Lupita Nyong’o marked her birthday with a different kind of Instagram post on Sunday—one that highlighted not her age but the number of fibroids (a.k.a. usually non-cancerous uterine tumors) she has had.
“Today is my birthday, and it’s got me feeling reflective,” writes Nyong’o. “Not about age, but about a different number: 77. Over the course of my lifetime, I have carried 77 uterine fibroids: 25 surgically removed, and more than 50 still growing inside me today, the largest the size of an orange. (Swipe to see my MRI ‼️) This is not a rare story. It is just a rarely told one.”
In 2025, the actress revealed that she was diagnosed with fibroids back in 2014, and like far too many other women with the condition, had suffered silently for much longer, dealing with heavy periods and severe pelvic pain that she’d been led to believe were normal. Also like many others, the surgery Nyong’o had to remove the roughly 30 fibroids dotting her uterus at the time proved only a temporary fix, with upward of 50 redeveloping in the 12 years since. It’s the reason the actress launched a research grant last year to fund the creation of better, longer-lasting treatments and doubled down last weekend with the social campaign #MakeFibroidsCount.
As Nyong’o recently told TODAY.com, fibroids are often addressed with a kind of “lightness, a casualness,” like how you’d refer to having a pimple—that is, if they’re talked about at all. It’s true that roughly half of people with uterine fibroids don’t feel anything. But for the rest, they can bring a host of seriously uncomfortable symptoms that all too often go overlooked and undertreated. And since asymptomatic fibroids can become symptomatic at any point, it’s important to know what to watch for. Here are six sometimes-subtle 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 certain days of your cycle just bring 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 cause a lot of cramping, 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. Fibroids can generate period-like symptoms outside of your cycle too, 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. And the large amounts of blood loss can trigger fatigue and even put you on a path toward anemia, as Nyong’o reportedly experienced.
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 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 surrounding your cycle.
How much a fibroid, or fibroids, causes you to bleed is also often tied to its type. Fibroids that bulge into the uterine cavity—called submucosal fibroids—are often associated with the most significant bleeding changes, regardless of 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 of the uterus) and intramural (which 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, Dr. Huynh says: “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; according to John Hopkins Medicine, this bulking is sometimes associated with increased urination and constipation.
Other times, the pain is less “all over,” and is more isolated (and maybe harsher). One rare example of this are pedunculated fibroids, which attach to the uterus with a long, stem-like growth, causing sudden, strong abdominal pain that goes in and out—similar to really bad period cramps. In other rare cases, a fibroid may grow faster than its blood supply, which can also cause similarly intense sensations.
3. Bathroom trips are a burden.
Dr. Huynh says that when a uterine fibroid puts pressure on the bladder or bowel, it might feel harder—or even painful—to poop or pee. “The sheer force of the fibroids pushing and compressing against the rectum [causes people to] push against that force to have a bowel movement,” she adds. Similarly, if the fibroid is pushing against the bladder, the organ doesn’t have as much space as it would if the fibroid wasn’t there. You may feel like you have to pee more frequently or are unable to empty your bladder completely.
4. Sex is painful.
In a study of more than 20,000 people diagnosed with uterine fibroids, nearly a quarter of participants reported that they often experienced pain and pressure during sex. Dr. Huynh explains that this can happen when a uterus that is enlarged by uterine fibroids shifts, moves, and presses on different areas during the act. You might feel mild discomfort or sharp pain, Dr. Kim says: “Depending on [the fibroid’s] location, just the act of intercourse can be uncomfortable, or [pain] only occurs [during] deep penetration.”
5. You feel pressure or pain in your lower back.
An enlarged uterus from uterine fibroids may press against surrounding nerves, organs, muscles, and the spine, which can lead to lower back pain. This might feel like a dull ache, cramp, sharp sting, or pain that travels down your leg. Lower back pain is most common when the fibroid is located toward the back of the uterus, Dr. Kim says.
6. You have trouble getting pregnant.
Many people with uterine fibroids, whether or not they’re symptomatic, can get pregnant, but the condition can contribute to infertility in 2% to 3% of cases. This usually happens for one of two reasons, Dr. Kim explains: Either the fibroid is so large that a fertilized egg is unable to implant on the wall of the uterus, or the fibroid blocks the fallopian tubes.
If you’ve been trying to get pregnant for a year or longer or are over 35 and have been trying for at least six months, your medical team can do an exam to see if fibroids may be involved. People who visit health care providers with fertility complaints are usually scanned via ultrasound or other imaging to assess for fibroids or other masses, Dr. Kim notes.
When to see a doctor about possible uterine fibroid symptoms
Though any of the scenarios noted above would warrant a call to your ob-gyn, one of the most telling uterine fibroid symptoms is heavy, abnormal periods. So if your cycle feels off, no matter the reason, it’s best to schedule an appointment. And if you don’t have an annual ob-gyn appointment on the books, it’s time to set one up. According to the Cleveland Clinic, many uterine fibroids are discovered during routine pelvic exams, as Nyong’o’s were.
Landing on a diagnosis—and eventual treatment—could take time. Don’t be afraid to speak up: If your doctor isn’t taking your pain or symptoms seriously, keep pressing for answers. Nyong’o, for one, had to mention her pain multiple times before her physician decided to order an ultrasound, the scan that ultimately uncovered her fibroids.
Also, remember to bring up all the symptoms you’re experiencing, not just ones that seem tied to your period. “If someone has heavy menstrual bleeding, constant back pain, [and] constipation, I may have a suspicion for a large uterine fibroid,” Dr. Kim says.
As far as treatment goes, your doctor may recommend a form of surgical removal (a.k.a. a myomectomy), like Nyong’o had—and it’s true that you might need to repeat the surgery at a later date because fibroids can regrow. But there are also some less intensive procedures (like embolization, which blocks the blood vessels that feed the fibroids; and endometrial ablation, which uses electricity to remove the uterine lining) as well as hormonal medications that may not eliminate fibroids but can lessen the symptoms. Your doctor can determine which approach may be best for you depending on factors like your medical history and age, as well as the type, size, location, and number of fibroids growing in or on your uterus.
Ultimately, whether your abdominal cramps and heavy periods are related to uterine fibroids or something else, one thing’s certain: You don’t have to endure recurring bouts of pain without help. The sooner you seek out help and advocate for answers, the quicker you can get on track to feeling better.
Original article appeared on SELF
