Fibroids Blood Test and Fibroids: What to Know

September 13, 2025

Fibroid Blood Tests and Uterine Fibroids: What to Know

Uterine fibroids (leiomyomas) are common, noncancerous growths of the uterus. They can cause heavy menstrual bleeding, pelvic pressure, pain, anemia, and fertility challenges. Many people ask whether there’s a simple blood test for fibroids. The short answer: there is no single blood test that can diagnose fibroids. Instead, blood tests are used to evaluate symptoms (like heavy bleeding and anemia), rule out other conditions, and prepare for or monitor treatment. Here’s what to know, with guidance informed by major medical organizations and U.S. health agencies.

Can a blood test detect fibroids?

No. Fibroids are diagnosed primarily with a combination of medical history, pelvic exam, and imaging—most commonly pelvic ultrasound. In some cases, MRI provides additional detail, especially for surgical planning or when ultrasound is inconclusive. While labs are important to assess how fibroids affect your health, they cannot confirm the presence of fibroids on their own. That job belongs to imaging.

What blood tests might your clinician order if you have fibroid symptoms?

Although there’s no “fibroid test,” several labs are commonly used when fibroids are suspected or confirmed:

Complete Blood Count (CBC): Heavy menstrual bleeding can cause iron-deficiency anemia. A CBC checks your hemoglobin and hematocrit (to gauge anemia) and platelets.
Iron studies (ferritin, iron, transferrin saturation): Ferritin reflects iron stores and helps confirm iron deficiency, which guides iron supplementation and follow-up.
Pregnancy test (hCG): Essential whenever there’s abnormal uterine bleeding to avoid missing pregnancy-related causes and to ensure safe imaging or treatment choices.
Thyroid-stimulating hormone (TSH): Thyroid disorders can contribute to abnormal bleeding. Testing helps rule out a non-fibroid cause of symptoms.
Screen for bleeding disorders (select patients): In those with lifelong heavy periods, a family history of bleeding, or bleeding since menarche, clinicians may test for inherited bleeding disorders (for example, von Willebrand disease). This is especially considered in adolescents and those with disproportionate bleeding.
Metabolic panels, type & screen, and coagulation tests: Often used before surgery or interventional procedures to assess general health, kidney/liver function, blood type, and clotting.

These tests don’t diagnose fibroids—they help quantify their impact and ensure that care is safe and tailored to you.

Are there tumor markers or special blood tests to rule out cancer?

This is a common and important question. There is no reliable blood test that distinguishes benign fibroids from uterine sarcoma (a rare cancer). Tumor markers such as CA-125 or LDH can be elevated in fibroids and many benign conditions; they are not specific and are not recommended to diagnose or exclude cancer in this setting. Imaging characteristics and clinical context guide risk assessment, and definitive diagnosis of sarcoma requires tissue pathology after removal.

Because preoperative testing cannot reliably exclude uterine sarcoma, the U.S. Food and Drug Administration (FDA) advises caution with certain surgical techniques—particularly power morcellation, which can spread unsuspected cancer. FDA safety communications emphasize careful patient selection and use of containment systems when morcellation is considered. Fortunately, uterine sarcoma remains rare, but the risk cannot be eliminated by a blood test.

How lab results guide fibroid management

Treating anemia: If your CBC shows anemia or low ferritin, your clinician may recommend oral or intravenous iron, dietary adjustments, and therapies that reduce menstrual blood loss. Improving iron levels can relieve fatigue, shortness of breath, headaches, and other anemia symptoms.
Choosing medical therapy: Nonhormonal options like tranexamic acid can reduce heavy bleeding during periods. Hormonal treatments—combined oral contraceptives, progestins, the levonorgestrel IUD, and others—can lessen bleeding or symptoms in some patients. These therapies don’t usually shrink fibroids but may control bleeding.
GnRH agonists and antagonists: Medications that lower estrogen (e.g., GnRH agonists like leuprolide, or oral GnRH antagonists combined with add-back hormones, such as elagolix with estradiol/norethindrone acetate or relugolix with estradiol/norethindrone acetate) can reduce bleeding and shrink fibroids while on therapy. Because these drugs can affect bone mineral density (BMD), the FDA-approved labels recommend pregnancy testing before initiation and BMD monitoring during treatment, along with “add-back” hormones to protect bone health. Your clinician may also check lipids or other labs based on your medical history.
Planning procedures: For surgeries (myomectomy, hysterectomy) or interventional procedures (uterine artery embolization), preoperative labs (CBC, type & screen, metabolic panel, coagulation tests, and hCG) help optimize safety. Correcting anemia beforehand reduces transfusion risk and improves recovery.

What about vitamin D? Some research has linked low vitamin D levels with fibroid risk or growth, but evidence is mixed and not sufficient to recommend vitamin D testing or supplementation specifically to treat fibroids. Your clinician may check vitamin D for other reasons (bone health, deficiency risk), but it’s not a standard fibroid test.

When should you ask about blood tests?

Consider seeing a clinician—and asking about appropriate labs and imaging—if you have:

Very heavy periods (soaking through a pad or tampon every 1–2 hours, passing large clots, bleeding longer than 7 days)
Symptoms of anemia: fatigue, dizziness, pale skin, shortness of breath, headaches
Persistent pelvic pressure or pain, urinary frequency, constipation, or abdominal distension
Difficulty conceiving or pregnancy complications in the past
Rapidly enlarging uterus or new, severe pain—especially after menopause (requires prompt evaluation)

How often labs are repeated depends on your symptoms and treatment plan. For example, if you’re iron deficient, your clinician may recheck CBC and ferritin after several weeks of therapy; if you’re using medications that affect bone density, you may need periodic BMD assessments.

Key takeaways

There’s no single “fibroid blood test.” Diagnosis relies on history, exam, and imaging (ultrasound and sometimes MRI).
Blood tests are essential to assess anemia, rule out other causes of abnormal bleeding, and ensure safe treatment.
No tumor marker reliably distinguishes fibroids from uterine sarcoma before surgery; caution is used in surgical planning.
Lab results directly inform care—iron replacement, choice of medical therapy, pregnancy testing before certain drugs, and pre-procedure safety checks.
Work with a gynecologist to individualize testing and treatment based on your goals (symptom relief, fertility preservation, or definitive cure).

Trusted sources and further reading

NIH MedlinePlus: Uterine Fibroids — https://medlineplus.gov/uterinefibroids.html
American College of Obstetricians and Gynecologists (ACOG), Uterine Fibroids FAQ — https://www.acog.org/womens-health/faqs/uterine-fibroids
U.S. FDA, Laparoscopic Power Morcellators (safety information on surgical techniques) — https://www.fda.gov/medical-devices/surgery-devices/laparoscopic-power-morcellators
U.S. FDA Prescribing Information: Oriahnn (elagolix, estradiol, norethindrone acetate) — https://www.accessdata.fda.gov/drugsatfda_docs/label/2020/213120s000lbl.pdf
U.S. FDA Prescribing Information: Myfembree (relugolix, estradiol, norethindrone acetate) — https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/214846s000lbl.pdf
U.S. Office on Women’s Health (HHS): Uterine Fibroids — https://www.womenshealth.gov/a-z-topics/uterine-fibroids

This article is for educational purposes and does not replace personalized medical advice. If you’re experiencing heavy bleeding, pelvic pain, or anemia, consult a qualified clinician.