Uterine fibroids are non-cancerous growths that develop within or on the muscular wall of the uterus. They are extremely common, yet their presence can sometimes lead to systemic health problems that extend beyond reproductive health. Many people who have fibroids experience symptoms like heavy bleeding, but they may not immediately connect these growths to other issues, such as feeling lightheaded or dizzy. The relationship between uterine fibroids and these systemic symptoms is not direct, but rather a chain reaction stemming from a common complication.
How Fibroids Lead to Dizziness
Fibroids themselves do not typically cause dizziness; instead, the root cause is often heavy and prolonged menstrual bleeding (menorrhagia). Chronic blood loss depletes the body’s iron stores faster than they can be replenished, leading directly to iron-deficiency anemia.
Iron is necessary for hemoglobin, the protein in red blood cells that transports oxygen throughout the body. Anemia reduces circulating hemoglobin, meaning the blood cannot carry enough oxygen. When oxygen delivery to the brain is compromised, cerebral hypoxia occurs, which the body registers as lightheadedness or dizziness.
The heart may begin to beat faster (tachycardia) to compensate for the low oxygen-carrying capacity of the blood. These rapid heartbeats can also contribute to feelings of dizziness and physical discomfort.
Other Common Symptoms of Anemia and Fibroids
The underlying iron deficiency that causes dizziness also manifests in other physical changes due to the body’s struggle to circulate oxygen efficiently. Anemia-related symptoms include extreme fatigue and weakness, shortness of breath, a pale appearance to the skin (pallor), and an unusual sensitivity to cold, particularly in the hands and feet.
Fibroids can cause other symptoms due to their size and location within the pelvis. As fibroids grow, they can exert significant pressure on surrounding organs, leading to pelvic pressure, a feeling of fullness, or an increase in the size of the abdomen.
Physical compression may also cause functional issues, such as frequent urination. A large fibroid pressing against the bladder can reduce its capacity or create a constant urge to urinate.
Confirming the Diagnosis
Confirming that fibroids are the cause of systemic symptoms like dizziness requires a two-pronged diagnostic approach. To confirm iron-deficiency anemia, a healthcare provider typically orders a Complete Blood Count (CBC), which measures hemoglobin and hematocrit levels to indicate the severity of the anemia.
Further blood work, such as an iron panel, checks the body’s iron stores, particularly serum ferritin levels. Low ferritin confirms a true iron deficiency, distinguishing this condition from other potential causes of anemia.
To locate and characterize the fibroids, imaging tests are required. The most common initial test is a transvaginal ultrasound, which confirms the presence, size, and location of the growths. A Magnetic Resonance Imaging (MRI) scan may also be performed to provide a detailed map of the fibroids, often helpful for surgical planning.
Treatment Approaches
Managing fibroid-related dizziness involves simultaneously addressing the immediate symptom of anemia and treating the underlying fibroids. For the anemia, relief comes from iron supplementation, either through high-dose oral tablets or, in severe cases, intravenous (IV) iron infusions. IV iron rapidly replenishes stores and helps the body produce healthy red blood cells faster than oral supplements.
Medical Management
Medical therapies focus on reducing bleeding or eliminating the fibroids. These include hormonal contraceptives or the non-hormonal medication tranexamic acid, both of which reduce the volume of menstrual flow. Gonadotropin-releasing hormone agonists (GnRH-a) may also be used short-term to temporarily shrink the fibroids and stop bleeding prior to a procedure.
Surgical and Minimally Invasive Options
Minimally invasive options like Uterine Fibroid Embolization (UFE) involve blocking the blood supply to the fibroids, causing them to shrink and significantly reducing heavy bleeding. Surgical approaches include a myomectomy (removing fibroids while preserving the uterus) or a hysterectomy (eliminating the possibility of recurrence). The choice of treatment depends on symptom severity, fibroid location, and whether the patient wishes to preserve fertility.