Sponsored by Sumitomo Pharma America Medical Affairs
You've probably had multiple conversations in life where someone casually describes their period as "a nightmare" or "absolutely brutal." And everyone nods along because a heavy flow is all too familiar.
Maybe you've been that person — the one doubling up on pads, switching out your tampon every two hours, canceling plans, or changing clothes in the middle of the day. When every woman you know seems to have a heavy-period horror story, it's easy to assume this is just how it goes.
But what if the bleeding you've been brushing off isn't just a rough period? What if it's actually your body trying to tell you something?
Uterine fibroids could be a potential explanation. Here's what to know.
What are uterine fibroids, and what do they have to do with heavy bleeding?
Heavy menstrual bleeding is one of the most common symptoms of uterine fibroids. Uterine fibroids (aka leiomyomas) are growths of tissue that form in and around the uterus.
Though they're technically tumors (as in, abnormal tissue growth), fibroids aren't cancer. They can range in size from as small as a seed to as big as an orange. Some people may have just one fibroid, while others have several at a time.
Do fibroids always cause heavy bleeding?
Fibroids can grow without any symptoms at all. But for many women, they're anything but silent.
Along with heavy periods and bleeding between cycles, fibroids can cause:
Pelvic pressure
Back pain
Bladder problems like frequent urination
Difficulty getting pregnant
The challenge is that many women don't connect their symptoms to fibroids because they've been taught to treat heavy bleeding as a "normal" inconvenience rather than a medical concern.
How common are uterine fibroids?
If you've never heard of fibroids, or only recently started seeing the term, you might assume they're rare. They're not.
Research published in BJOG in 2017 analyzed data on uterine fibroids from 60 publications. It found that about 70% of women will develop them by the time they reach menopause. That makes fibroids one of the most common conditions affecting the uterus.
Fibroids can occur in anyone of reproductive age, though they most commonly affect women between the ages of 30 and 40. And while they can impact all women, the burden isn't equally shared.
The disproportionate impact on Black women
Black women are more likely to develop uterine fibroids than other populations, and they tend to get them at an earlier age.
Research published in the Journal of Minimally Invasive Gynecology in 2022 analyzed data from 127 women enrolled in the LAP-RFA Pivotal Trial (for laparoscopic radiofrequency ablation uterine fibroid treatment). It found that Black women are up to three times as likely to develop uterine fibroids compared to white women. Black women in the trial were also more likely to experience more severe symptoms that may affect quality of life.
A prospective observational registry study published in Obstetrics & Gynecology in 2020 assessed the self-reported outcomes of nearly 1,000 pre-menopausal women throughout Canada who had uterine fibroids with symptoms. It found that Black women were an average of almost 5 years younger when they first reported symptoms and experienced symptoms for a longer duration than white women.
When heavy bleeding is already normalized, women who face additional barriers to being heard by their providers can go even longer without a diagnosis. Understanding that fibroids affect some communities more than others is an important piece of the bigger picture — and another reason symptom awareness matters so much.
Signs your heavy period might be something more
So how do you know when your period has crossed the line from "heavy" into "something worth investigating"? It's not always obvious, especially when you've been living with your version of normal for years. But there are some signals worth paying attention to:
Soaking through a pad or tampon every hour for several consecutive hours
Periods lasting longer than seven days
Passing blood clots larger than a quarter
Needing to wake up at night to change your pad or tampon
Feeling fatigued, dizzy, or short of breath — possible signs of anemia from chronic blood loss
Pelvic pain or pressure that doesn't go away after your period ends
Frequent urination or difficulty emptying your bladder
Lower back pain that seems to have no clear cause
Any one of these symptoms is worth a conversation with a healthcare provider. More than one? That's your body waving a flag.
Why women wait so long to seek help
On average, women with fibroids experience symptoms for years before receiving a diagnosis. A Mayo Clinic study found that women delayed seeking treatment an average of 3.6 years, with 32% of women waiting more than five years after the onset of symptoms. That delay doesn't happen because women aren't paying attention. It happens because of a deeply embedded cultural script that tells women their pain is just part of having a uterus.
Think about it. From the moment you got your first period, the messaging was pretty consistent: cramps are normal, heavy flow is normal, discomfort is just the price of admission. That conditioning makes it genuinely difficult to recognize when something crosses from "expected" to "problematic." Add in period stigma — the discomfort many people still feel talking openly about menstruation — and it's no surprise that women minimize their symptoms even to their own doctors.
There's also the issue of normalization within families. If your mom had heavy periods and never questioned them, you probably absorbed the idea that this is just how your body works, too. Fibroids do have a genetic component, which means the very women most likely to have them may also be the ones least likely to flag their symptoms as unusual.
Fibroid-related bleeding vs. a normal heavy period
Not every heavy period is caused by fibroids. Hormonal fluctuations, thyroid disorders, polyendocrine metabolic ovarian syndrome (PMOS) — the official new name for polycystic ovary syndrome (PCOS) — and other conditions can all contribute to heavier-than-usual cycles. The difference often comes down to pattern, severity, and whether other symptoms are present.
Fibroid-related bleeding tends to be consistently heavy, cycle after cycle, rather than an occasional rough month. Women with fibroids often describe their bleeding as getting progressively worse over time. The clots tend to be larger, and fatigue is often more intense. Sometimes, bleeding comes with pelvic pressure, bloating that doesn't resolve, or a feeling of fullness in the lower abdomen.
Tracking your cycle can give both you and your provider valuable information. This includes how many pads or tampons you go through, how many days your period lasts, and any symptoms between periods.
The Uterine Health Guide from Sumitomo Pharma offers tools and resources to help you understand your period health and learn when to flag your flow.
What happens if fibroids go undiagnosed?
Fibroids are generally benign, but leaving them undiagnosed and unmanaged can lead to real consequences. Chronic heavy bleeding could result in iron-deficiency anemia, which causes exhaustion, brain fog, dizziness, and shortness of breath. Over time, anemia can affect your heart health if left untreated.
Fibroids can also grow. A fibroid that's currently small and symptom-free might not stay that way.
Depending on their size and location, fibroids can distort the shape of the uterus, press on the bladder or bowels, and create complications during pregnancy. A 2024 meta-analysis of 24 studies involving more than 237,000 participants found that uterine fibroids significantly elevated the risk of miscarriage, preterm birth, and cesarean delivery.
Early detection gives you more options. When fibroids are caught before they become severe, you have a wider range of treatments to explore, from medication to minimally invasive procedures. Waiting until symptoms become unbearable often narrows those options.
How to talk to your provider about fibroid symptoms
Being specific about what you're experiencing gives your healthcare provider something concrete to work with.
A few strategies that can help:
Track your symptoms before your appointment. Note how many days you bleed, how often you change your pad or tampon, the size of blood clots, and any pain or pressure you experience.
Use clear, specific language. For instance, "I soak through a super tampon in less than two hours" or "I've been passing clots the size of a golf ball."
Mention the impact on your life. If you're missing work, avoiding social events, or losing sleep, say so. This helps your provider understand the full picture.
Ask directly about fibroids. If you suspect fibroids, name them. Ask whether an ultrasound or other imaging might be appropriate.
Bring a resource. The Society for Women's Health Research, with support from Sumitomo Pharma America, created a toolkit with guidance to help you prepare for these conversations and understand your options.
Taking the first step toward answers
The hardest part of addressing fibroid symptoms is often just recognizing that what you've been experiencing isn't something you have to put up with. Remember, looking for answers isn't dramatic, no matter how normalized heavy bleeding is. It's necessary.
Maybe you're in the early stages and wondering, Is this normal? Or maybe you've been dealing with symptoms for years and are ready for answers. Understanding what's happening in your body is the first step toward doing something about it, and resources exist to help you navigate the path forward.
Trusted resources to get started:
