Fibroids and Anaemia: Could Heavy Periods Be the Cause?

Heavy periods and the tiredness that follows are easy to dismiss as just another part of your cycle. But when fibroids are driving the bleeding, that exhaustion often has a name: anaemia. 

Knowing the difference between a difficult month and a condition that is quietly depleting your iron levels could change what you do next. 

What are uterine fibroids?

Fibroids are benign (noncancerous) growths that develop in the muscle wall of the uterus. They are common during the reproductive years, particularly in women in their 30s and 40s. Their growth is influenced by hormones such as oestrogen and progesterone . 

Depending on where they grow, fibroids are described differently: 

• Intramural fibroids grow within the uterine wall

• Submucosal fibroids project into the uterine cavity

• Subserosal fibroids extend outward from the uterus

• Pedunculated fibroids grow on a stalk, either inside or outside the uterus

Some women with fibroids have no symptoms at all, while others experience heavy periods, pelvic pain, pressure symptoms, or difficulty conceiving. 

What is anaemia?

Anaemia is a condition where the body does not have enough healthy red blood cells or haemoglobin to carry oxygen effectively. Haemoglobin is the protein inside red blood cells that carries oxygen from the lungs to your body's tissues and organs.

When haemoglobin levels fall too low, your body receives less oxygen than it needs. You may notice symptoms such as fatigue, dizziness, breathlessness, and weakness.

The most common type linked to fibroids is iron deficiency anaemia. This happens when heavy or prolonged bleeding causes the body to lose more iron than it can replace.

How fibroids can lead to anaemia

The main way fibroids cause anaemia is through persistent blood loss. Fibroids that grow close to or into the uterine cavity, especially submucosal fibroids, are more likely to cause heavy or prolonged menstrual bleeding. 

Fibroids that grow outward from the uterus may be more likely to cause pressure symptoms, depending on their size and location. They may also interfere with the uterus's ability to contract and control bleeding. 

Over time, this can lead to:

Heavy periods 

Fibroids can cause periods that are much heavier than usual. You may find yourself soaking through pads or tampons quickly, passing large blood clots, or needing to change your protection frequently throughout the day and night. 

Prolonged periods 

Some women with fibroids experience periods lasting longer than seven days. Even when the daily flow seems manageable, bleeding over many days each month can steadily deplete your body's iron stores. 

Ongoing blood loss over time

When heavy or prolonged bleeding happens repeatedly over months or years, your body may not be able to replace lost iron fast enough. This can lead to iron deficiency and eventually iron deficiency anaemia.

In more severe cases, management may involve iron supplements, intravenous iron, or occasionally a blood transfusion. Addressing the fibroids themselves may also be recommended to help prevent the anaemia from returning.

Persistent fatigue and heavy menstrual bleeding should not be dismissed as something you simply have to live with. Request an appointment with Thomson Medical for timely evaluation, appropriate investigations, and guidance on suitable next steps for care.

When is a period considered “heavy”?

You may be experiencing heavy menstrual bleeding if you: 

• Need to change pads or tampons every 1 to 2 hours

• Pass large clots

• Bleed for more than 7 days

• Need to wake up at night to change your menstrual protection 

Heavy bleeding is also worth discussing with a doctor if it affects your daily activities or leaves you feeling unusually tired. 

What symptoms can fibroid-related anaemia cause?

Fibroid-related anaemia often develops gradually, which means symptoms can be easy to overlook or dismiss at first. Many women adapt to feeling constantly tired without realising that ongoing blood loss may be the cause. 

You may notice a range of symptoms, including:

• Fatigue or weakness, even after rest

• Dizziness or lightheadedness, especially when standing up quickly

• Shortness of breath with mild activity

• Palpitations, such as a racing or fluttering heartbeat

• Pale skin, lips, or nails

• Persistent headaches or difficulty concentrating

If these symptoms sound familiar, especially alongside heavy or prolonged periods, it is worth speaking with your doctor rather than waiting for them to improve on their own.

How is fibroid-related anaemia diagnosed? 

If your doctor suspects fibroids or iron deficiency anaemia, they will usually begin by asking about your symptoms and menstrual bleeding patterns. 

To get a clearer picture, your doctor may arrange further investigations:

• Ultrasound scan to detect fibroids and assess their size and location

• MRI scan in more complex situations or when treatment planning is needed

• Blood tests to check haemoglobin levels, ferritin (which reflects your iron stores), and a full blood count

Your doctor may also consider other possible causes of anaemia, such as dietary iron deficiency, pregnancy, bleeding disorders, gastrointestinal blood loss, or other causes of abnormal uterine bleeding. This helps ensure the treatment plan addresses the actual cause of low iron or low haemoglobin. 

Early diagnosis can help prevent anaemia from becoming more severe. It also allows treatment to begin before symptoms have a greater impact on your daily life.

Treatment options for fibroid-related anaemia 

Managing fibroids and anaemia usually involves treating both conditions together. Improving iron levels helps you feel better in the short term, while treating the fibroids addresses the ongoing blood loss. 

Treating anaemia

Each treatment option has potential benefits, risks, and recovery considerations. Your doctor will discuss these with you before recommending a treatment plan.  

Options may include:

• Oral iron supplements are often the first step for mild to moderate anaemia, though it usually takes time to rebuild iron stores, and some people may need to continue treatment for a period even after haemoglobin improves 

• Iron-rich foods, such as leafy greens, red meat, lentils, beans, and fortified cereals

• Vitamin C with meals, which can improve iron absorption

• Intravenous iron, given through a drip if anaemia is more severe or oral iron is not well tolerated

• Blood transfusion, used in more serious cases to rapidly restore haemoglobin levels

Treating fibroids to reduce bleeding

Reducing or controlling heavy bleeding is key to preventing anaemia from returning. Depending on your situation, your doctor may discuss a range of treatment options.

Medical treatments may include:

• Hormonal contraceptives such as the pill, which help regulate hormone levels and reduce heavy or irregular bleeding

• Progestogen-releasing coils, which release a small amount of progestogen to thin the uterine lining and reduce menstrual blood loss

• Medications to help shrink fibroids and reduce bleeding by lowering the hormones that stimulate fibroid growth

If medical treatment is not sufficient, procedural or surgical options may be considered:

• Uterine artery embolisation (UAE) is a minimally invasive procedure that reduces blood supply to fibroids, causing them to shrink

• Myomectomy is a surgical procedure to remove fibroids while keeping the uterus intact

• Hysterectomy involves removal of the uterus and may be discussed when symptoms are severe and other treatments have not brought enough relief

The most suitable approach will depend on your symptoms, the size and location of your fibroids, and whether you are planning a future pregnancy. Your doctor will help you understand which option is most appropriate for your situation. 

When to seek urgent help

While anaemia from fibroids often develops slowly, there are times when it can become more serious and needs prompt attention, especially if your symptoms are severe. 

Doctors may also consider urgent treatment when haemoglobin levels are very low, but the decision depends on your symptoms, overall health, and whether bleeding is ongoing. 

Seek medical attention promptly if you notice:

• Extreme fatigue that prevents you from carrying out normal daily activities

• Breathlessness at rest or with very minimal movement

• A rapid or irregular heartbeat that feels new or worsening

• Fainting or near-fainting episodes

• Very pale skin, including the inner eyelids or nail beds

These signs suggest that your haemoglobin may have dropped significantly. Getting seen quickly means treatment can start sooner and prevent further complications.

Preventing anaemia from returning 

Living with fibroids does not have to mean living with fatigue and heavy periods. With appropriate monitoring and treatment, many women are able to manage heavy bleeding and anaemia more effectively. 

There are some practical steps that may help you stay ahead of things:

• Attend regular check-ups so your doctor can track any changes in fibroid size and catch problems early

• Have periodic blood tests to monitor your iron levels before anaemia becomes severe

• Include iron-rich foods in your everyday diet regularly

• Take iron supplements if your doctor recommends them, and try to take them consistently

• Speak to your doctor promptly if your periods are becoming heavier, longer, or harder to manage

Heavy periods and persistent tiredness can be managed with the right support. If your symptoms are affecting your daily life, speaking to your doctor early means treatment can begin before things become harder to manage.

If heavy periods or ongoing fatigue is affecting your daily life, requesting an appointment with Thomson Medical can help identify whether fibroids or iron deficiency may be contributing to your symptoms and what treatment options may help.

FAQ

Can fibroids cause severe anaemia?

How do I know if my anaemia is caused by fibroids?

Can iron supplements treat fibroid iron deficiency?

Will anaemia improve after fibroid treatment?

Yes, treating fibroids often improves anaemia by reducing or stopping heavy bleeding. Once blood loss is controlled, iron supplementation and dietary measures can help restore normal haemoglobin and iron stores over time. Recovery depends on how severe the anaemia was and how effectively the bleeding is managed.

When is a blood transfusion needed for fibroid-related anaemia?

A blood transfusion may be necessary when anaemia becomes severe. This may apply if you experience chest discomfort, fainting, severe weakness, shortness of breath at rest, or very low haemoglobin levels. Transfusions provide rapid stabilisation while longer-term treatment for fibroids and iron deficiency is arranged.

Can anaemia return if fibroids are untreated?

Yes, anaemia can recur if fibroids continue to cause heavy or prolonged bleeding. Even after iron levels improve temporarily, ongoing blood loss may gradually deplete iron stores again if the fibroids are not managed.

Should fibroids or anaemia be treated first?

Both conditions are usually managed together, but the priority depends on severity. Mild to moderate anaemia may be treated with iron supplements while planning fibroid treatment. Severe or symptomatic anaemia may require urgent stabilisation with iron therapy or blood transfusion before fibroid treatment can begin.

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 situations, please consult a specialist at Thomson Medical. Request an appointment with Thomson Medical today.