Do Fibroids Cause UTIs? UTIs and Fibroids: What to Know

Uterine fibroids and urinary tract infections (UTIs) are both common in women, and their symptoms can overlap. If you’re dealing with frequent bathroom trips, pelvic pressure, or recurrent UTIs, you may wonder whether fibroids are to blame. Here’s what the evidence says, how to tell the difference, and when to seek care.

What Are Fibroids?

Fibroids (uterine leiomyomas) are noncancerous growths of the muscle tissue of the uterus. Most are small and harmless, but some can grow large or numerous enough to cause symptoms such as heavy periods, pelvic pressure, and bladder changes. The National Institutes of Health notes that up to 70–80% of women develop fibroids by age 50.^NIH/NICHD

Do Fibroids Cause UTIs?

Fibroids do not directly cause infection. However, they can increase the risk of UTIs in some people by affecting how the bladder and urinary tract function. Here’s how:

• Bladder pressure and reduced capacity: Fibroids, especially those located on the front (anterior) wall of the uterus, can press on the bladder, causing frequent urination and urgency.
• Incomplete bladder emptying: If a fibroid compresses the bladder outlet or distorts the pelvic anatomy, it may interfere with complete emptying. Residual urine can promote bacterial growth, raising UTI risk.^NIH/NIDDK
• Rarely, ureteral compression: Very large fibroids can press on the ureters (tubes from the kidneys to the bladder), potentially causing back-up of urine. This is uncommon but can be serious and requires medical evaluation.

The bottom line: fibroids don’t cause UTIs on their own, but in certain situations—particularly with larger fibroids—they can contribute to conditions that make infections more likely.

UTI Symptoms vs. Fibroid-Related Bladder Symptoms

Because symptoms can overlap, it helps to know the typical patterns:

Common UTI symptoms

• Burning or pain with urination
• Frequent, urgent urination with small amounts
• Cloudy or foul-smelling urine
• Pelvic or lower abdominal discomfort
• Blood in the urine
• Fever or back/flank pain (can suggest a kidney infection)

Learn more about UTI symptoms and evaluation from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).^NIH/NIDDK

Bladder symptoms often linked to fibroids

• Urinary frequency and urgency without burning
• Waking at night to urinate (nocturia)
• A sensation of incomplete emptying
• Pelvic pressure or fullness
• Other fibroid clues: heavy or prolonged periods, menstrual cramping, pelvic bloating

If you have burning with urination or fever, a UTI is more likely. If your main issues are pressure and frequent urination without burning—especially alongside heavy periods or pelvic fullness—fibroids may be playing a role.

When to See a Clinician

• UTI symptoms that don’t improve within 24–48 hours
• Fever, back/flank pain, nausea, or vomiting
• Visible blood in your urine
• Symptoms during pregnancy
• Recurrent UTIs (two within 6 months or three within a year)
• Severe pelvic pressure, difficulty starting urination, or inability to empty the bladder

Prompt evaluation can prevent complications and help tailor treatment—whether the driver is infection, fibroids, or both.

How UTIs and Fibroids Are Diagnosed

UTI evaluation

• Urinalysis and urine culture: Detects white blood cells, bacteria, and confirms the specific organism to guide antibiotics.^NIH/NIDDK
• Further testing: Considered if infections are recurrent or severe, or if there are signs of kidney involvement.

Fibroid evaluation

• Pelvic exam and imaging: Ultrasound is the first-line test; MRI may be used for detailed mapping if procedures are being considered.^ACOG
• Kidney/urinary tract imaging: If there’s concern for ureteral compression or hydronephrosis, your clinician may order additional imaging.

Treatment: Tackling Infection and the Underlying Cause

Managing a UTI

• Antibiotics: Uncomplicated UTIs are typically treated with short courses of antibiotics selected based on local resistance patterns and culture results. Common first-line options include nitrofurantoin, trimethoprim-sulfamethoxazole (if appropriate), and fosfomycin; fluoroquinolones are generally not first-line for uncomplicated UTIs due to safety concerns highlighted by the FDA.^FDA
• Symptom relief: Hydration and, when advised by a clinician, urinary analgesics can help with discomfort.

Prevention strategies if UTIs recur

• Hydrate and don’t hold urine: Regular voiding helps flush bacteria.^NIH/NIDDK
• Postcoital urination and gentle hygiene: Wipe front to back; avoid spermicides if you experience recurrent UTIs.
• Vaginal estrogen (postmenopause): Low-dose vaginal estrogen can reduce recurrent UTIs in postmenopausal women; discuss risks and benefits with your clinician.
• Cranberry products: Evidence is mixed; some people find benefit, but results vary.^NIH/NIDDK

Addressing fibroids that impact the bladder

If a fibroid’s size or location leads to troublesome urinary symptoms or contributes to recurrent UTIs, treating the fibroid can help. Options include:^ACOG

• Watchful waiting: Many fibroids shrink after menopause and can be monitored if symptoms are mild.
• Medications: Hormonal therapies (combined hormonal contraception, progestin IUD), tranexamic acid for heavy bleeding, and GnRH agonists/antagonists can shrink fibroids temporarily or control symptoms.
• Minimally invasive procedures: Uterine artery embolization, MRI-guided focused ultrasound.
• Surgical options: Myomectomy (fibroid removal, preserves the uterus) or hysterectomy (removal of the uterus) depending on symptoms, fibroid size/location, and reproductive plans.

Your gynecologist can help match treatment to your goals (symptom control, fertility preservation, recovery time) and assess whether bladder or ureter compression is present.

FAQs

Can small fibroids cause UTIs?

Small fibroids typically don’t increase UTI risk. Problems are more likely when fibroids are large or positioned to press on the bladder outlet.

What about pregnancy?

Pregnancy itself increases UTI risk due to hormonal and anatomic changes. Fibroids may worsen urinary frequency or retention in some cases. Pregnant individuals with urinary symptoms should seek prompt evaluation.

Could frequent UTIs be my only sign of a fibroid?

Uncommon. Recurrent UTIs usually have other drivers (sexual activity, postmenopausal changes, bladder emptying issues unrelated to fibroids). If you also notice pelvic pressure, heavy periods, or a visible abdominal mass, ask your clinician about imaging.

The Takeaway

Fibroids don’t directly cause UTIs, but they can set the stage for infections by pressing on the bladder and interfering with complete emptying. If you’re experiencing urinary frequency, urgency, or recurrent UTIs—especially alongside pelvic pressure or heavy periods—talk with your clinician. Testing can distinguish infection from fibroid-related symptoms, and targeted treatment can relieve discomfort and lower your risk of future problems.

Sources

• NIH/NICHD: Uterine Fibroids. https://www.nichd.nih.gov/health/topics/uterine/conditioninfo/fibroids
• NIH/NIDDK: Urinary Tract Infections in Adults. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-tract-infections-uti-adults
• NIH/NIDDK: Urinary Retention. https://www.niddk.nih.gov/health-information/urologic-diseases/urinary-retention
• ACOG: Uterine Fibroids FAQ. https://www.acog.org/womens-health/faqs/uterine-fibroids
• FDA: Fluoroquinolone Safety Communications. https://www.fda.gov/drugs/drug-safety-and-availability/fda-updates-warnings-oral-and-injectable-fluoroquinolone-antibiotics

This article is for informational purposes and is not a substitute for professional medical advice. Always consult a qualified health professional with questions about your health.

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