Uterine fibroids are non-cancerous growths that develop in or on the uterus. They are composed of muscle and connective tissue. These growths are common, with many women developing them during their reproductive years, although not everyone experiences symptoms. Fibroids can vary significantly in size, ranging from microscopic to masses large enough to alter the shape of the uterus.
How Fibroids Can Cause Tiredness
Fibroids can contribute to feelings of tiredness primarily through heavy menstrual bleeding, a common symptom. When fibroids cause excessive or prolonged bleeding during periods, the body can lose more iron than it can replenish. This leads to iron-deficiency anemia, a condition where there are not enough healthy red blood cells to transport oxygen efficiently throughout the body. The reduced oxygen delivery to tissues and organs results in symptoms like fatigue, weakness, dizziness, and shortness of breath.
Beyond blood loss, large fibroids can also indirectly cause fatigue by affecting sleep quality. Fibroids can exert pressure on surrounding organs, leading to discomfort or pain, especially in the pelvic area or lower back. This pain and pressure, along with frequent urges to urinate, can disrupt sleep patterns. Poor sleep then contributes to chronic fatigue.
Other Common Signs of Fibroids
While fatigue is a notable symptom, fibroids often present with a range of other signs. Heavy or prolonged menstrual bleeding is common, sometimes requiring sanitary product changes hourly or periods lasting longer than seven days. This excessive bleeding can also occur between periods.
Many women with fibroids experience pelvic pressure or pain, which can manifest as a constant feeling of fullness or discomfort in the lower abdomen. Large fibroids can press on the bladder, leading to frequent urination or difficulty completely emptying it. Similarly, pressure on the rectum can cause constipation or difficulty with bowel movements. Some individuals also report lower back or leg pain, or pain during intercourse.
Managing Fibroid-Related Fatigue
Addressing fibroid-related fatigue often involves managing the underlying fibroid symptoms, starting with diagnosis through a pelvic exam, ultrasound, or MRI. For fatigue caused by anemia, iron supplements can help replenish iron levels. In severe cases, intravenous iron infusions may be necessary.
Medical treatments can reduce bleeding and manage fibroid symptoms. Hormonal medications like oral contraceptives, hormone-releasing intrauterine devices (IUDs), or gonadotropin-releasing hormone (GnRH) agonists can decrease menstrual bleeding and sometimes shrink fibroids. Nonsteroidal anti-inflammatory drugs (NSAIDs) and tranexamic acid can also reduce heavy bleeding and pain.
For more persistent symptoms, minimally invasive procedures offer alternatives. Uterine fibroid embolization (UFE) involves blocking the blood supply to fibroids, causing them to shrink. Other options include radiofrequency ablation, which uses heat to destroy fibroid tissue, and hysteroscopic myomectomy for fibroids located inside the uterine cavity. Surgical removal of fibroids, known as myomectomy, preserves the uterus, while hysterectomy provides a definitive solution.
When to Talk to a Doctor
Seeking medical advice is advisable if you experience persistent or worsening fatigue, especially if it significantly impacts your daily activities. Heavy or prolonged menstrual bleeding that is disruptive or causes signs of anemia, such as ongoing tiredness and weakness, requires evaluation.
Consult a healthcare provider if you notice new or intensifying pelvic pain, bleeding between periods, or any other concerning symptoms. A doctor can conduct a thorough assessment, including a physical exam and imaging tests, to determine if fibroids are the cause of your symptoms and discuss appropriate treatment options.