For decades, fibroids were managed almost exclusively as a reproductive health problem: heavy bleeding, pelvic pain, difficulty conceiving. The question of what fibroids might be doing to the heart was, until recently, largely unexplored. Prior studies on the relationship between fibroids and heart disease were described by researchers as “sparse and inconclusive.” That gap closed significantly when one of the largest analyses of this question ever conducted landed in a major cardiology journal – and drew national attention.
At one year after diagnosis, women with uterine fibroids had 2.47 times the cardiovascular risk of matched women without them. By the 10-year mark, that figure remained more than 80% elevated. But the finding that most surprised the researchers wasn’t the magnitude – it was who carried the steepest risk.
Women under 40 had a 251% higher cardiovascular risk compared to fibroid-free peers of the same age. Young women with an incidentally discovered growth that their gynecologist may have dismissed as “common” are, according to the December 2025 data, potentially carrying one of the most significant unrecognized heart disease signals in clinical medicine.
A Condition Hidden in Plain Sight
Fibroids are predominantly benign growths that develop from the muscle tissue of the uterus. The U.S. Office of Women’s Health notes that between 20% and possibly up to 80% of women will develop fibroids by the time they reach age 50. That extraordinary range reflects the core challenge: many women have fibroids and simply don’t know it.
Nearly 26 million pre-menopausal women in the U.S. are affected by uterine fibroids, and many do not experience any symptoms. A fibroid can sit silently in uterine tissue for years, causing no pain and no bleeding changes, only discovered incidentally during an ultrasound for something else entirely. A growth can be as small as a seed or as large as a watermelon, making a woman appear pregnant. At both extremes, the cardiovascular implications may be present regardless of whether the woman is symptomatic.
Fibroid symptoms, when they do occur, include heavy menstrual bleeding that can lead to anemia, pelvic pain and pressure, urinary and bowel problems as growing growths press on the bladder and bowels, infertility, and adverse pregnancy outcomes. The burden goes beyond physical symptoms – some women with the condition experience significant distress that negatively affects quality of life, including depression, anxiety, and body image issues. Fibroids are also the most common reason for hysterectomy in the United States.
The Study That Changed the Conversation
The landmark analysis, published in the Journal of the American Heart Association in December 2025, included 450,177 women with fibroids and 2,250,885 matched control individuals using data from Optum’s Clinformatics Data Mart from 2000 to 2022. More than 2.7 million women contributed data, with a mean age of 41 years; none had atherosclerotic cardiovascular disease at baseline. Participants were followed for up to 10 years.
The study was led by scientists at the University of Pennsylvania Perelman School of Medicine. Lead author Julia DiTosto, a doctoral candidate in epidemiology at Penn, described the significance of reproductive health as a window into cardiovascular risk. “We do hope that our study adds to this growing evidence that reproductive health may provide important insights into cardiovascular health,” DiTosto said, adding that “there is a need for more information on how exactly, biologically, these conditions are related and also identifying potential strategies for cardiovascular prevention.”
The cardiovascular endpoints tracked were not limited to one type of heart event. Women with fibroids had a higher risk for coronary artery disease, cerebrovascular disease, and peripheral artery disease at 10 years than those who did not have fibroids. For every specific condition studied – including stroke and heart attack – as well as overall heart disease, women with fibroids had a higher risk at each follow-up period.
The Risk Was Highest in the Youngest Women
Women younger than 40 had a stronger link between fibroids and heart disease – and a 251% higher risk at 10 years. This was a particularly surprising finding for the research team, given that older age is a known risk factor for heart disease.
That inversion is clinically significant. Younger women are generally considered low-priority candidates for aggressive cardiovascular screening. The new data specifically identified uterine fibroids as a potential signal of increased long-term risk for atherosclerotic cardiovascular disease, particularly in women younger than 40. A 35-year-old woman with an incidentally discovered fibroid may now need a conversation with her doctor about her heart – not just her reproductive health.
At one year after fibroid diagnosis, women with fibroids had a 2.47-fold higher adjusted risk for atherosclerotic cardiovascular disease than matched control individuals. The association diminished over time but remained statistically meaningful. Long-term heart disease risk among women with fibroids was more than 80% higher than in women without uterine fibroids across the full 10-year follow-up.
Not Explained by the Usual Suspects
One of the most important findings in the data concerns causality. The Penn team controlled carefully for known cardiovascular risk factors – hypertension, diabetes, obesity, smoking – to determine whether those conditions were simply driving the elevated heart disease rates in fibroid patients.
Women with fibroids had an elevated risk of heart disease across all age groups, races, and ethnicities. The elevated risk compared to women without fibroids persisted even after accounting for other factors such as obesity and diabetes – suggesting that biological factors specifically related to fibroids contribute to cardiovascular risk independently of those common drivers.
DiTosto noted in the published research that fibroids and cardiovascular disease share biological pathways, including the growth of smooth muscle cells, the excessive buildup of fibrous connective tissue, calcification, and inflammatory responses. These overlapping mechanisms suggest fibroids may not simply coexist with cardiovascular disease but may share a pathological substrate – a direction that will require significantly more mechanistic research to confirm.
The Biology Behind the Link
Uterine fibroids are associated with hypertension and cardiometabolic risk factors, yet the onset and severity of cardiovascular disease in women with fibroids remains understudied. Several biological pathways have been proposed to explain the connection, and they converge on systemic inflammation, hormonal dysregulation, and vascular dysfunction.
Cardiovascular risk factors differ by sex, and several – including gestational hypertension, gestational diabetes, preeclampsia, and premature menopause – are specific to women. Fibroids may now belong on that list of female-specific cardiovascular signals. Widely used cardiovascular risk assessment tools such as the Framingham Risk Score and the ACC/AHA ASCVD Risk Calculator do not factor in female-specific reproductive history. Currently, no dedicated risk assessment tool specifically addresses the cardiovascular risk factors unique to women.
Chronic inflammation is one of the most credible mechanistic bridges. Research published in the Journal of the American Heart Association has previously identified inflammation as comparable to high LDL cholesterol as a heart disease risk factor – helping explain why some women have heart attacks and strokes despite appearing healthy by conventional metrics. Fibroids are associated with a pro-inflammatory state, and inflammatory signaling may be the thread connecting uterine tissue pathology to arterial disease.
A 2025 Mendelian randomization study – a method that uses genetic variants to test for causal relationships rather than simple associations – further examined the fibroid-cardiovascular link. That study, drawing on genome-wide association data from a UK Biobank cohort of 462,933 Europeans, used genetic variants as instrumental variables to evaluate the causal relationship between genetically predicted uterine fibroids and cardiovascular disease risk. Genetic approaches like this are valuable because they reduce the confounding that observational studies cannot fully eliminate.
A Condition That Hits Some Women Harder
Uterine fibroids are not experienced equally across the population. Although prevalent among all women, fibroids are uniquely pernicious in Black women, who experience significantly higher rates, with earlier onset and more complex disease.
Black women are diagnosed with fibroids roughly three times as frequently as white women, develop them earlier in life, and tend to experience larger and more numerous fibroids that cause more severe symptoms. According to the NIH’s women’s health research division, nearly a quarter of Black women between 18 and 30 have fibroids, compared to about 6% of white women.
Black women in the U.S. are more likely to get fibroids, get them at a younger age, and suffer more severe symptoms, including anemia requiring blood transfusions, infertility, and reduced quality of life. They are also 2 to 3 times more likely to have a hysterectomy and 7 times more likely to have a myomectomy, despite the availability of effective non-surgical options that carry fewer complications.
A 2025 study published in JAMA Network Open expanded that picture beyond the Black-white binary. Fibroid diagnosis rates were 71% higher for South Asian, 47% higher for East Asian, and 29% higher for Southeast Asian patients compared with non-Hispanic White patients. Diagnosis rates were also elevated among Hispanic and Black patients compared with White patients. The racial and ethnic dimensions of fibroid burden are broader than previously appreciated – and given the new cardiovascular data, the health equity stakes are correspondingly higher.
The Funding Gap
In 2024, the National Institutes of Health awarded $17 million toward the study of fibroids, up from $14 million in 2023. By comparison, NIH records show $28 million went to endometriosis, $59 million to menopause, and $740 million to breast cancer.
The disparity is stark when set against the prevalence figures. Fibroids affect tens of millions of women across every demographic group, with a cardiovascular risk profile that the latest research suggests is clinically significant – yet they receive a fraction of the research investment directed at other women’s health conditions. Despite the high prevalence, fibroids remain understudied and poorly understood, a fact that DiTosto and her colleagues explicitly acknowledged in their published research.
The cardiovascular dimension of fibroids has gone largely ignored partly because the condition has historically been siloed within gynecology. No dedicated cardiovascular risk assessment tool exists that specifically addresses the risk factors unique to women, making it a pressing gap in the current era of precision medicine. Adding fibroids to the list of female-specific cardiovascular signals is a necessary first step.
Why Women Go Undiagnosed – and Unwarned
Only about 56% of U.S. women recognize that heart disease is their number one killer – a gap in awareness that has persisted for decades despite public health campaigns. Into that existing blind spot now falls a new, underappreciated risk factor that affects millions of women who may have fibroids and don’t know it, or who know about their fibroids but have never been told they carry cardiovascular implications.
The problem is compounded by the tendency of cardiovascular screening tools to miss women. Several cardiovascular risk factors are specific to women, but widely used risk scoring tools do not account for them – meaning a woman with fibroids could score as “low risk” on a standard cardiovascular assessment while carrying a meaningfully elevated actual risk.
Measuring inflammation – another female-specific cardiovascular signal – is not a standard part of screening in the United States, and there are no outward signs that a person may have high levels. The same invisibility applies to fibroids: a woman without symptoms has no obvious reason to seek imaging, and her provider may have no protocol prompting one.
Read More: Subtle Heart Attack Symptom Many Women Miss Without Realizing
What to Do With This Information
The December 2025 Penn study is observational in design, which means it identifies association rather than proven causation. The researchers themselves called for more work to confirm the biological mechanisms at play. That’s an important limitation – but it doesn’t reduce the practical significance of what the data showed. An 80% elevated cardiovascular risk that persists for 10 years, independently of obesity, diabetes, and hypertension, is a signal that clinical practice cannot wait for mechanistic confirmation to act on.
The most concrete step available right now is a conversation with a primary care physician. Women diagnosed with uterine fibroids – especially those under 40 – should ask about blood pressure monitoring, cholesterol panels, and inflammatory markers such as high-sensitivity C-reactive protein. These are standard, low-cost tests that can reveal cardiovascular risk patterns that standard scoring tools miss. Black women, who carry both a higher fibroid burden and a higher baseline cardiovascular risk, have the most to gain from proactive screening.
For women who haven’t been evaluated for fibroids but experience heavy periods, pelvic pressure, or unexplained urinary frequency, a pelvic ultrasound is a straightforward diagnostic step. Heart disease kills more American women than any other condition. Fibroids, now linked to a significant amplification of that risk, deserve a place in the cardiovascular conversation – at every age, and in every exam room.
Disclaimer: This information is not intended to be a substitute for professional medical advice, diagnosis, or treatment and is for information only. Always seek the advice of your physician or another qualified health provider with any questions about your medical condition and/or current medication. Do not disregard professional medical advice or delay seeking advice or treatment because of something you have read here.
AI Disclaimer: This article was created with the assistance of AI tools and reviewed by a human editor.