Do Fibroids Cause Constipation? What Every Woman Should Know

Constipation isn’t the symptom most people associate with fibroids, but the anatomy explains it. The bowel sits directly behind the uterus, so a fibroid that’s growing on the back wall of the womb, if large enough, can press against the rectum and make stools harder to pass. Some notice incomplete emptying or a sense of pressure low down that doesn’t ease after going.

Constipation has plenty of more common causes, and fibroids are well down the list. But when it appears alongside heavy periods or pelvic pressure, the connection is worth knowing about. Here's how fibroids affect the bowel, what tends to distinguish it from ordinary constipation, and which other symptoms usually appear with it.

What are fibroids?

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

They are most commonly diagnosed during a woman's reproductive years, typically between the ages of 30 and 50. This is because, although the exact cause of fibroids is not fully understood, oestrogen and progesterone – the hormones that regulate your menstrual cycle – play a role in stimulating their growth. 

Do fibroids cause constipation?

As fibroids may grow to several centimetres in size, they could put pressure on nearby organs, particularly the rectum and lower bowel. This reduces the space needed for stool to pass through, slowing its movement and making it harder to pass normally. As a result, you may experience constipation, straining or a feeling that your bowels are not fully empty.

Additionally, hormonal changes during your menstrual cycle may also affect bowel habits. Progesterone levels rise after ovulation and may slow the natural movement of the gut, which may contribute to constipation. Though this hormone-related slowing is not caused by fibroids, it could make constipation more noticeable when fibroids are also putting pressure on the bowel.

These factors may occur independently or at the same time, so it may be difficult to identify whether constipation is mainly related to fibroid pressure or cycle-related hormone changes. or another cause.

If bowel changes are affecting your daily comfort, request an appointment with Thomson Medical. Our specialists could evaluate whether fibroids are contributing and recommend care based on your symptoms and fibroid size.

Which fibroids are most likely to cause constipation?

Although fibroids may put pressure on nearby organs, particularly the rectum, not all fibroids affect the bowel in the same way. The location of the fibroids within or around your uterus plays a role in determining which symptoms develop.

The types of fibroids most likely to cause bowel symptoms include:

• Subserosal fibroids: 

  • This type of fibroid grows on the outer surface of your womb. So, if they develop on the back wall (posterior), they are in close proximity to your rectum and are more likely to cause pressure on your bowels.

• Intramural fibroids:

  • These growths sit within your uterine wall. However, when they grow large, they could significantly increase the size of your uterus, putting pressure on your bowel.

• Pedunculated fibroids:

  • As these growths are attached to the uterus by a thin stalk, if a large pedunculated fibroid settles near the bowel, it may cause significant pressure symptoms.

• Submucosal fibroids: 

  • As they grow inside your uterine cavity, they are generally less likely to cause bowel issues; their primary impact is usually on menstrual flow and fertility unless they grow large enough to significantly enlarge your entire uterus.

Smaller fibroids growing inside your womb are less likely to affect bowel habits on their own. However, if you have several fibroids together, they could still make the womb bigger and put enough pressure on the rectum or lower bowel, which may contribute to constipation.

How is fibroid-related constipation diagnosed?

If you are experiencing constipation alongside other fibroid symptoms, your doctor will want to understand your symptoms in full.Diagnosis typically includes:

• A review of your symptom history

• A pelvic exam

• Diagnostic imaging tests, often beginning with a transvaginal ultrasound

• Magnetic resonance imaging (MRI) in more complex cases

Your doctor may also rule out other causes, such as:

• Dietary factors

• Thyroid disorders

• Irritable bowel syndrome (IBS)

• Medication side effects

If your constipation eases when fibroid size reduces, this helps confirm that the fibroids are the likely cause. This pattern may help your doctor guide the right treatment options for you.

How could constipation related to fibroids be managed?

Managing fibroid-related constipation often involves a combination of approaches. You may find relief through simple daily changes, medicines, or treatment aimed at the fibroids themselves.

Lifestyle tips

Simple dietary and lifestyle changes may help ease symptoms, even if they do not treat the fibroids directly. Simple steps that may help include:

• Increase fibre gradually through fruits, vegetables, and whole grains

• Drink plenty of water throughout the day

• Walk daily to help stimulate bowel movement

• Try not to delay when you feel the urge to use the toilet

Additionally, repeatedly delaying the urge to use the toilet may weaken the body's signals over time, making constipation harder to manage. Therefore, responding promptly when the urge arises could support better long-term bowel function.

Medicines

If lifestyle changes are not enough, medications may be used to provide short-term relief. Your doctor may suggest:

• Stool softeners

• Osmotic laxatives (medicines that draw water into the bowel to soften stools)

• Fibre supplements

These are generally used for short-term relief while the root cause is being looked into.

Treating the fibroids

If pressure from the fibroids is the main cause, treating them directly may offer more lasting relief. Your doctor may discuss the following options with you:

• Hormonal therapy: which may help regulate the hormones that influence fibroid growth.

• Uterine artery embolisation (UAE): which blocks the blood supply to fibroids, causing them to shrink.

• Myomectomy: a minimally invasive surgery, which removes fibroids while preserving the uterus.

• Hysterectomy: which removes the uterus entirely, preventing uterine fibroids from recurring in the future.

When pressure on your bowels is reduced, your bowel function will often improve as well. So, it is worth tracking your bowel symptoms alongside your other fibroid-related symptoms. If your constipation worsens at certain points in your cycle, this information may help your doctor understand how your fibroids are affecting the surrounding area.

When should you see a doctor?

Constipation linked to fibroids is worth raising with your doctor, especially if it is affecting your daily routine. Some symptoms, however, need prompt medical attention.

See your doctor promptly if you notice:

• Severe or worsening constipation

• Stools that are noticeably narrow or pencil-thin

• Blood in your stool

• Unintentional weight loss

• Severe abdominal and pelvic pain

• No bowel movement for several days despite treatment

These symptoms may sometimes point to other conditions that need proper assessment. Getting checked promptly means any other causes could be ruled out, and the right care may be arranged.

If you experience unusual symptoms such as blood in your stool or ongoing discomfort, it is recommended that you consult a doctor for a diagnosis. Request an appointment with Thomson Medical to discuss your care options and management plan.

FAQ

Can fibroids affect bowel movements even if they are small?

Small fibroids are less likely to cause constipation. However, fibroids positioned near or pressing against the rectum may still lead to bowel symptoms, even if they are not very large.

Are all fibroids likely to cause constipation?

No, most fibroids do not cause bowel problems. Constipation is more commonly associated with larger fibroids or those located at the back of your uterus, where they can press on the rectum.

How do doctors treat constipation caused by fibroids?

Can constipation improve after fibroid treatment?

Yes, many people notice improvement after fibroids are treated, especially if constipation was caused by pressure on the bowel. Reducing or removing the fibroids can help restore more normal bowel function.

How can I prevent constipation if I have fibroids?

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 a consultation with Thomson Medical.