomy or hysterectomy.
How can I shrink my fibroids naturally?
There is no proven natural cure that reliably shrinks fibroids. Some small studies suggest vitamin D may play a role, but more research is needed.
Do fibroids have an odor?
Fibroids themselves do not have an odor. However, if heavy bleeding or infection occurs, there may be a noticeable smell.
Citations
Mayo Clinic Press. Uterine fibroids are more common and severe in Black women — but there are treatment options. Mayo Clinic. https://mcpress.mayoclinic.org/women-health/uterine-fibroids-are-more-common-and-severe-in-black-women-but-there-are-treatment-options/
NLM Staff. Uterine Fibroids. National Library of Medicine: Medline Plus. https://medlineplus.gov/uterinefibroids.html
NICHD Staff. About Uterine Fibroids. National Institute of Child Health & Human Development. November 2018. https://www.nichd.nih.gov/health/topics/uterine/conditioninfo
Cleveland Clinic Staff. Uterine Fibroids: Symptoms & Treatment. Cleveland Clinic. July, 2023. https://my.clevelandclinic.org/health/diseases/9130-uterine-fibroids
Office on Women’s Health Staff. Uterine Fibroids. Office on Women’s Health. https://womenshealth.gov/a-z-topics/uterine-fibroids
CDC Staff. About Heavy Menstrual Bleeding. Centers for Disease Control & Prevention. May 2024. https://www.cdc.gov/female-blood-disorders/about/heavy-menstrual-bleeding.html
NHLBI Staff. Anemia – What Is Anemia? National Heart Lung & Blood Institute. March 2022. https://www.nhlbi.nih.gov/health/anemia
ACOG Staff. Uterine Fibroids. American College of Obstetricians and Gynocologists. https://www.acog.org/womens-health/faqs/uterine-fibroids
Mayo Clinic Staff. Uterine Fibroids. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/diagnosis-treatment/drc-20354294
NIH NLM Staff: Uterine Fibroids: Learn More – What Are the Pros and Cons of Uterine Artery Ambolization? National Institutes of Health: National Library of Medicine. June 2025. https://www.ncbi.nlm.nih.gov/books/NBK279533/
Woźniak S. The Role of Nutrition in Pathogenesis of Uterine Fibroids. Nutrients. December 2023. https://pmc.ncbi.nlm.nih.gov/articles/PMC10708302/
Singh S, Kanwar M, Bakshi G, et al. Navigating the Relationship Between Diet and Uterine Fibroids: A Narrative Review. Cureus. March 2024. https://pmc.ncbi.nlm.nih.gov/articles/PMC10975324/