Do fibroids cause anaemia?
Yes, they can. Fibroids that face the uterine cavity in particular lengthen and increase menstrual bleeding, gradually depleting iron stores and leading to iron-deficiency anaemia. Not every fibroid bleeds; attributing anaemia to a fibroid requires looking at the bleeding pattern, the blood count and the fibroid’s location together. Iron corrects the deficiency, but while the source of bleeding persists, a lasting solution needs a plan that reduces the bleeding.
How do fibroids increase bleeding?
A period is the shedding of the uterine lining. Fibroids that grow towards the cavity or distort its shape enlarge the surface of the lining, make it harder for the uterus to contract and stop the bleeding, and alter the surrounding blood vessels. Periods become longer and heavier, often with clots. Fibroids growing towards the outer surface, by contrast, often leave the bleeding pattern unchanged even when large.
How is anaemia noticed?
- Tiredness and weakness that rest does not relieve.
- Breathlessness on stairs, palpitations.
- Pallor, dizziness, headaches.
- Increased hair shedding, brittle nails.
- Cravings for unusual things such as ice.
When bleeding increases gradually the body adapts, and many women put these symptoms down to a busy life. Soaking a pad or tampon within an hour or two, having to change at night, large clots and bleeding beyond a week all meet the definition of heavy periods and call for a blood count and a measurement of iron stores (ferritin).
Heavy menstrual bleeding and the resulting anaemia are listed among the indications for treating symptomatic fibroids; fibroids related to the uterine cavity are the group most closely linked to bleeding.
Other causes of heavy bleeding (polyps, adenomyosis, hormonal irregularity, clotting disorders) need to be excluded.
Source: 2021 · Obstetrics & Gynecology — klinik guideline
Treat the anaemia first, or the fibroid?
Both are addressed together. Iron therapy (oral, or intravenous where needed) replenishes stores and brings blood values to a safe level before any planned procedure. For the bleeding itself the options are stepped: medication and hormonal methods that reduce bleeding, hysteroscopic removal for fibroids inside the cavity, and myomectomy, embolisation or HIFU for other locations. Which is suitable depends on the fibroid’s location and number and on pregnancy plans.
Does HIFU reduce bleeding?
Focused ultrasound studies report improvement in symptom scores and bleeding complaints; the effect appears as the treated tissue is absorbed and the fibroid shrinks over months, not immediately. For pedunculated fibroids lying entirely within the cavity, hysteroscopic surgery is usually the first option. When bleeding is the main problem, the fibroid’s relationship to the cavity is therefore examined specifically during the eligibility assessment.
Pooled analyses report improvement in symptom severity scores in symptomatic fibroids treated with focused ultrasound.
Studies mostly measure bleeding as part of a composite symptom score; improvement develops over months and depends on patient selection.
Source: 2022 · International Journal of Hyperthermia