Can Fibroids Cause Edema? What to Know About Fibroids and Swelling

Uterine fibroids are common, noncancerous growths of the uterus that can cause heavy bleeding, pelvic pressure, and pain. Many people also wonder whether fibroids can lead to swelling in the legs, ankles, or elsewhere (edema). The short answer: fibroids themselves don’t usually cause body-wide fluid retention, but in certain situations they can contribute to leg swelling or localized edema—most often by pressing on nearby blood vessels or lymphatic channels. Here’s how to tell what’s going on and what to do next.

Quick takeaways

• Fibroids can cause leg swelling when large enough to compress pelvic veins or lymphatic vessels.
• Abdominal “bloating” from an enlarged uterus is not the same as edema (fluid swelling under the skin).
• Sudden, painful leg swelling is a red flag for possible blood clots—seek urgent care.
• Treating fibroids and addressing underlying causes of edema usually improves symptoms.

What are fibroids?

Fibroids (uterine leiomyomas) are benign tumors of the uterine muscle. They vary in size from tiny seedlings to masses that can enlarge the uterus. Many are asymptomatic; others cause heavy menstrual bleeding, anemia, pelvic fullness, urinary frequency, constipation, and pain. Risk increases with age through the 40s and is higher among Black women. Fibroids are influenced by hormones such as estrogen and progesterone.

What is edema?

Edema is swelling caused by excess fluid trapped in body tissues, most commonly in the legs, ankles, feet, or hands. It can result from vein problems, lymphatic obstruction, heart/kidney/liver disease, certain medications, pregnancy, and inflammation. Edema typically leaves a pit after pressing on the swollen area (pitting edema), though not always.

How fibroids can contribute to edema

While fibroids don’t usually cause widespread fluid retention, they can lead to localized swelling through:

• Venous compression: Large fibroids can press on the iliac veins or inferior vena cava in the pelvis, slowing blood return from the legs. This can cause one- or two-sided leg swelling and a feeling of heaviness. In rare cases, compression may promote deep vein thrombosis (DVT), a blood clot that requires urgent care.
• Lymphatic obstruction: Pressure on pelvic lymphatic channels can impair lymph drainage, leading to swelling that may be non-pitting and worse at the end of the day.
• Severe anemia and low protein states: Heavy bleeding from fibroids can cause iron-deficiency anemia. Rarely, profound illness or poor nutrition can lower blood protein (albumin), promoting edema. This is uncommon but treatable.
• Hormonal factors and medications: Hormonal fluctuations can cause mild fluid retention. Some treatments or coexisting medications (e.g., certain hormonal therapies, NSAIDs) can worsen swelling in predisposed individuals.

What swelling from fibroids looks like

• Leg and ankle swelling: Often worse after standing or later in the day; may be one-sided if compression is asymmetric. Pain, warmth, and redness raise concern for DVT.
• Pelvic fullness vs. true edema: Many people describe “bloating” or a fuller abdomen from an enlarged uterus. That sensation is enlargement, not fluid under the skin.
• Urinary or bowel symptoms: Frequent urination or constipation from mass effect can accompany swelling due to the same pelvic pressure mechanism.

When to seek urgent care

• Sudden leg swelling, especially if one-sided, painful, red, or warm (possible DVT).
• Shortness of breath or chest pain (possible pulmonary embolism).
• Rapid generalized swelling with shortness of breath or reduced urine output (possible heart, kidney, or severe allergic issue).

How clinicians evaluate swelling when you have fibroids

Your clinician will start with history and physical exam to determine whether the swelling is pitting, if it’s symmetric, and whether it varies through the day. Depending on findings, tests may include:

• Pelvic ultrasound to confirm fibroid size, number, and location.
• Duplex ultrasound of the legs if a blood clot is suspected.
• Blood tests for anemia, kidney and liver function, and albumin level.
• Urinalysis to look for protein loss suggesting kidney disease.
• Advanced imaging (CT/MRI) if significant pelvic vascular compression is suspected.

Managing edema related to fibroids

Treatment targets both the swelling and its underlying cause.

Self-care for mild leg swelling

• Leg elevation above heart level for 20–30 minutes several times daily.
• Graduated compression stockings if advised by your clinician.
• Regular walking and calf muscle activation; avoid prolonged standing or sitting.
• Limit high-sodium foods; stay well hydrated.

Note: Diuretics (water pills) are not a cure-all and are generally used only when there’s an underlying condition (e.g., heart failure) that warrants them.

Treating the fibroids

Addressing fibroid size and symptoms can relieve pelvic pressure and improve swelling. Options include:

• Watchful waiting for small, asymptomatic fibroids.
• Medications to control heavy bleeding and pain:
  • Hormonal methods such as combined pills, progestins, or the levonorgestrel-releasing intrauterine system for bleeding control.
  • GnRH antagonists with add-back therapy (e.g., relugolix-estradiol-norethindrone acetate; elagolix-estradiol-norethindrone) approved by the FDA to reduce heavy menstrual bleeding due to fibroids.
  • GnRH agonists (short-term) can shrink fibroids preoperatively.
  • Tranexamic acid during menses to reduce bleeding volume.
• Procedures when symptoms are significant:
  • Uterine artery embolization (UAE) to shrink fibroids by cutting off their blood supply.
  • Myomectomy to remove fibroids while preserving the uterus.
  • Hysterectomy for definitive treatment when appropriate.
  • MRI-guided focused ultrasound in select candidates.

The right choice depends on your symptoms, fibroid size and location, fertility goals, and overall health. Reducing fibroid bulk can decrease pelvic venous or lymphatic compression and, in turn, lessen leg swelling.

Special situations

• Pregnancy: Fibroids may grow during pregnancy and contribute to pelvic pressure. Leg swelling is common in pregnancy from normal physiologic changes—seek care urgently for unilateral painful swelling.
• Large fibroids and urinary tract issues: Very large fibroids can, rarely, contribute to urinary obstruction and kidney problems; kidney-related edema requires prompt evaluation.
• Medication review: If you develop new swelling after starting a medication (hormonal therapy, NSAIDs, steroids), ask your clinician whether it could be contributing.

When to follow up

Schedule an appointment if you have persistent or worsening swelling, new pelvic pressure, heavy bleeding, symptoms of anemia (fatigue, shortness of breath, dizziness), or urinary or bowel changes. Early evaluation helps distinguish fibroid-related compression from other causes and guides effective treatment.

Bottom line

Fibroids don’t typically cause body-wide edema, but large or strategically located fibroids can compress pelvic veins or lymphatics and lead to leg swelling. Any sudden or painful swelling deserves urgent assessment. Treating fibroids and addressing the underlying cause of edema usually improves symptoms and quality of life.

Sources and further reading

• NIH MedlinePlus: Uterine fibroids – https://medlineplus.gov/uterinefibroids.html
• NIH MedlinePlus: Edema – https://medlineplus.gov/ency/article/003104.htm
• American College of Obstetricians and Gynecologists (ACOG) – Uterine Fibroids FAQ – https://www.acog.org/womens-health/faqs/uterine-fibroids
• U.S. Food and Drug Administration (FDA): Myfembree (relugolix, estradiol, norethindrone acetate) – approved for heavy menstrual bleeding associated with uterine fibroids – https://www.fda.gov
• U.S. Food and Drug Administration (FDA): Oriahnn (elagolix, estradiol, norethindrone acetate) – approved for heavy menstrual bleeding associated with uterine fibroids – https://www.fda.gov