Fibroid Symptoms: 9 Signs to Know

The most common fibroid symptoms are heavy or long periods, bleeding between periods, pelvic pressure or fullness, frequent urination, constipation, lower back pain, pain during sex, a swollen lower belly, and tiredness from anemia. Many women with fibroids have none of these. Symptoms depend mostly on where the fibroids sit and how large they are, and each of them can also have other causes, so they are worth checking with a doctor rather than assuming.

Many fibroids cause no symptoms

ACOG notes that fibroids sometimes cause no symptoms at all and may be found during a routine pelvic exam or a scan for something else. A 2020 review in the International Journal of Gynecology and Obstetrics estimated that about 30% of women with fibroids have severe symptoms. If your fibroids were found by chance and you feel well, that is common and usually reassuring.

When symptoms do appear, they tend to fall into two groups: bleeding symptoms, and "bulk" symptoms caused by the size of the fibroids pressing on nearby organs.

The 9 signs of fibroids

The list below is drawn from ACOG, the federal Office on Women's Health (OWH) and the National Institute of Child Health and Human Development (NICHD).

1. Heavy or long periods

ACOG lists "longer, more frequent, or heavy menstrual periods" first. You might soak through pads or tampons quickly, need to double up, pass large clots, or plan your days around bathroom access. Our article on heavy periods and fibroids explains what counts as heavy and when to get help.

2. Bleeding between periods

ACOG and NICHD both include bleeding at times other than your period. This sign deserves a check-up because it has many possible causes, including polyps, hormone changes, infection and, less often, problems with the lining of the uterus.

3. Tiredness, weakness or shortness of breath from anemia

Heavy bleeding month after month can drain your iron stores. OWH notes that fibroid bleeding can be heavy enough to cause anemia. You might feel worn out, short of breath on stairs, or lightheaded. A simple blood count can check for it.

4. Pelvic pressure or a feeling of fullness

Larger fibroids can make the lower belly feel heavy or full. NICHD describes this as feeling "full" in the lower abdomen. Some women describe it as a constant awareness of something being there.

5. Frequent urination or trouble emptying the bladder

A fibroid pressing on the bladder can make you need to go more often or make it harder to empty your bladder. ACOG lists both difficulty urinating and frequent urination. Read more in fibroids and frequent urination.

6. Constipation or rectal pressure

Fibroids at the back of the uterus can press on the rectum. ACOG lists constipation, rectal pain and difficult bowel movements, and OWH mentions rectal pressure.

7. Lower back pain

ACOG describes fibroid pain in the abdomen or lower back as often dull, heavy and aching, though it may be sharp. Back pain is very common for other reasons, so it is worth a full assessment. See can fibroids cause back pain? for how doctors sort out the cause.

8. Pain during sex

ACOG, OWH and NICHD all list pain during sex.

9. A swollen or enlarged belly

ACOG lists an enlarged uterus and abdomen. OWH notes that very large fibroids can make a woman look pregnant. Our article on fibroid belly and bloating covers this in more detail.

Other things fibroids can affect

Beyond these nine, ACOG lists menstrual cramps, abdominal cramps, miscarriages and infertility. ACOG adds that fibroids may cause infertility, although other causes are more common and should be explored first. OWH notes that most women with fibroids have normal pregnancies, though fibroids raise the chance of some delivery problems, including a cesarean birth.

This article is part of our Fibroid Treatment Guide.

Symptoms that can mean something else

None of these signs is unique to fibroids. The NHS and MedlinePlus list other causes of heavy or irregular bleeding, including polyps, adenomyosis, endometriosis, hormone changes, infection and bleeding disorders. The UK's National Institute for Health and Care Excellence (NICE) asks doctors to take a history covering the nature of the bleeding and related symptoms, such as bleeding between periods, pelvic pain and pressure, which may point to fibroids, adenomyosis or a problem with the lining. An exam and a pelvic ultrasound usually sort this out. Adenomyosis in particular can look and feel similar, which we cover in adenomyosis vs fibroids.

When to see a doctor

Make an appointment with your gynecologist or primary care doctor if:

• Your periods are heavy or painful enough to disrupt work, sleep, exercise or social plans
• You bleed between periods or after sex
• You feel unusually tired, weak or short of breath
• You notice pelvic pressure, a firm lower belly, or new bladder or bowel changes
• You have been trying to get pregnant without success, or have had repeated miscarriages
• A known fibroid seems to be growing quickly

ACOG lists heavy or painful periods that cause anemia or disrupt your activities, bleeding between periods, rapid growth, infertility and pelvic pain as signs that may signal the need for treatment.

When to get care right away

Get same-day or emergency care if:

• You are bleeding through two or more pads or tampons an hour for two to three hours in a row
• Heavy bleeding comes with dizziness, fainting, chest pain or trouble breathing
• You have sudden, severe pelvic pain, especially with nausea or fever (ACOG notes a fibroid on a stalk can twist and cause these)
• You are pregnant and have any bleeding
• You have any bleeding after menopause, which always needs prompt evaluation

If your symptoms are caused by fibroids

Treatment is about your symptoms and your goals, not the number on a scan. Options range from medication that reduces bleeding, to procedures that shrink fibroids, to surgery that removes fibroids or the uterus. Our fibroid treatment guide compares them. If you would like to keep your uterus and avoid an incision, uterine fibroid embolization (UFE) is one option to discuss. It is used for both heavy bleeding and bulk symptoms such as pressure and frequent urination.

Frequently Asked Questions

What is the most common symptom of fibroids?

Changes in periods are the symptom ACOG lists first: longer, more frequent or heavier menstrual periods. Pressure symptoms such as pelvic fullness and frequent urination are also common when fibroids are large.

Can you have fibroids with no symptoms?

Yes. Many fibroids cause no symptoms and are found by chance during a pelvic exam or ultrasound. A 2020 review estimated that about 30% of women with fibroids have severe symptoms.

Can fibroids make you tired?

Yes, indirectly. Heavy bleeding can lower your iron and cause anemia, which can make you tired, weak, short of breath or lightheaded. A blood count can check for this.

Do fibroid symptoms get worse over time?

They can. ACOG notes a fibroid may stay small for a long time and then grow quickly, or grow slowly over years. Symptoms often ease after menopause, when fibroids usually shrink.

When are fibroid symptoms an emergency?

Get care right away for bleeding through two or more pads or tampons an hour for two to three hours, bleeding with dizziness, fainting, chest pain or trouble breathing, sudden severe pelvic pain with nausea or fever, any bleeding in pregnancy, or bleeding after menopause.

Keep Reading

• Uterine Fibroid Embolization (UFE) in New York City
• Heavy Periods and Fibroids: What Counts as Heavy and What to Do
• Fibroids and Frequent Urination: When Fibroids Press on the Bladder
• Can Fibroids Cause Back and Leg Pain?
• Fibroid Belly: Why Fibroids Cause Bloating and a Bigger Abdomen
• Fibroids and Anemia: Why Heavy Periods Drain Your Iron
• Fibroid Treatment Guide: every option, compared

Sources

1. ACOG, Uterine Fibroids patient FAQ (last reviewed December 2025)
2. Office on Women's Health, Uterine fibroids (updated February 2025)
3. NICHD, What are the symptoms of uterine fibroids? (last reviewed 2018)
4. Giuliani, As-Sanie and Marsh, Int J Gynaecol Obstet, 2020 — Epidemiology and management of uterine fibroids
5. NICE guideline NG88, Heavy menstrual bleeding: assessment and management (updated July 2026)
6. Office on Women's Health, Period problems (updated September 2025)
7. Cleveland Clinic, Menorrhagia (heavy menstrual bleeding)
8. MedlinePlus, Abnormal uterine bleeding (reviewed October 2024)
9. NHS, Heavy periods (reviewed September 2024)
10. MedlinePlus, Vaginal bleeding between periods (reviewed May 2025)
11. ACOG Committee Opinion No. 734, Obstet Gynecol, 2018 — Role of transvaginal ultrasonography in evaluating postmenopausal bleeding
12. van Overhagen and Reekers, Cardiovasc Intervent Radiol, 2015 — CIRSE standards of practice for uterine artery embolization

Medically reviewed by David Fox, MD, FACS, RPVI. This article is general information, not a substitute for a medical evaluation.

Living with heavy periods, pelvic pressure or other fibroid symptoms? Schedule a consultation with Dr. David Fox at Fox Vein & Vascular in Manhattan to find out whether uterine fibroid embolization is right for you. Call (212) 362-3470 or request a UFE consultation online.