How I Knew I Had Uterine Cancer and Fibroids: What to Know

September 13, 2025

How I Knew I Had Uterine Cancer and Fibroids: What to Know

Note: This is a patient-style narrative blended with medical guidance. It is not a diagnosis. If you notice similar symptoms, talk with your clinician promptly.

The turning point: when my bleeding pattern changed

I had been told I had uterine fibroids years earlier, and for a long time, heavy periods and pelvic pressure were simply my “normal.” What made me seek help again was a new pattern: bleeding between periods, needing to change pads every hour, and eventually spotting after sex. When the bleeding continued after I thought I was nearing menopause—and especially when I noticed any bleeding after months without a period—I knew I couldn’t chalk it up to fibroids alone. Postmenopausal bleeding is never normal and should be evaluated.

Another clue was fatigue from anemia. I felt winded climbing stairs and craved ice (a classic sign of iron deficiency). Fibroids can cause heavy bleeding and anemia, but the change from my baseline plus bleeding after a stretch without periods made me and my doctor consider endometrial (uterine) cancer as well.

Fibroids vs. uterine cancer: overlapping symptoms, key differences

Fibroids are benign (noncancerous) growths of the uterine muscle. They’re common, especially in people in their 30s–50s. They can cause heavy or prolonged periods, pelvic pressure or pain, urinary frequency, constipation, back pain, and—depending on their location—trouble with fertility. Most fibroids do not become cancer.

Endometrial (uterine) cancer often presents with abnormal uterine bleeding. In people who still menstruate, that may mean very heavy, frequent, or irregular bleeding or bleeding between periods. After menopause, any bleeding is a red flag. Some people also notice pelvic pain, but pain is less specific. Unintentional weight loss is less common early on. The National Cancer Institute (NCI) and ACOG emphasize that abnormal bleeding—especially after menopause—warrants prompt evaluation.

What raised my suspicion was not the presence of fibroids themselves, but a shift: bleeding that didn’t follow my usual fibroid pattern, spotting after sex, and postmenopausal bleeding. Rapid enlargement of a uterine mass after menopause is also concerning, although imaging can’t reliably distinguish a fibroid from the rare uterine sarcoma.

The tests that gave clarity

My clinician started with a focused history and pelvic exam, then ordered tests commonly used to sort this out:

Transvaginal ultrasound (TVUS): This looks at the uterus, measures the lining (the endometrium), and maps fibroids. In postmenopausal people, a thin endometrial lining (around 4 mm or less) is reassuring; a thicker lining can prompt biopsy. Ultrasound showed my known fibroids—but also a thicker-than-expected lining.
Endometrial biopsy: This office procedure samples cells from the uterine lining. It’s the key test to diagnose or rule out endometrial cancer and precancer. My biopsy provided the answer: early-stage endometrial cancer.
Hysteroscopy or saline-infusion sonohysterography (in some cases): These help visualize the cavity and identify polyps or focal lesions that might be missed otherwise.
MRI (selectively): Helpful to characterize fibroids and plan treatment, but it cannot definitively diagnose or exclude cancer.

Blood tests, like a complete blood count (CBC), checked for anemia. There’s no reliable blood screening test for endometrial cancer; tumor markers are not used for routine diagnosis.

Who is at higher risk—and why that matters

Knowing your risk helps you decide how quickly to seek evaluation and how assertive to be about testing:

Endometrial cancer risk factors (NCI, ACOG): age over 50; obesity; diabetes; high blood pressure; unopposed estrogen exposure (including estrogen-only hormone therapy); polycystic ovary syndrome with infrequent ovulation; early first period or late menopause; tamoxifen use; and hereditary syndromes like Lynch syndrome. Having a uterus after menopause and experiencing any bleeding is a key warning sign.
Fibroid risk factors (NIH/MedlinePlus): being in your reproductive years, family history, earlier age at first period, and Black race/ethnicity (fibroids are more common, larger, and occur earlier in many Black women). Pregnancy history and certain lifestyle factors can influence risk as well.

Remember: fibroids are common and benign, but they don’t protect you from cancer. New or changing bleeding patterns still need evaluation.

Choosing treatment: immediate needs and long-term plans

Because my biopsy confirmed early-stage endometrial cancer, the recommended treatment was surgery—typically a hysterectomy with removal of the fallopian tubes and ovaries, plus staging as appropriate. Some very early, low-risk cases may be candidates for fertility-sparing hormonal therapy under close specialist care, but most people are treated surgically. Depending on final pathology, radiation and/or chemotherapy may be advised.

For my fibroids, options had previously included watchful waiting, medications to control bleeding (NSAIDs, tranexamic acid), hormonal therapy (such as a levonorgestrel-releasing IUD or combined hormonal contraception), short-term use of GnRH agonists or antagonists to shrink fibroids, uterine artery embolization, myomectomy, or hysterectomy. The decision depends on symptoms, fibroid size and location, fertility goals, and personal preferences.

If you and your surgeon are considering minimally invasive surgery for presumed fibroids, ask about the FDA’s safety guidance on power morcellation. In rare cases of unsuspected uterine sarcoma, morcellation can spread cancer cells. The FDA recommends contained morcellation only when appropriate and avoiding power morcellation in many peri- and postmenopausal patients. Discuss safer alternatives with your surgeon.

What finally made the difference

Three things helped me get diagnosed promptly:

Tracking my symptoms: I noted dates, volume (pads/tampons per hour), and any bleeding after sex.
Knowing red flags: Postmenopausal bleeding, sudden changes from my baseline, and persistent bleeding despite prior fibroid management.
Advocating for a biopsy: When bleeding didn’t match the usual fibroid pattern, I asked whether we should sample the lining.

When to call your clinician now

Any postmenopausal bleeding—even light spotting.
Bleeding that soaks through a pad or tampon every hour for more than 2 hours, or passing large clots.
New bleeding between periods, bleeding after sex, or bleeding that persists despite your usual fibroid treatments.
Severe pelvic pain, fever, dizziness, or symptoms of anemia (fatigue, shortness of breath, pica such as craving ice).

If you have risk factors like obesity, PCOS, tamoxifen use, or Lynch syndrome, tell your clinician and ask whether earlier or more aggressive evaluation is warranted.

Key takeaways

Fibroids are common and benign, but they can mask or overlap with symptoms of endometrial cancer.
Any postmenopausal bleeding or a significant change in bleeding pattern should prompt evaluation.
Endometrial biopsy is the definitive way to diagnose or rule out uterine cancer.
Treatment is individualized: fibroid management ranges from medication to procedures; endometrial cancer is often treated surgically, with additional therapy based on stage and grade.
Use trustworthy information and partner with a gynecologist or gynecologic oncologist to tailor decisions to your goals.

Trusted sources and further reading

National Cancer Institute (NCI): Uterine/Endometrial Cancer overview and treatment – https://www.cancer.gov/types/uterine
ACOG: Abnormal Uterine Bleeding – https://www.acog.org/womens-health/faqs/abnormal-uterine-bleeding
ACOG: Endometrial Cancer FAQ – https://www.acog.org/womens-health/faqs/endometrial-cancer
NIH MedlinePlus: Uterine Fibroids – https://medlineplus.gov/uterinefibroids.html
FDA Safety Communication: Laparoscopic Power Morcellation – https://www.fda.gov/medical-devices/safety-communications/update-perform-only-contained-morcellation-when-laparoscopic-power-morcellation-appropriate-and
NCI: Uterine Sarcoma (rare cancers of the uterus) – https://www.cancer.gov/types/uterine/patient/uterine-sarcoma-treatment-pdq

This article is for general information and does not replace personalized medical advice. If you’re worried about your symptoms, seek care promptly.