Ask the Doctor: Fibroids and Anemia

Anemia and Fibroids: Abnormal menstrual bleeding is one of the most common fibroid symptoms we hear about at USA Fibroid Centers:

  • “I bleed for 20 days every month!” (too long)
  • “I bleed off and on at random times!” (too unpredictable)
  • “I have to use a tampon, plus-sized pad, cross my legs, and not laugh or blood will come pouring out.”  (too heavy)
But did you know that heavy bleeding can result in you being anemia which is a lack of red blood cells in the body that reduces the oxygen flow to the body’s organs? Anemia can cause fatigue, skin pallor, shortness of breath, lightheadedness, dizziness, or a fast heartbeat. Untreated anemia can exacerbate underlying cardiovascular issues.

    Why do fibroids cause so much bleeding?

    While fibroids are benign (noncancerous), they tend to grow over time, especially during the hormone-charged years in your 20s and 30s. As they grow they affect the surrounding area and cause symptoms. A growing fibroid can push on the bladder to cause increased urinary frequency, it can push on the colon and cause abdominal distention and bloating, and it can push on a nerve and cause pain, to name a few. A fibroid that grows in the central part of the uterus, called the endometrium, will cause bleeding. The endometrium is programmed to go through its natural monthly cycle of bleeding to allow for implantation and growth of a baby, but a fibroid that grows into the endometrium can upset that cycle and cause bleeding that is too heavy or too frequent.

    The slippery slope

    Most patients say that slowly over time their periods became heavier or longer. Their primary care doctor or gynecologist may have taken a thorough history and physical examination and reassured them that heavy periods are common and to use heavier pads to keep them under control. As time goes on the bleeding gets worse and worse, until the body can no longer make blood as fast as the fibroid is bleeding. At this point, you have anemia: not enough red blood cells in your body.

    So I’m anemic. Why should I care?

    Mild anemia is usually asymptomatic and most patients don’t even know they have it. But as it progresses to moderate or severe anemia, the red blood cells are so depleted that symptoms start to set in. Since red blood cells are responsible for delivering oxygen to the body, when there aren’t enough red blood cells there isn’t enough oxygen for all the cells in our body. There are many symptoms of anemia which can include dizziness, shortness of breath, fatigue, pale skin, and certain food cravings.

    I have those symptoms! What can I do about it?

    Since the anemia from bleeding fibroids creates a red blood cell deficiency, iron can be given to try to boost the body’s ability to make more red blood cells. Iron pills are readily available and easy to take (aside from the frequent side effect of constipation), but this only provides a small boost to the body’s ability to make red blood cells and cannot compensate for more serious cases of anemia. Intravenous iron infusion can provide much more iron for the body to make more red blood cells, but those iron stores will be depleted within a few weeks or months if a fibroid is bleeding heavily. The worst-case scenario is so severe that a blood transfusion is required.

    Treating the underlying cause

    Uterine fibroid embolization (UFE) is a minimally invasive same-day procedure that treats fibroids so they no longer cause heavy bleeding. The remainder of the uterus and the ovaries are unaffected, but the fibroids are treated from the inside, cutting off their blood supply to completely solve the problem. Within a few weeks of the procedure, the period will normalize and will be MUCH lighter blood flow. Without the heavy bleeding the body’s natural processes for manufacturing red blood cells are able to reverse the anemia and the red blood cell levels will return to normal within a month or two, any anemic symptoms will fade away, and no further iron supplementation will be needed.

    If you’re experiencing symptoms associated with uterine fibroids and/or anemia, please give us a call at (855) 615-2555 or schedule on our website! Our experienced interventional radiologists will create a personalized fibroid treatment plan that’s right for you. Our doctors are passionate about helping their patients live healthy, happy, symptom-free lives.

    UFE is covered by most major health insurance, and Medicaid plans. Don’t see your insurance listed on our website? Give us a call to verify!

    Jacob White, M.D.

    Dr. Jacob White has been studying and practicing interventional radiology for 15 years. He has conducted research at Drexel Hahnemann University Hospital Radiology, Georgetown University Hospital Radiology, and the National Institutes of Health Radiology. He has contributed extensive research and knowledge to the medical academy through a multitude of presentations and publications. He is the Director of Fibroid Services at USA Fibroid Centers. All of our doctors specialize in minimally invasive, non-surgical procedures to treat uterine fibroids.

    Interested in up-to-date information regarding our clinics, doctors, patient stories, and treatments? Give us a like or follow on Facebook: or Twitter: