Uterine Fibroids in Black Women: Symptoms, Treatment & Fertility
Updated: Sep 20
Uterine fibroids are one of the most common conditions affecting the uterus, and they are particularly common among Black women. Some women have fibroids without experiencing any symptoms, while others experience heavy periods, pelvic pressure, pain, or fertility concerns.
At Harlem GYN, we believe women deserve clear, evidence-based information about fibroids—including what they are, how they are diagnosed, how they can be treated, and what they may mean for fertility.
What Are Uterine Fibroids?
Uterine fibroids are noncancerous growths that develop from the muscle tissue of the uterus. They can vary greatly in size, number, and location.
Some fibroids are very small and cause no symptoms. Others can become large enough to cause noticeable changes in menstrual bleeding, pelvic pressure, abdominal enlargement, or discomfort.
The exact cause of fibroids is not fully understood. Hormonal and genetic factors are believed to play important roles.
Why Are Fibroids More Common in Black Women?
Fibroids affect women of all backgrounds, but studies have consistently found a higher prevalence among Black women.
Research suggests that Black women may also develop fibroids at younger ages and may experience more symptomatic or severe disease. Genetics, hormonal factors, and other biological and environmental factors may contribute to these differences.
Because fibroids are so common, understanding the symptoms—and knowing when to seek medical evaluation—is especially important.
What Are the Symptoms of Fibroids?
Many women with fibroids have no symptoms at all.
When symptoms occur, they may include:
Heavy or prolonged menstrual bleeding
Painful periods
Pelvic pressure or fullness
Lower abdominal discomfort
Frequent urination or pressure on the bladder
Constipation or pressure on the bowel
Pain during sex
Abdominal enlargement
Difficulty becoming pregnant in some cases
The location and size of a fibroid can influence the symptoms it causes.
Heavy menstrual bleeding should not simply be accepted as “normal.” If your periods have become significantly heavier, longer, or more painful, it is worth discussing those changes with a gynecologist.
How Are Fibroids Diagnosed?
A gynecologist may suspect fibroids based on your symptoms and pelvic examination. An ultrasound is commonly used to identify fibroids and evaluate their size and location.
Depending on your symptoms and medical history, additional testing may sometimes be recommended.
Getting an accurate diagnosis is important because heavy bleeding, pelvic pain, and changes in your menstrual cycle can have many different causes.
Can Fibroids Go Away on Their Own?
Fibroids do not always require treatment.
Some fibroids remain stable, while others may grow or shrink over time. Fibroids can also change after menopause as hormone levels decline.
The right approach depends on factors such as:
Your symptoms
The size and location of the fibroids
Whether they are growing
Your age and overall health
Whether you want to become pregnant
Your personal treatment preferences
The important point is that not every woman with fibroids needs surgery.
Can Diet or Supplements Shrink Fibroids?
There is a great deal of information online about diets, supplements, and natural remedies for fibroids.
While maintaining a healthy lifestyle is important for your overall health, there is not a proven diet or supplement that reliably eliminates uterine fibroids.
If you have been diagnosed with fibroids, talk with your gynecologist before relying on an online treatment or supplement—particularly if your symptoms are significant or you are trying to become pregnant.
How Are Fibroids Treated?
Treatment depends on the individual.
If fibroids are small and are not causing symptoms, your doctor may recommend monitoring them rather than treating them immediately.
When treatment is necessary, options may include medication, procedures that reduce the blood supply to fibroids, or surgery.
Surgical treatment can include procedures such as a myomectomy, which removes fibroids while preserving the uterus, or a hysterectomy, which removes the uterus.
The best treatment depends on your symptoms, the characteristics of your fibroids, your reproductive plans, and your overall health.
Can Fibroids Affect Fertility?
Having fibroids does not automatically mean that you will have difficulty becoming pregnant.
Many women with fibroids become pregnant without treatment.
However, certain fibroids may affect fertility depending on their size and location—particularly fibroids that distort the inside of the uterine cavity.
If you are having difficulty conceiving and have been diagnosed with fibroids, your gynecologist can evaluate whether the fibroids may be contributing to the problem and determine whether additional fertility evaluation is appropriate.
Can You Get Pregnant With Fibroids?
Yes. Many women with fibroids have healthy pregnancies.
However, fibroids can sometimes be associated with pregnancy complications, depending on their size, number, and location.
If you know you have fibroids and are planning a pregnancy, discussing them with your gynecologist before conception can help you understand your individual situation.
What Happens if You Have Fibroids During Pregnancy?
Most fibroids do not require treatment during pregnancy.
Your doctor may monitor them during prenatal care, particularly if they are large or located in a position that could affect the pregnancy.
Treatment decisions during pregnancy are different from treatment decisions outside of pregnancy, so women who are pregnant or planning to become pregnant should discuss their individual circumstances with their physician.
When Should You See a Gynecologist?
Consider scheduling an evaluation if you are experiencing:
Periods that have suddenly become much heavier
Bleeding that lasts longer than usual
Significant pelvic or abdominal pressure
Persistent pelvic pain
Pain during sex
Unexplained abdominal enlargement
Difficulty becoming pregnant
Symptoms that are interfering with your daily life
You do not have to wait until your symptoms become severe before seeking care.
Frequently Asked Questions About Fibroids
Are fibroids cancerous?
Most uterine fibroids are benign, meaning they are not cancerous.
Are fibroids more common in Black women?
Yes. Research has consistently found a higher prevalence of uterine fibroids among Black women compared with women of other racial and ethnic groups.
Can fibroids cause heavy periods?
Yes. Heavy or prolonged menstrual bleeding is one of the most common symptoms associated with symptomatic fibroids.
Can fibroids affect fertility?
They can in some circumstances, particularly depending on their size and location. Having fibroids does not automatically mean you will have fertility problems.
Do all fibroids need to be removed?
No. Fibroids that are not causing symptoms may simply be monitored.
Can fibroids come back after treatment?
Some treatments remove existing fibroids but do not eliminate the possibility of developing new fibroids in the future. Your doctor can explain the likelihood based on your individual treatment.
The Bottom Line
Fibroids are common, particularly among Black women, but having fibroids does not automatically mean you will need surgery or have difficulty becoming pregnant.
The most important step is understanding what is happening in your body and getting an individualized evaluation when symptoms develop.
If you are experiencing heavy periods, pelvic pressure, pain, or fertility concerns, Harlem GYN can help evaluate your symptoms and discuss appropriate treatment options.
**Concerned you may have fibroids? Schedule a consultation with Harlem GYN to get answers and understand your options.**
Symptoms and Diagnosis
Asymptomatic: Many women have fibroids and never experience any symptoms at all.
Symptomatic: When symptoms do occur, the main signs are:
Changes in menstrual bleeding, typically periods becoming heavier or more painful.
In some cases, rapid growth or location of a fibroid can make a person appear pregnant when they are not.
If you are experiencing symptoms, a simple ultrasound can confirm the presence of fibroids. Debunking the Myths: Can They Just Disappear?We understand the desire to find a simple solution, and many patients tell us they have seen information online claiming that fibroids can disappear with special diets, supplements, or items like molasses. The Reality: The truth is that getting rid of fibroids is not possible without medication or surgery. The only way to make a fibroid "disappear disappear" is to surgically remove it. Your Treatment Options Fibroids can be managed through different modes of treatment:
Shrinking: Medications or a procedure called embolization (which blocks or reduces blood supply to the fibroids) can significantly shrink them.
Removal: For complete removal, surgery is the definitive option.
Fibroids and FertilityIf you are trying to conceive, it’s natural to worry about how fibroids might affect your chances. Infertility Ranking: Fibroids do not rank very high as a primary cause of infertility. In medical practice, a provider will first investigate other common factors like ovulation issues, tubal blockage, or the partner's sperm quality. Pregnancy can often occur even with fibroids present. Fibroids During Pregnancy: If a woman becomes pregnant with fibroids, the medical literature advises against touching the fibroids until after the pregnancy is over. Attempting removal during pregnancy can precipitate a miscarriage or cause significant bleeding.
