Porsha Williams had an emergency partial hysterectomy this year after doctors found 21 uterine fibroids, one of them the size of a cantaloupe. She was 45. For months she had put her symptoms down to perimenopause.
The detail worth carrying away: the symptoms she dismissed are the common ones. A long menstrual cycle, migraines and fatigue. She had lived with fibroids since her late 20s, and still didn’t recognize what was happening until it became an emergency.
What happened
Writing in a personal essay for Glamour, Williams said the surgery happened fast enough that it didn’t register until she woke up in a hospital bed. She had previously undergone uterine fibroid embolization, a procedure that shrinks fibroids by cutting off their blood supply while leaving the uterus intact. It’s a common choice for women who want to preserve fertility.
The hysterectomy was partial, meaning her ovaries were left in place and only the uterus was removed. That distinction matters medically: keeping the ovaries avoids surgical menopause, which arrives abruptly rather than gradually. She has said the operation saved her life and also ended any possibility of more children, and she has been direct that both things are true at once.
Why this story is more common than it sounds
Uterine fibroids are benign growths, and they aren’t rare. A large share of women develop them by age 50, frequently without symptoms. When symptoms do appear they’re the kind that get absorbed into ordinary life: heavy or prolonged periods, fatigue, pelvic pressure, frequent urination. Every one of those has a dozen other explanations, and fatigue in a woman in her forties gets attributed to perimenopause constantly.
Black women develop fibroids earlier, more often, and with more severe symptoms, and are significantly more likely to end up having a hysterectomy. That disparity is well documented and not well explained, and the delay between first symptoms and diagnosis is a recognized part of it.
What to actually do with this
Not panic. Fibroids are common and usually manageable, and most women who have them will never need surgery. The useful move is narrower: if periods have become heavier or longer, or fatigue has arrived without a clear cause, that’s worth naming specifically to a doctor rather than filing under getting older. Fibroids are typically found on a pelvic exam or ultrasound, which isn’t an elaborate investigation.
And if a doctor attributes symptoms to perimenopause without examining for anything else, it’s reasonable to ask directly whether fibroids have been ruled out. Williams had a known history and still reached an emergency.
Writing in a personal essay for Glamour, Williams described how quickly it moved: “It all happened so fast. It really didn’t hit me until I woke up in the hospital bed.” She has also been direct about holding two things at once: “I didn’t have a choice about the hysterectomy, but it saved my life.”
