Fibroids & Heavy Menstrual Bleeding
Symptoms of Fibroids
Excessive menstrual bleeding (medically termed ‘menorrhagia’) is one of the most common symptoms reported by women with uterine fibroids.¹
Bleeding abnormalities caused by uterine fibroids include:²
• Heavy menstrual bleeding with fibroids
• Prolonged duration of menstrual bleeding - longer than 6 days³
• Fibroids bleeding between periods
• Frequent periods - more often than every 24 days³
• Irregular / unpredictable periods
Bleeding abnormalities are not exclusive to uterine fibroids and may indicate another condition, but women with a diagnosis of uterine fibroids report bleeding problems 2-3 times more frequently than women without a diagnosis of uterine fibroids.²
Many women with excessive menstrual bleeding mistakenly assume that their heavy periods are normal and do not seek care.⁴ In some women, excessive bleeding can be severe enough to cause iron-deficiency anemia; leading to fatigue, weakness, headaches, dizziness, and other more severe complications. Other women experience day-to-day discomfort, social isolation, and loss of productivity as a consequence of managing heavy periods.¹⁻²
Connection Between Fibroids and Heavy Bleeding
Heavy bleeding in women with uterine fibroids has been attributed to fibroids in the intramural (in the wall of the uterus) and submucosal (just underneath the uterine lining) locations.⁵ While the exact cause and effect relationships have not been established, a few theories have been proposed to explain why bleeding increases in women with uterine fibroids: ¹
• Fibroids in these locations can increase the surface area of the uterine lining, meaning that more menstruate is expelled during your period.
• The formation of fibroids increases vascularity of the uterine lining to feed the fibroids, increasing the availability of blood.
• Fibroids interfere with normal uterine contractility.
• Fibroids just underneath the uterine lining render the lining more susceptible to ulceration, which could also contribute to bleeding between periods if you have fibroids.
• Fibroids may compress the venous plexus within the myometrium, causing congestion of the myometrium and endometrium, leading to heavy bleeding.
If your periods are abnormally heavy, last longer than a week, or you’re experiencing bleeding between periods, you may be living with uterine fibroids. You can review other symptoms of uterine fibroids here.
 Gupta, S., Jose, J., & Manyonda, I. (2008). Clinical presentation of fibroids. Best Practice and Research: Clinical Obstetrics and Gynaecology, 22(4), 615–626.
 Zimmermann, A., Bernuit, D., Gerlinger, C., Schaefers, M., & Geppert, K. (2012). Prevalence, symptoms and management of uterine fibroids: An international internet-based survey of 21,746 women. BMC Women’s Health, 12(1), 6.
 Marret, H., Fauconnier, A., Chabbert-Buffet, N., Cravello, L., Golfier, F., Gondry, J., … Fernandez, H. (2010). Clinical practice guidelines on menorrhagia: Management of abnormal uterine bleeding before menopause. European Journal of Obstetrics Gynecology and Reproductive Biology, 152(2), 133–137.
 Nelson, A. L., & Ritchie, J. J. (2015). Severe anemia from heavy menstrual bleeding requires heightened attention. American Journal of Obstetrics & Gynecology, 213(1), 97.e1-97.e6.
 Stewart, E. A. (2001). Uterine fibroids. Lancet, 357(9252), 293–298.