Can Uterine Fibroids Cause Bleeding?

Marie-Claire De Villiers
By Marie-Claire De Villiers
Head and Shoulders Photo of Michelle Meyer
Edited by Michelle Meyer

Published September 7, 2022.

Woman laying in bed holding her stomach

Fibroids are non-cancerous, tumorous growths of muscle and connective tissue, which may occur anywhere in your body without any harmful or painful effects.

Uterine fibroids develop in the space inside the uterus or in its soft tissue walls. They may be as small as a pea or a cluster of them may become as big as a watermelon and are found in women mainly between the ages of 35 and 50.

There is as yet no definite answer from medical researchers about what causes the growth of uterine fibroids in some women. Suggested causes are prolonged exposure to estrogen, genetics, cells developing in the wrong place since birth, an excess of micronutrients, or stress.

Why Uterine Fibroids Cause Bleeding

Uterine fibroids are affected by hormone imbalances. Therefore, they respond by growing larger during the menstrual cycle when a woman's hormone levels change constantly. The growth irritates the uterus cavity or uterine lining, which then begins to bleed. The soft tissue of the uterine lining will manifest as clots in a heavy bleed. This may be part of a regular menstrual bleed or can even occur in between periods.

Symptoms of Uterine Fibroids

Uterine fibroids affect the uterus's general well-being and normal functioning. If you experience the following symptoms, ask your doctor to check for the presence of uterine fibroids:

  • pelvic pain
  • painful period cramps
  • heavy bleeding or prolonged bleeding during a period (the most common symptom)
  • heavy bleeding between periods
  • missed periods
  • pain during sex
  • lower back pain
  • frequent urination
  • bloating and a distended abdomen
  • a mass that can be felt in the abdomen
  • complications during pregnancy, including the risk of a cesarean delivery

You'll only be sure that these symptoms are caused by fibroids when you've had a pelvic examination by a doctor, and possibly other assessments via an MRI or scanner. A full investigation is necessary to identify fibroids. They may be a real obstacle to fertility, therefore affecting your likelihood of falling pregnant.

How To Stop Fibroid Bleeding

Conducting a complete hysterectomy—removing the uterus and ovaries—is no longer the only treatment available. The current trend is to be minimally invasive and not remove anything, but rather starve the fibroids of hormones or of blood flow. This method aims to shrink the fibroids and to diminish abnormal vaginal bleeding.

This can be done through a variety of non-invasive surgical procedures, most commonly by uterine fibroid embolization (UFE), a process of injecting particles into the arteries that supply the fibroids. Once in the arteries, these particles swell up and block the blood flow to the fibroids, causing the fibroids to shrink dramatically and die. UFE is 95% effective and is considered one of the best treatments for fibroids.

Other Treatment Options for Uterine Fibroids Are:

  • tranexamic acid, a prescription medication taken during the menstrual cycle
  • antifibrinolytics which decrease the clotting and the duration of the bleeding
  • a progesterone IUD which acts as a contraceptive and minimizes bleeding
  • a low-dose birth control pill, which provides counter-acting hormones which shrink the fibroids
  • a prescription of Gonadotropin-releasing hormone agonists (GHA), which releases a hormone in such a way that it reduces estrogen in the body, precipitating a menopause-like state. This deprives the fibroids of estrogen, causing them to shrink and become less active.

These treatments help to stop the bleeding caused by uterine fibroids. However, it remains important to receive specialist gynecological management of the uterine fibroids, because of the risk of diminished fertility.

Treatment of Uterine Fibroids Improves Fertility

After treatment, it is easier to get pregnant because fibroids are less likely to block the fallopian tubes and hinder ovulation. The sperm can then also move freely through a normally shaped cervix, uncluttered by fibroids, as well as in the uterus. Without fibroids preventing the sperm's movement, the likelihood of fertilization increases.

Conclusion

It's vital to get an expert medical assessment of your symptoms if you think you have uterine fibroids. There is help available to relieve all the difficult and painful symptoms as well as to support you when managing your fertility proactively.