Can Fibroids Cause Hormonal Imbalance? What You Need to Know

Heavier periods and persistent tiredness often arrive together, and if a scan has picked up fibroids along the way, it’s natural to assume they explain everything. Fibroids do cause heavy bleeding, and heavy bleeding can lead to iron deficiency anaemia, which is a common reason for feeling tired. 

What fibroids don’t do is directly cause hormonal imbalance; they respond to oestrogen rather than produce it, so symptoms that look hormonal, such as thyroid problems or PMOS, which was formerly known as PCOS. Here’s what fibroids can and can’t explain and what else is worth checking.

What are uterine fibroids?

Uterine fibroids are non-cancerous growths that develop around or within your uterus (womb). They are made of muscle and fibrous tissue and may range from very small (about the size of a pea) to several centimetres across. But not all women with fibroids experience symptoms, as these growths sometimes cause no symptoms at all.

When symptoms do appear, some of the most common symptoms you might notice include: 

• Heavy menstrual bleeding

• Pelvic pain, pressure, or discomfort

• A sensation of fullness or swelling in the lower abdomen

• Difficulty conceiving or carrying a pregnancy

• Bladder or bowel changes, such as needing to urinate more frequently or feeling constipated

What symptoms you experience and how severe they are tend to depend on the size, number, and location of the growths. This is why women with fibroids could have different experiences.

Can fibroids cause a hormonal imbalance?

Fibroids themselves do not directly cause hormonal imbalances. Your blood levels of oestrogen and progesterone remain generally the same, regardless of whether you have fibroids. However, hormones such as oestrogen and progesterone may stimulate their growth, resulting in symptoms such as menstrual irregularities that resemble signs of a hormonal imbalance.

How do fibroids and hormones interact?

Since oestrogen and progesterone – the hormones that regulate your menstrual cycle – play a role in stimulating these abnormal growths, this is how the relationship works:

• Oestrogen supports fibroid growth:

  • Fibroid cells contain more oestrogen receptors than the surrounding uterine tissue, which means they respond more strongly to oestrogen and could enlarge over time.

  • Oestrogen may also make these abnormal growths more responsive to progesterone.

• Progesterone stimulates cell division:

  • This hormone could stimulate fibroid growth by promoting cell division within fibroid tissue.

• Fibroid tissue produces oestrogen locally:

  • Fibroid tissue contains an enzyme called aromatase, which converts androgens into oestrogen inside the fibroid itself.

  • This creates a small localised hormonal environment that supports the fibroid's continued growth but does not usually raise the overall hormone levels in your blood.

Because oestrogen and progesterone levels fall after menopause, fibroids may become smaller and symptoms may improve. However, this does not happen for everyone.

What are the signs of hormonal imbalance?

As fibroids grow in response to hormones, they may make hormonal symptoms more noticeable and make your cycle less manageable. You may experience some of the following changes:

• Irregular or unusually heavy periods

• Prolonged bleeding lasting more than seven days

• Severe premenstrual syndrome (PMS)

• Fatigue or low energy, often linked to iron loss from heavy bleeding

• Mood changes, such as irritability or low mood

• Unexplained weight changes or difficulty losing weight

• Changes in sexual drive

When should you see a doctor?

Noticing one or two of the above symptoms does not necessarily mean that something is wrong. However, you should consider seeing a doctor if:

• Your symptoms have been persistent or are getting worse over time

• Heavy or prolonged bleeding is affecting your energy, mood, or daily life

• You suspect you may be anaemic

• Mood changes, low libido, or skin and hair changes are significantly affecting your well-being

• You are planning a pregnancy or have been struggling to conceive

• You experience any vaginal bleeding after menopause

Speaking to your doctor about your symptoms means any underlying causes may be identified and the suitable care could be arranged for you. Request an appointment with Thomson Medical.

How to manage fibroids and support your hormones

Treatment is not the same for every woman, and your doctor will consider your symptoms, the size and location of your fibroids, and whether you are hoping to have children in the future. 

Medical treatment options

A range of medications and procedures may help manage fibroids. Depending on your situation, your doctor may discuss one or more of the following:

• Non-hormonal medications:

  • Tranexamic acid or anti-inflammatory medicines could help reduce heavy bleeding and ease period pain.

• Hormonal contraceptives:

  • The combined pill or a progestogen-releasing intrauterine device (IUD) may help reduce heavy bleeding and regulate your cycle.

• GnRH agonists and antagonists:

  • These work by temporarily lowering oestrogen and progesterone levels, which may shrink fibroids. They are typically used for short periods, often in preparation for surgery.

• Minimally invasive procedures:

  • Options such as uterine fibroid embolisation or focused ultrasound treatment may reduce fibroid size without the need for major surgery.

• Surgery:

  • Myomectomy removes the fibroids while preserving the uterus. 

  • Hysterectomy, which involves removal of the uterus, may be considered where symptoms are more severe and other treatments have not provided sufficient relief.

When deciding which treatment is suitable for you, your doctor will usually start with the least risky options and only consider more invasive treatments if your symptoms are still not under control.

Lifestyle changes

Alongside medical treatment, adopting certain everyday habits may support your hormonal balance and help you return to your usual daily activities. While these are not a replacement for medical care, they may help improve your overall well-being over time.

• For example, regular exercise could help to regulate hormones, support a healthy weight and improve blood flow to the pelvis.

• Stress management, such as yoga, gentle breathwork, or protecting your sleep, may all help your body regulate hormones more effectively.

• Avoiding smoking and limiting alcohol may also help, as both could influence how your body processes oestrogen.

However, you should note that while lifestyle habits may support overall health and symptom management, they cannot reliably shrink fibroids or correct an underlying hormonal condition on their own.

Diet

You do not need to follow a strict or complicated diet, but the foods you choose may influence inflammation and hormonal balance over time. 

As a general guide, including the following in your meals regularly may help:

• Fruits and vegetables, especially leafy greens and berries

• Whole grains, such as oats, brown rice, and wholemeal bread

• Lean protein, such as fish, legumes, and poultry

• Healthy fats, from sources like nuts, seeds, and oily fish

On the other hand, it may be worth reducing your intake of processed foods, refined sugars, sweetened drinks, and large amounts of red meat, as these have been linked to higher inflammation and may worsen your symptoms over time.

FAQ

What happens if fibroids are left untreated?

What tests can detect hormonal imbalance?

Should I see a gynaecologist for hormonal imbalance?

Yes, it is advisable to see a gynaecologist if you experience irregular periods, heavy bleeding, severe PMS, fertility issues, or other signs of hormonal imbalance. Your specialist can identify the underlying cause and recommend appropriate treatment or management strategies.

How do I know if my fibroids are getting worse?

Fibroids may be progressing if they increase in size or number, or if symptoms become more severe. Signs include heavier or longer periods, worsening pelvic pain or pressure, urinary or bowel changes, bloating, and abdominal enlargement. Regular imaging such as ultrasound or MRI helps monitor changes over time.

The information provided is intended for general guidance only and should not be considered medical advice. For personalised recommendations and tailored advice based on your unique conditions, request an appointment with Thomson Medical.