Uterine fibroids are non-cancerous growths that develop in or on the uterus. Also known as leiomyomas or myomas, these common growths are composed of muscle and connective tissue. While many individuals with fibroids experience no symptoms, these growths can contribute to fatigue. This article explores the various ways uterine fibroids can cause tiredness and outlines approaches to manage this and other associated symptoms.
How Uterine Fibroids Lead to Fatigue
One of the most frequent ways uterine fibroids cause fatigue is through heavy menstrual bleeding, a condition known as menorrhagia. Fibroids can increase the surface area of the uterine lining and prevent the uterus from contracting properly, leading to excessive or prolonged bleeding during periods. This significant blood loss often depletes the body’s iron stores, resulting in iron-deficiency anemia.
Anemia occurs when the body lacks sufficient healthy red blood cells to transport oxygen throughout the body. When less oxygen reaches tissues and muscles, individuals may experience symptoms such as unusual tiredness, weakness, dizziness, and shortness of breath. The heart also works harder to circulate oxygen-rich blood, further contributing to exhaustion. This physical toll directly manifests as persistent fatigue.
Beyond blood loss, fibroids can interfere with sleep patterns, which in turn leads to fatigue. Pelvic pain, pressure, and cramping caused by fibroids can make it difficult to find a comfortable sleeping position, disrupting restful sleep. Discomfort may intensify at night, making it challenging to fall asleep or remain asleep.
Fibroids that press on the bladder can lead to frequent urination, particularly at night. Waking up multiple times to use the bathroom fragments sleep, preventing the body from achieving restorative rest. Additionally, the chronic stress of managing fibroid symptoms, including unpredictable heavy bleeding, can contribute to mental exhaustion and impact overall sleep quality.
Other Common Symptoms of Uterine Fibroids
Uterine fibroids manifest in various ways, and symptoms often depend on their size, number, and location. Heavy or prolonged menstrual bleeding is common, sometimes accompanied by blood clots. Individuals may also experience fullness or pressure in the lower abdomen.
Fibroids can cause frequent urination when they press against the bladder, or constipation if they exert pressure on the rectum. Lower back or leg pain can occur, especially if fibroids are large or press on nerves. Pain during sexual intercourse and abdominal enlargement (sometimes mimicking pregnancy) are other symptoms.
Diagnosing Uterine Fibroids
The diagnostic process for uterine fibroids typically begins with a physical examination. During a pelvic exam, a healthcare provider may feel for an enlarged uterus or irregular masses. This initial assessment prompts further investigation.
Ultrasound is a primary imaging tool used to confirm the presence of fibroids. This non-invasive test uses sound waves to image the uterus, mapping and measuring fibroids. Both transabdominal and transvaginal ultrasounds can be performed.
Magnetic Resonance Imaging (MRI) offers more detailed images of the uterus, providing a clearer view of fibroid number, size, and location. MRI can also differentiate fibroids from other conditions. For complex cases or specific treatment planning, MRI is recommended. Hysteroscopy, involving a thin, lighted instrument, may be used for direct visualization of fibroids within the uterine cavity.
Managing Fibroid-Related Fatigue
Managing fatigue associated with uterine fibroids often involves addressing the underlying fibroids and their symptoms. For anemia from heavy bleeding, iron supplements replenish iron stores. Dietary adjustments to include iron-rich foods can support recovery. In severe anemia, intravenous iron infusions may be administered.
Medications can help control bleeding and manage fibroid size. Hormonal therapies, such as birth control pills, can reduce heavy menstrual flow. Gonadotropin-releasing hormone (GnRH) agonists and antagonists can temporarily shrink fibroids by lowering estrogen and progesterone, reducing bleeding and improving anemia. Non-hormonal medications like tranexamic acid can reduce heavy bleeding.
Minimally invasive procedures offer options to treat fibroids while preserving the uterus. Uterine Artery Embolization (UAE) blocks blood supply to fibroids, causing them to shrink. Other procedures like radiofrequency ablation or myolysis use heat or energy to destroy fibroid tissue. These interventions alleviate symptoms like heavy bleeding and pressure, which can reduce fatigue.
Surgical options are considered when other treatments are insufficient. Myomectomy is a procedure to remove only the fibroids, leaving the uterus intact, which can improve symptoms and preserve fertility. Hysterectomy, the surgical removal of the uterus, eliminates fibroids and their symptoms, including fatigue, as fibroids cannot regrow. Consulting a healthcare professional helps determine the most appropriate treatment plan.