The duration of fibroid bleeding varies depending on the location of the fibroid in the uterus and the pressure it exerts on the uterine lining. "How long does fibroid bleeding last?" is a frequently asked question, and in this article, I’ll provide information about fibroid bleeding, which is one of the most common complaints among fibroid symptoms.
A fibroid is a benign tumor-like structure arising from smooth muscle cells in the uterine wall. Here, the term “tumor” emphasizes the mass effect the fibroid has on the uterus.
Being labeled a tumor does not necessarily imply cancer. Tumors can be benign or malignant. The probability of finding cancer cells within a fibroid is 3 in 1,000, making fibroids generally benign in nature.
The reason for fibroid bleeding lies in the fibroid’s location. If the fibroid is situated in a way that it disturbs or presses against the uterine lining (endometrium),bleeding becomes inevitable.
Fibroids are classified based on their location in the uterus as subserosal, intramural, or submucosal. Bleeding is more common in intramural and submucosal fibroids due to their proximity to the endometrium. Subserosal fibroids, being closer to the outer uterine wall, typically do not cause bleeding.
Ultrasonography and pelvic MRI are the best tools to show the location of fibroids and to link them with clinical complaints.
Symptoms of fibroid bleeding include prolonged menstrual bleeding or bleeding that occurs between menstrual periods. A normal menstrual cycle in women covers a 21 to 35-day period with a maximum of seven days of bleeding. Bleeding outside this range is classified as abnormal uterine bleeding.
Abnormal uterine bleeding can have many causes besides fibroids. During investigations of these causes, fibroids are often identified.
It is challenging to give an exact duration for fibroid bleeding. As long as the fibroid continues to exert pressure on the uterine lining, fibroid bleeding is likely to recur intermittently.
Fibroid bleeding can extend the duration of menstrual bleeding or increase the intensity of bleeding on menstrual days. Thus, both the duration and intensity of bleeding are significant factors. Sometimes, bleeding can resume a few days after a menstrual period has ended.
Although many medical agents have been proposed to stop fibroid bleeding, it is challenging for medications to stop bleeding in the long term when the fibroid exerts pressure on the uterine wall.
Curettage procedures to stop fibroid bleeding often result in recurrent bleeding shortly afterward.
Birth control pills are the most frequently used medications to control fibroid bleeding. These pills aim to control bleeding by regulating the thickness of the uterine lining, the endometrial tissue. Although they may reduce bleeding in the short term, they are ineffective in the long term against a fibroid pressing on the uterine lining.
Pseudo-menopause injections or GnRH analogs, which are used to shrink fibroids or stop bleeding, can cause degeneration and some shrinking in fibroid tissue. Due to their side effect of bone loss, they cannot be used for more than three months. The degeneration caused by the medication may complicate the removal of the fibroid from the uterus during surgery.
The use of hormonal IUDs is often recommended to reduce fibroid bleeding. Hormones released by the IUD thin the uterine lining, temporarily reducing bleeding. However, bleeding can become more intense over time. Due to the pressure from the fibroid, the IUD may not be correctly positioned in the uterine cavity, leading to displacement or complete ineffectiveness.
Uterine artery embolization may be recommended for patients unable to undergo surgery soon to reduce or stop fibroid bleeding. However, this procedure can affect ovarian reserve or have negative effects on the endometrium, which is why it is not the first choice in reproductive medicine.
Some pain relievers can be used to reduce fibroid bleeding, such as:
Non-hormonal medications that increase blood clotting can also reduce menstrual bleeding. However, they have no definitive effect on fibroid treatment. Iron supplements may be recommended to raise low blood levels but do not prevent bleeding or reduce the size of the fibroid.
If fibroid bleeding cannot be stopped, severe bleeding can lead to deep anemia, causing palpitations, fatigue, and discomfort. The patient’s general condition may worsen, and the intensive use of blood medications may not stabilize blood levels. Patients hospitalized due to bleeding frequently require blood transfusions.
