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 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 #1 and #2), 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: While 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.
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, says Dr. Huynh: “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.