Uterine fibroids are benign (non-cancerous) growths that grow in the uterine wall. They’re also called leiomyomas or myomas.

They’re very common: Up to 70 percent of women will develop fibroids. Some people have no symptoms. Others may have heavy bleeding, abdominal pressure, or pain in the back and abdomen.

These symptoms bring tens of thousands of people into emergency rooms every year. Heavy bleeding can lead to iron-deficiency anemia, resulting in fatigue and weakness. Fibroids can affect daily living and quality of life if you aren’t able to get the right care.

The number of emergency room visits for fibroids is on the rise. Care in the emergency department costs more than care provided in other settings. It’s estimated that visits to the emergency department for fibroids cost nearly $500 million in 2017.

People with fibroids often come to emergency rooms before and after a diagnosis. In rare cases, fibroids do require emergency care, but fibroids can typically be treated outside of the emergency department. The rise in emergency visits suggests that people aren’t getting the right care in other places.

There are differences seen when it comes to race and fibroids.

African American women have significantly higher rates of fibroids. It’s estimated that they’re three times as likely to have fibroids as white women. They also tend to develop fibroids at an earlier age.

Research shows that people of African descent have fibroids that grow faster. There could be specific genes to explain this, but more studies are needed. Research is lacking for Black individuals, despite the high rates of fibroids.

People aren’t always able to get the best care due to systemic racism in healthcare. Some healthcare professionals may hold harmful beliefs about Black people.

For example, one 2016 study showed that Black patients’ pain was often rated as lower than white patients’ pain. Black people are also less likely to receive the right dose of medications to manage their pain.

There are several treatment options for fibroids, including medications, procedures, or surgeries. Treatment decisions depend on many things, including fibroid size and number.

Surgical procedures include myomectomy, which involves removing fibroids, and hysterectomy, which involves removing the uterus. These surgeries can be done laparoscopically (through a small incision) or open. Laparoscopic surgeries cause less tissue damage, and they have a lower risk of complications and shorter recovery times.

Overall surgery rates are much higher for African Americans with fibroids. They’re two to three times more likely to have a hysterectomy and seven times more likely to have a myomectomy than other racial groups.

Research also suggests that they’re less likely to have a laparoscopic hysterectomy, which means a longer recovery and a higher risk of complications. After surgery, African Americans are twice as likely to have complications, including blood loss or infection.

The reason for these numbers isn’t completely clear. It’s possible that earlier diagnosis and better ongoing care could improve these outcomes. At earlier stages, medications or less invasive treatments may be an option.

There are trends when it comes to emergency care for uterine fibroids. Looking at the factors at play can help us understand why fibroids bring so many patients to emergency rooms:

  • Insurance type. People with private insurance are most likely to seek emergency care for fibroids. People without insurance are least likely to stay in hospital after coming to the emergency room.
  • Geographic location. One study divided the United States into four regions: Midwest, Northeast, South, or West. It found that 46.2 percent of visits for fibroids happened in the South. Despite this, people in the South were least likely to be admitted to hospital.
  • Age. People ages 36 to 45 made up 44.5 percent of emergency visits for fibroids in the United States. People ages 46 to 55 were the group most likely to be admitted for fibroid-related concerns.
  • Bleeding vs. non-bleeding complaint. People who presented with heavy bleeding were almost 15 times as likely to be admitted. This is compared to those who had other fibroid symptoms such as pain.

Care is more expensive in the emergency department, but much of the care given in emergency departments can be done in other health settings. The following interventions could help people seek care outside of emergency departments:

  • Better screening. Since fibroids are so common, better screening may help diagnose people earlier. Over time, fibroids can grow and cause more symptoms. If you have any concerns, particularly with heavy bleeding, talk with your doctor.
  • Monitoring. Regular check-ins with your doctor are ideal. If your symptoms start to change, tests can be done to find out more. Any necessary treatments or procedures can get started earlier.
  • Clear guidance on when to seek care. In some cases, fibroid symptoms can be an emergency. Other times, symptoms can be managed outside of the emergency department. It may be helpful to have a plan for follow-up care. This would include what to watch for, when to call your doctor, and when to seek emergency care.

Heavy menstrual bleeding is a common symptom of uterine fibroids. For many people, this means time away from work and challenges with daily tasks. The loss of blood can lead to iron-deficiency anemia. This can cause fatigue, weakness, dizziness, lightheadedness, and a racing heart rate.

Here are some things that may help:

  • Take pain medications. Abdominal cramping and pain are common symptoms of fibroids. Pain medications can help you cope. Talk to your doctor about recommendations and the best dose for you.
  • Take iron supplements. Heavy bleeding can cause you to lose too much iron from your body. You may need an iron supplement to prevent or treat iron deficiency. There are many types of iron supplements and your doctor can advise you on the best one for you.
  • Consider hormonal birth control. The hormones in some types of birth control can help to regulate your period and reduce blood loss. Talk to your doctor about whether this might be right for you.
  • Monitor your symptoms. It may be helpful to keep notes on the length of your cycle and your flow. Keep track of your use of pads or tampons, or note the volume of blood in a menstrual cup. This information can help your doctor understand what you’re dealing with.
  • Keep in touch with your doctor. Let your doctor know if you notice a change in your symptoms. It’s smart to follow up after starting on medications or supplements for fibroids. This way, if they’re not working well, you can have that conversation with your doctor.
  • Be aware of healthcare options. It can be helpful to know what choices you have to help meet your health needs. If your usual doctor is away, is there someone else in the office available to cover patient care? Does your area offer virtual healthcare? Is there an after-hours or urgent care clinic in your area?

People with uterine fibroids may be cared for by a primary care doctor or a specialist.

Specialty care is with a gynecologist or an obstetrician/gynecologist (OB-GYN). A gynecologist is an expert in the care of the uterus, breasts, fallopian tubes, and cervix. An obstetrician is a specialist who deals with pregnancy and childbirth. Since these concerns may overlap, a doctor may cover both specialties.

Finding a doctor you like and trust is important. You should feel like your needs are met and you’re getting the care you deserve. If you need a specialist, your primary care doctor can suggest someone. You can also ask friends or family members for recommendations.

Ideally, your doctor is someone you follow up with on a regular basis. Any changes to symptoms can be treated early, preventing the need for emergency care.

Uterine fibroids are very common, affecting up to 70 percent of women. Despite how common they are, people aren’t always getting the care they need. Emergency department visits for fibroid symptoms have been going up. Much of this care can be provided in other settings.

African American people have higher rates of uterine fibroids, surgeries, and surgical complications. They may face additional barriers to accessing care.