Uterine fibroids are common, non-cancerous growths that develop in the uterus. They are composed of muscle and connective tissue. While many individuals with fibroids experience no symptoms, abnormal uterine bleeding is a frequently reported concern. The duration and characteristics of this bleeding can vary considerably.
Understanding Fibroid-Related Bleeding
Fibroid-related bleeding often presents as prolonged menstrual periods (menorrhagia), bleeding between periods (metrorrhagia), or unusually heavy menstrual flow. The duration of bleeding can extend beyond the typical 7 days, sometimes lasting for weeks or involving constant spotting. Characteristics include a heavy flow that necessitates frequent changes of sanitary products, often every hour or two, and the passage of large blood clots. This extended and heavy bleeding can significantly disrupt daily life.
Factors Influencing Bleeding Duration
The duration and intensity of fibroid bleeding are influenced by several factors, including their number, size, and location within the uterus. Fibroids that grow just beneath the inner lining of the uterus, called submucosal fibroids, are particularly associated with heavy bleeding. They can disrupt the uterine cavity, affect the blood vessels within the uterine wall, leading to increased blood flow, and can also interfere with the uterus’s ability to contract effectively to stop bleeding. Hormonal influences, specifically estrogen and progesterone, also play a role; fibroids tend to grow when these hormone levels are higher, potentially exacerbating bleeding symptoms.
When to Consult a Doctor
Seek medical attention if fibroid-related bleeding significantly impacts daily activities. Symptoms such as ongoing fatigue, weakness, dizziness, or shortness of breath could indicate anemia, a common complication of heavy blood loss from fibroids. Bleeding that lasts more than 7 days, or requires frequent changes of sanitary protection (e.g., soaking through a pad or tampon every hour), warrants professional evaluation. Any severe pelvic pain accompanying the bleeding should prompt a visit to a healthcare provider.
Managing Fibroid Bleeding
Various approaches can help manage or reduce the duration and severity of fibroid-related bleeding. Non-hormonal medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), can reduce pain and flow. Tranexamic acid is another non-hormonal option that helps control heavy menstrual bleeding. Hormonal therapies include birth control pills, which can regulate menstrual cycles and reduce bleeding, and progestin-releasing intrauterine devices (IUDs) that thin the uterine lining to lessen flow. Gonadotropin-releasing hormone (GnRH) agonists can temporarily induce a menopause-like state, shrinking fibroids and stopping periods, though their use is typically short-term due to potential side effects.
Minimally invasive procedures offer additional management options. Uterine artery embolization (UAE) involves blocking the blood supply to the fibroids, causing them to shrink and reducing bleeding. Myomectomy is a surgical procedure that removes only the fibroids while preserving the uterus, which can be suitable for individuals wishing to retain fertility. Endometrial ablation, which removes the uterine lining, can significantly reduce heavy bleeding but is generally not recommended for those who desire future pregnancies. In cases of severe, persistent bleeding and when other treatments are not suitable, a hysterectomy (the surgical removal of the uterus) offers a permanent solution to fibroid-related bleeding.