Fibroids Frequent Periods and Fibroids: What to Know

Frequent Periods and Fibroids: What to Know

If your menstrual cycles are coming sooner than usual or you’re spotting between periods, uterine fibroids may be part of the picture. Fibroids (also called uterine leiomyomas) are benign growths of the muscle wall of the uterus. They are very common and can cause heavy or more frequent bleeding, pelvic pressure, and fertility challenges for some people. This guide explains how fibroids can affect your cycle, what else might be causing frequent periods, how doctors evaluate the problem, and the full range of treatments—grounded in guidance from trusted medical organizations.

Can fibroids cause frequent periods?

Yes. Fibroids can change both the amount and timing of menstrual bleeding. This is most likely when fibroids distort or press on the uterine lining (endometrium):

  • Submucosal fibroids (just beneath the lining) are strongly linked with heavy and sometimes frequent bleeding.
  • Intramural fibroids (in the uterine wall) can increase uterine surface area and affect uterine contractions, leading to heavier and sometimes prolonged periods.
  • Subserosal fibroids (on the outer surface) typically cause pressure or bulk symptoms and are less likely to affect bleeding, though exceptions exist.

“Frequent periods” generally means cycles that come sooner than usual for you, often defined as fewer than about 24 days between the first day of one period and the next. Fibroid-related bleeding may also show up as spotting between periods, prolonged periods lasting more than seven days, or passage of clots. Because chronic heavy or frequent bleeding can lead to iron-deficiency anemia, it’s important to seek evaluation if this is happening to you.

Other causes of frequent or irregular bleeding

Fibroids are common, but they’re not the only cause of frequent periods. Your clinician will consider other possibilities, including:

  • Hormonal fluctuations (e.g., perimenopause), thyroid disorders.
  • Pregnancy-related issues (early miscarriage or ectopic pregnancy)—seek urgent care for severe pain or heavy bleeding if pregnancy is possible.
  • Endometrial polyps, adenomyosis, endometriosis.
  • Bleeding disorders (such as von Willebrand disease), especially if symptoms began in adolescence or you bruise easily.
  • Medications such as anticoagulants, or a copper IUD (which may increase bleeding).
  • Infection of the uterus or cervix.
  • Endometrial hyperplasia or cancer (more common after age 45 or with risk factors)—any postmenopausal bleeding requires prompt evaluation.

Who is at risk for fibroids?

Fibroids can occur at any reproductive age but are most common in the 30s and 40s. Studies suggest that by age 50, the majority of people with a uterus have fibroids, though many are asymptomatic. Black women are more likely to develop fibroids, tend to develop them earlier, and often have more severe symptoms. Other risk factors include family history, early onset of menstruation, and higher body weight.

How doctors evaluate frequent periods and fibroids

Your clinician will start with a detailed history and exam, then tailor tests to your symptoms and goals (for example, desire for pregnancy):

  • Pregnancy test for anyone who could be pregnant.
  • Blood work: complete blood count (to check for anemia), iron studies if anemia is suspected, and sometimes thyroid tests.
  • Pelvic exam to assess uterine size and tenderness.
  • Imaging: pelvic ultrasound is first-line. If needed, a saline infusion sonohysterogram (to better see the cavity), MRI (for mapping fibroids), or hysteroscopy (a tiny camera inside the uterus) may be used.
  • Endometrial sampling may be recommended based on age, risk factors, or very heavy/irregular bleeding to rule out other causes.

Treatment options for fibroid-related frequent periods

Effective treatment depends on symptom severity, fibroid size and location, your preferences, and reproductive plans. Options range from watchful waiting to medicines and procedures.

Relief without surgery

  • Watchful waiting: If symptoms are mild, monitoring with periodic check-ins may be appropriate. Fibroids often shrink after menopause.
  • NSAIDs (e.g., ibuprofen, naproxen) can reduce cramps and may modestly decrease bleeding by lowering prostaglandins. Not suitable for everyone; ask your clinician.
  • Iron therapy and iron-rich diet to correct anemia from chronic blood loss.

Medications that reduce bleeding

  • Tranexamic acid (oral, taken only during menses) helps clot formation and can significantly reduce menstrual blood loss. The FDA-approved brand Lysteda (tranexamic acid) is one option; it’s non-hormonal and does not prevent pregnancy.
  • Hormonal contraception: Combined pills, patch, or ring can regulate cycles and lighten bleeding. Progestin-only options (including the levonorgestrel intrauterine system) are highly effective at reducing bleeding and cramps; the IUD also provides contraception.
  • GnRH agonists (e.g., leuprolide) and newer oral GnRH antagonists with add-back therapy can shrink fibroids and markedly reduce bleeding. The FDA has approved combinations such as elagolix with estradiol/norethindrone and relugolix with estradiol/norethindrone for heavy menstrual bleeding due to fibroids in premenopausal women. Because these drugs can reduce bone density, treatment duration is usually limited and monitored.

Procedural options

  • Hysteroscopic myomectomy: Removes submucosal fibroids via the vagina and cervix; no abdominal incisions. Often ideal when bleeding is the main symptom and fibroids protrude into the cavity.
  • Myomectomy (laparoscopic or open): Removes fibroids while preserving the uterus. Appropriate for those who want to maintain fertility; fibroids can recur.
  • Uterine artery embolization (UAE/UFE): A radiologist blocks blood flow to fibroids, causing them to shrink. Many people experience reduced bleeding and pressure. Pregnancy is possible afterward, but data are mixed; discuss fertility goals before choosing UFE.
  • Radiofrequency ablation (laparoscopic or transcervical): Uses heat to shrink fibroids with relatively quick recovery; long-term fertility data are still evolving.
  • MRI-guided focused ultrasound: Noninvasive thermal ablation for selected fibroids; availability varies, and not all fibroid types are suitable.
  • Hysterectomy: Definitive cure for fibroid symptoms by removing the uterus. Not an option for future pregnancy.

Your clinician can help you compare effectiveness, recovery times, and risks—and align the plan with your symptoms and goals.

Fertility and pregnancy considerations

Many people with fibroids conceive and carry healthy pregnancies. However, certain fibroids—especially those distorting the uterine cavity—can make conception harder or increase risks such as miscarriage, malpresentation, or preterm birth. If you’re trying to conceive or plan future pregnancy, ask whether a targeted treatment (for example, hysteroscopic myomectomy for a cavity-distorting fibroid) could improve outcomes. Some medicines used for bleeding control (e.g., GnRH agents, certain hormonal methods) are not compatible with pregnancy, so timing matters.

When to seek care

  • You’re soaking through a pad or tampon every hour for several hours, passing large clots, or feeling lightheaded—seek urgent care.
  • You have pelvic pain with a positive pregnancy test or could be pregnant.
  • You’re fatigued, short of breath, or pale—possible anemia.
  • You have bleeding after menopause.

Tips to track and advocate for your health

  • Keep a menstrual diary or app log: first day, flow volume, clots, spotting, pain, and missed activities.
  • Ask about anemia screening and iron tests if you have heavy or frequent bleeding.
  • Clarify your goals (symptom relief only, uterine preservation, future pregnancy) before choosing a treatment.
  • Bring your questions: treatment effectiveness, recovery, recurrence risk, medication side effects, and how options affect fertility.

Bottom line

Frequent periods can be frustrating and draining. Fibroids are a common, treatable cause—especially when bleeding is heavy, prolonged, or accompanied by pelvic pressure. A focused evaluation can pinpoint the cause and match you with options ranging from medications to minimally invasive procedures and surgery. With the right plan, most people gain excellent control of bleeding and improvement in quality of life.

Trusted resources and references

This article is for educational purposes and does not replace personalized medical advice. Always consult your clinician for diagnosis and treatment tailored to you.

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