Many women wonder, “Do fibroids cause constipation?” The answer is yes. Research findings that were published in the International Journal of Women’s Health show that more than 60% of women with uterine fibroids experience digestive issues, including constipation, bloating, or diarrhea.
Fibroids are most commonly associated with heavy menstrual bleeding and pelvic pain, but there are other less-known symptoms that can be caused by fibroids. Constipation, lower back pain, shooting pain down the leg, frequent urination, and pain during sex are all symptoms that can be connected to uterine fibroids.
When fibroids grow large, they can exert pressure on your colon or rectum and cause constipation.
Uterine fibroids are noncancerous tumors that grow in or on the uterus. They form from the same type of tissue that makes up the muscular part of the uterine wall and can vary in size from 1 millimeter to as big as a grapefruit. Fibroids develop in different locations, and the symptoms they create are connected to where they grow and how large they become.
Subserosal fibroids grow on the outer surface, intramural fibroids develop within the uterine wall, submucosal fibroids form beneath the uterine lining, and some are attached to the uterus by a thin stalk (pedunculated fibroids). Some fibroids can cause constipation depending on where they are located and how large they grow.
Do Fibroids Cause Constipation?
Yes. Fibroids can sometimes cause constipation because your uterus sits right in front of your rectum and large intestine. If your fibroids grow big enough or in certain locations, they can put pressure on certain places and physically squish these organs. This can cause constipation because it makes the pathway for elimination much skinnier and more difficult for the stool to pass through.
Which Fibroids Are Usually The Cause Of Constipation?
Fibroids that get over 5 centimeters or more that are located on the back side of the uterus (posterior subserosal fibroids) are most likely to push against the rectum and colon and cause constipation.
Fibroids that grow to be 10 centimeters or larger can cause severe constipation along with frequent urination and visible abdominal enlargement. Pressure can build up and make you feel like you need to have a bowel movement, but because of the fibroids, you are unable to do so.
Also, if a woman has a uterus that tilts backward, any fibroids that grow nearby are even more likely to press against the colon and rectum. Large subserosal and intramural fibroids that significantly enlarge the uterus can also cause fibroid constipation by crowding the pelvic space.
Is It Common To Have Constipation Because Of Fibroids?
No. Constipation is not one of the most common side effects of fibroids, but it is on the list. Not all fibroids cause constipation because it depends on their size and location.
Research published in the International Journal of Women’s Health on uterine fibroid symptoms reported that 7.7% of the women in the study with uterine fibroids had symptoms of severe constipation, bloating, or diarrhea vs. 4.7% of women who experienced these symptoms but did not have fibroids.
In the study, constipation caused by fibroids was lumped in with the symptoms of bloating and diarrhea, so the actual percentage of women who experience constipation with fibroids is likely even smaller.
Recognizing Fibroid-Related Constipation
You might be wondering, “What are the symptoms of fibroid-related constipation?” The symptoms can vary due to where the fibroids are located, but some common constipation symptoms from fibroids include:
- Difficulty having a bowel movement
- Straining during bowel movements
- Going several days without a bowel movement
- Hard or lumpy stool
- Feeling of incomplete bowel emptying
- Abdominal pain & pressure
- Bloating
- Feeling of fullness in the abdomen
Women with constipation caused by fibroids are often misdiagnosed. Often, doctors fail to make the connection between the enlarged fibroid-filled uterus and constipation.
After performing a GI workup, the misdiagnosed woman is instructed to drink more fluids and increase her consumption of fiber, which can further exacerbate her condition. Her fibroids are causing constipation by compressing the colon from the outside and not allowing a clear path. Sometimes after extensive gastrointestinal testing, they are given an accurate diagnosis that links their constipation to fibroids.
If you have been diagnosed with fibroids and are dealing with chronic constipation, talk with your doctor about setting up an MRI or pelvic examination combined with an ultrasound to determine whether your fibroids are the underlying cause.
How Do Fibroids Cause Constipation?
Fibroids usually begin to cause trouble when they start to grow larger. The symptoms they begin to create are linked to where the fibroids are located.
If a large fibroid is growing on the backside of the uterus or the woman’s uterus is enlarged with fibroids and retroverted (tilted toward the back), it can begin to exert pressure on whatever is in close proximity. Sometimes the colon is affected and becomes kinked, which leads to constipation and sometimes painful bowel movements.
Fibroids are linked to hormonal changes, like a rise in estrogen levels, which may also contribute to constipation. Your intestines move stool through your body using smooth muscle contractions. Higher estrogen levels may affect how well these muscles contract, which can slow down this process and may cause constipation and bloating for some women.
Treatment Options for Fibroids and Constipation
If fibroids are causing constipation, then the quickest way to find relief is to eliminate the fibroids.
Using laxatives and stool softeners will only provide temporary relief and will not resolve the compression of the colon if this is the underlying issue.
Some options for treatment include:
- Alleviating constipation symptoms with more fiber, more water, regular exercise, stool softeners or mild laxatives.
- Temporary treatments like hormonal GnRH agonists may help shrink fibroids and relieve pressure that is being put on the bowel.
- Surgeries such as myomectomy to remove fibroids one at a time or a hysterectomy that removes the entire uterus.
- Uterine fibroid embolization (UFE) is a procedure that cuts off the blood that is flowing to the fibroids so they shrink and may relieve symptoms like constipation and pelvic pressure.
How Can UFE Help Fibroid-Related Constipation?
During UFE, a thin catheter is used to inject tiny particles that block the blood supply to the fibroids, causing them to shrink. As the fibroids decrease in size, the pressure on the rectum and colon is relieved, allowing normal bowel function to resume.
UFE is performed as an outpatient procedure with no surgical incisions, and most women return to their normal schedule within one to two weeks.
Chronic constipation is only one of the multiple, bulk-related symptoms that fibroids can cause. Others include abdominal/pelvic pain and pressure, bloating, lower back pain and sciatica, increased urinary frequency, waking at night to urinate, urinary leaking, painful sex (dyspareunia), and more.
Where Can I Find Expert Treatment For Fibroids?
Drs. John Lipman and Dr. Banerjee at the Atlanta Fibroid Center are experts in uterine fibroid embolization and have performed over 10,000 procedures. Patients travel from near and far to access their expertise and receive treatment for fibroids and adenomyosis.
If you have fibroids and chronic constipation, you need to know your options. UFE may be the answer for you. To make an appointment with our experts, please call the Atlanta Fibroid Center at 678-679-6669 today or schedule your consultation online.
Frequently Asked Questions
What can I do to help manage fibroid constipation naturally?
To manage symptoms of fibroid constipation naturally, make sure to stay very hydrated, eat foods that are high in fiber, like oatmeal, pineapple, banana, get regular exercise, and use stool softeners if you need them. You may find some temporary relief, but if your fibroids are large and compressing your bowel, the relief they can offer may be very limited. The best solution is to treat the underlying fibroids so they will shrink and take the pressure off your digestive tract, which will result in the resolution of constipation and other bulk symptoms.
Does everyone with fibroids get constipated?
No. Constipation happens in less than 8% of women with fibroids. Some women with fibroids have no symptoms, and others have such debilitating ones that it affects their quality of life.
