Do you feel that your period is particularly heavy? Sometimes a heavy period is just a heavy period. Or it could be an indicator of a larger issue, such as uterine fibroids.
What Are Uterine Fibroids?
One in five women in their reproductive years experience heavy menstrual bleeding, or menorrhagia, according to the Centers for Disease Control and Prevention (CDC). For some, this may be a sign of uterine fibroids, or myomas or leiyomyomas, which are noncancerous growths that develop in the uterus.
Uterine fibroids are common: Up to 80 percent of women develop fibroids by the age of 50, according to the U.S. Department of Health & Human Services. “The prevalence of uterine fibroids is extremely common, depending on age, race, and family history,” says Linda Bradley, MD, the director of the fibroid and menstrual disorders center at Cleveland Clinic in Ohio.
“The racial group with the highest incidence of uterine fibroids are of African descent,” says Dr. Bradley. “They’re less common in Caucasian women.” They’re also thought to develop at a younger age and grow more quickly in Black women.
While they may sound scary, uterine fibroids are typically not life-threatening, and they are treatable.
For some people, uterine fibroids cause no symptoms at all. For others, they contribute to a host of uncomfortable symptoms, such as:
- Heavy menstrual bleeding
- Longer, more frequent periods
- Bleeding between periods
- Anemia due to blood loss
- Abdominal pain and cramping
- Painful sex
- Bladder and bowel pressure
- Difficult, frequent, or urgent urination or bowel movements
- Increased abdominal size
- Miscarriage
- Infertility
How Do Uterine Fibroids Contribute to Heavy Menstrual Bleeding?
Heavy menstrual bleeding is typically defined as a period that lasts more than seven days and requires frequent changing of sanitary products. While there’s no one reason uterine fibroids cause heavy, prolonged periods, there are a few theories.
- Uterine fibroids may press against the uterine lining, causing more bleeding than usual.
- The uterus may not contract properly, which means it can’t stop the bleeding.
- Fibroids may stimulate the growth of blood vessels, which contributes to heavier or irregular periods and spotting between periods.
- Elevated levels of hormones called prostaglandins may also contribute to heavy bleeding.
“Heavy menstrual bleeding related to uterine fibroids is typically based on the location of the fibroids, contractility of the uterus, the presence of ancillary prostaglandins, and any distortion to the lining of the uterus,” explains Bradley.
Confirming a Uterine Fibroid Diagnosis
If you’re experiencing heavy periods, it’s important to talk to your doctor. “While fibroids are common, about half of women with uterine fibroids don’t experience heavy bleeding,” says Bradley.
So it’s important to get to the root of your heavy periods, whether it’s uterine fibroids or something else. “Heavy menstrual bleeding can have many causes,” explains Bradley, including:
To determine if your symptoms are due to uterine fibroids, your doctor will likely perform a pelvic exam to check for irregularities in the size or shape of your uterus, which may indicate the presence of fibroids. Other tests, such as an ultrasound or pelvic MRI, may be needed to confirm a diagnosis.
“You have to find a doctor who looks at everything: your medical history, family history, plus imaging and blood tests,” says Bradley.
How to Find the Right Treatment for Uterine Fibroids and Heavy Menstrual Bleeding
If your heavy periods are due to uterine fibroids, it’s important to be treated to improve your quality of life, says Bradley.
“If you bleed a lot, you can become anemic,” she explains. “You may experience symptoms like fatigue, hair loss, headaches, insomnia, palpitations, even pica, or cravings for unusual things.”
Potential treatment options for heavy menstrual bleeding related to uterine fibroids include:
“Treatment is quite individualized,” says Bradley. “Work with your doctor to find the most minimally invasive way to treat your condition, based on your age, desire for fertility, and the size and location of the fibroids.”
