What Every Woman Should Know About Fibroids

Black Maternal Health Week, now in its 10th year, is a national call to action to address the disparities that put Black mothers at greater risk. This year, Dr. Elissa Trieu, a gynecologist at GBMC HealthCare, is drawing attention to one of the most common and overlooked conditions affecting women's reproductive health: uterine fibroids. 

Fibroids are benign, non-cancerous growths of the uterus, but their impact is anything but minor. 

"Even though they're not cancer, they're a huge public health crisis," Dr. Trieu said, noting that the U.S. spends more than $40 billion annually on fibroid treatment. Symptoms can range from heavy menstrual bleeding and pelvic pressure to serious pregnancy complications, including infertility and postpartum hemorrhage. 

While fibroids are found in roughly 80% of women by age 50, Black women are disproportionately affected. 

"We see them three times more frequently," Dr. Trieu said. "And not only are they more common, but they get bigger, they grow at younger ages, and they're more symptomatic." 

She attributes this to a combination of factors, including molecular and biological differences as well as inequities in healthcare access rooted in structural racism, implicit bias, and a longstanding distrust of the medical system. 

Knowing when to seek care is critical. Dr. Trieu offers what she calls "the rule of too much" as a guide: too much bleeding, too heavy, with too much pressure. Practically speaking, that means changing a pad more than once an hour, passing clots larger than a quarter, periods lasting more than seven days, or feeling persistent bloating or pressure. 

"By the time you're planning your life around a period," she said, "you really should be going to see a GYN." 

For women who do seek care, Dr. Trieu emphasizes that options are broader than many realize. Treatments range from hormonal and non-hormonal medications to surgical approaches, including robotic myomectomies, which are minimally invasive procedures using small incisions. 

GBMC also offers a newer technology, which uses radiofrequency ablation to treat fibroids from the inside out. For those seeking a permanent solution, minimally invasive hysterectomies are also available. 

Dr. Trieu is particularly vocal about advocating for yourself if your concerns aren't being heard. 

"If you ever find that your doctor is telling you that this is normal, or that you only have one treatment option, then I think it's time to go talk to somebody else," she said. 

Her advice: come prepared with data. Track your cycle, document how often you're changing pads, note how many days of work you've missed. 

"These are things that are hard to argue with," she said, "and it sort of helps your provider find treatment options for you." 

For more information or to connect with GBMC's team, visit gbmc.org/migs.