You’re bloated like never before and your period has been acting CRAZY for the past few months. Probably just PMS gone wild, right? Not so much. Those are both symptoms of uterine fibroids, which you definitely shouldn’t just ignore.

Fibroids are abnormal uterine muscle tissue growths. They can occur inside the uterine cavity, within the uterine wall, on the outside edge of the uterine wall, or even outside of the uterus, and they strike roughly 70 percent of women at some point in their lives, according to Taraneh Shirazian, M.D., a gynecologist at NYU Langone Health specializing in minimally invasive gynecologic surgery.

So why isn’t anyone talking about them? Probably because the majority of women who have them never even know they’re there, says Shirazian. “Uterine fibroids symptoms vary depending on how many you have, where they’re located, and how large they are,” she says. So if they’re small and few enough, chances are, you’ll never feel anything. But in some women, they can be very serious—and if they’re large or painful enough, they may have to be removed via medical or surgical methods.

“Typically, when women come in with fibroids, it’s because they’re experiencing pelvic pressure or abnormal bleeding,” she says. But there are other symptoms of fibroids you can look out for—and if you’re experiencing one or two of the issues below, you should get to your ob-gyn for a full workup ASAP.

1. Your Pelvis Feels Heavy

This is probably the most common symptom of fibroids. “We call this a mass-effect symptom—an effect of having some sort of growth in your body,” says Uchenna Acholonu Jr., M.D., obstetrician-gynecologist at Weill Cornell Medicine and New York-Presbyterian in New York. Women with larger fibroids tend to feel a sensation of something pushing down on the pelvis—because there is something pushing down on the pelvis.

The exact feeling is hard to describe because, unless you’ve had a bun in the oven, you have probably never felt this sort of pressure before. But, when you feel it, you know it, he says.

2. Your Periods Are Out Of Control

There are a lot of things that can cause changes to your menstrual cycle, and fibroids are a super-common culprit. “If you have what we call a submucosal fibroid, a fibroid within the uterine cavity, you’ll bleed much more than typical,” says Shirazian. “That means your period would be longer, heavier, or you might bleed in between periods.”

We’re not talking an extra day or a little spotting here—the bleeding would be significantly greater than or different from your norm.

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3. You Feel Fatigued

Some fibroids can actually lead to anemia, a lack of red blood cells, or iron deficiency. The reason comes down to those heavy periods. “Usually with submucosal fibroids, women bleed quite extensively, even to the point of requiring blood or iron transfusions,” says Shirazian.

Symptoms of anemia include fatigue, shortness of breath, lightheadedness, dizziness, or an overactive heartbeat. Your doctor can also perform a simple blood test to diagnose anemia.

4. You’re Crazy Bloated

“Women will come to me and say, ‘people are saying that I look pregnant, but I’m clearly not.’ That’s usually the result of a fibroid,” says Shirazian. For the most part, fibroids just make you look or feel bloated, but they can even grow to a size where they can cause difficulty breathing or kidney failure, says Shirazian.

“If your abdomen is expanding in size, don’t just write it off as weight gain if you’re not gaining weight elsewhere,” she says.

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5. You Constantly Have To Pee

If you’ve noticed that you’re peeing more frequently, or just feel the urge to pee more frequently, it might be the result of a fibroid. “Because the uterus is located right next to the bladder, a mass growing on the left side of your uterus could very well cause urinary pressure or frequency,” says Shirazian.

6. You Actually Can’t Pee—Or Poop

On the flip side, a fibroid can actually make it harder to use the bathroom, too. “If you’re accommodating urinary frequency and your body gets used to that, after a while, your anatomy changes so much that the urethra, the tube that leads from the bladder out, becomes so kinked or bent you have difficulty urinating,” says Acholonu. “Some people will actually have to lift up on the fibroid or lift up on their uterus to straighten out the urethra enough to allow themselves to void.”

It’s the same effect with constipation—if the fibroid is in the back of the uterus, it going to push on your rectum, which can limit bowel movements, says Shirazian.

Constipation happens to everyone from time to time, but if it doesn’t clear up in a couple of days or you are experiencing difficulty urinating, you need to talk to your doctor about your symptoms.

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7. Your Pelvis, Legs, Or Back Are Killing You

Pain is less common with fibroids than it is with, say, endometriosis or other gynecological issues, but you may experience it—although it’s difficult to define. “Pain for some people is just a light ache, for other people it’s a stabbing, hard pain they can’t walk or talk through. And you can have the full range with fibroids,” says Acholonu. “It really depends on location. If you have a fibroid within the uterus, that may cause more central pelvic pain; if you have fibroids that are really pushing against your back bones, you can have lower back pain or pain all the way down your leg.”

8. You’re Feeling Pain During Sex

This isn’t a fibroid symptom that ob-gyns are going to hang their hats on, but it can occur along with other fibroid symptoms. “You could have a fibroid that protrudes or bulges down into the vagina,” says Acholonu, which could cause pain during penetration, “or, because a fibroid is generally attached to the uterus, it could be jostled during intercourse and hit another part of the anatomy, which can result in pain.”

Painful sex can result from several other down-there issues, ranging from cervical cancer to vaginal dryness. Pain is nothing to shrug off, but talk to your gyno before sounding any alarms.