If you’ve been dealing with heavy periods, pelvic pressure, or pain that feels out of proportion to what you’ve been told is ‘normal’, fibroids might be part of the picture. Fibroids affect roughly 1 in 3 women in the UK by age 50, making them one of the most common gynaecological conditions there is. And yet many women live with them for years without a diagnosis.
Fibroids are non-cancerous growths that develop in or around the uterus. They’re made of muscle and fibrous tissue and they’re almost entirely driven by hormones — specifically oestrogen. They’re not dangerous in the way that cancer is, but they can have a significant impact on quality of life and that impact is routinely minimised.
Part of the problem is that fibroid symptoms are easy to dismiss as ‘just heavy periods’ or ‘bad PMS.’ Many women are told their period is normal when it isn’t, or just offered pain relief rather than investigation. Discover what your period can say about your health.
Not all fibroids are the same and where they sit in relation to the uterus makes a significant difference to the symptoms they cause.
These grow within the muscular wall of the uterus and are the most common type. They can cause the uterus to enlarge, leading to heavier, longer periods, a feeling of fullness or pressure in the pelvis and sometimes lower back pain.
These develop just beneath the lining of the uterus and push inward into the uterine cavity. They’re the type most likely to cause very heavy or prolonged bleeding and in some cases can affect fertility. Even a small submucosal fibroid can cause disproportionately heavy periods.
These grow on the outside of the uterus and tend to cause pressure-related symptoms rather than bleeding problems. These can be pelvic pressure, back pain and frequent urination as the fibroid presses on the bladder.
Fibroid symptoms vary enormously. Some women with fibroids have no symptoms at all. In fact, fibroids are sometimes discovered incidentally during an ultrasound for something unrelated. Please don’t read this list and panic. But if several of these resonate, it’s worth having a conversation with your GP.
Fibroids are oestrogen-dependent, which explains a lot about when and why they develop. They grow during the reproductive years when oestrogen is active and often enlarge during pregnancy when oestrogen levels are high. They tend to shrink after menopause when oestrogen declines.
Oestrogen dominance - where oestrogen is relatively high compared to progesterone - is thought to be a significant driver of fibroid growth. This can happen at any point in the reproductive years, but is particularly common in the late 30s and 40s as progesterone starts to decline while oestrogen remains relatively elevated.
Diet, body weight, stress and gut health can all influence oestrogen levels in the body. This is why lifestyle factors can sometimes affect how fibroids behave, even if they can’t be treated through lifestyle alone.
This is one of the most searched questions around fibroids and it’s a difficult one because the symptoms do overlap, particularly around pain and bloating. Here’s how to think about it.
PMS symptoms are cyclical — they appear in the 1–14 days before your period and resolve within a day or two of it starting. Fibroid symptoms, particularly pelvic pressure, back pain and urinary symptoms, tend to be more persistent and less tied to a specific point in the cycle.
PMS doesn’t typically cause heavier periods - it affects mood, bloating and pain, but not usually the volume of blood loss. If your periods are very heavy (flooding, clots, or lasting more than 7 days), that’s a fibroid signal rather than a PMS one.
If your pain doesn’t resolve when your period starts, if you’re experiencing significant pressure or urinary symptoms, or if your periods have become noticeably heavier over time, these are signs that something more than PMS might be going on.
Chronic stress affects hormone balance by elevating cortisol, which can in turn suppress progesterone production. Lower progesterone relative to oestrogen can create an environment where fibroids are more likely to grow or cause symptoms. Managing stress isn’t a cure for fibroids, but it’s part of the bigger picture. You may be interested in reading about whether stress can delay your period.
Some foods contain compounds that interact with oestrogen in the body. Phytoestrogens - found in soy, flaxseeds and some legumes can have a modulating effect. A diet high in processed foods, alcohol and refined carbohydrates can contribute to inflammation and may affect how oestrogen is metabolised. Cruciferous vegetables (broccoli, kale, Brussels sprouts) support healthy oestrogen metabolism via a compound called DIM and are generally worth including. Continue reading about how diet can impact your hormones.
Nutrition can’t treat fibroids. If fibroids are causing significant symptoms, medical assessment and treatment are essential. But nutritional support can help manage some of the downstream effects of fibroids and is worth taking seriously.
Heavy periods caused by fibroids can lead to significant iron loss and iron deficiency is one of the most common and most overlooked) consequences. Fatigue, brain fog, breathlessness and poor concentration are all signs of low iron. If you’re experiencing very heavy periods, getting your iron levels checked and supplementing if needed is important. Try to avoid ferrous sulfate, which is poorly absorbed. Continue reading about why iron is so important for women.
Magnesium helps relax smooth muscle, which may help with cramping and pelvic tension associated with fibroids. It’s also involved in hundreds of bodily processes, including nervous system regulation and sleep, both of which can be affected when you’re dealing with ongoing pain or heavy bleeding. Continue learning about why women need magnesium.
Please see your GP if:
You deserve to be investigated, not dismissed. If your GP doesn’t take your symptoms seriously, you are entitled to ask for a referral or seek a second opinion. An ultrasound is typically the first line of investigation and is a straightforward procedure.
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