Fibroids Naturopathic Support

What are uterine fibroids?

Uterine fibroids (also called leiomyomas) are benign (non-cancerous) growths that develop from the smooth muscle and connective tissue of the uterus.

They can vary considerably in size, number and location, which is why two women with fibroids can have completely different symptoms. Some women have small fibroids with significant bleeding, while others have larger fibroids that mainly cause pressure or no symptoms at all.

Depending on their size and location, fibroids may be associated with:

• Heavy or prolonged menstrual bleeding
• Passing blood clots during your period
• Pelvic pressure or a feeling of heaviness
• Bloating or abdominal distension
• Bladder frequency or urgency
• Constipation or bowel pressure
• Pelvic pain or discomfort
• Fertility or pregnancy challenges in some women

What fibroids can feel like day to day

Fibroids are more than a finding on an ultrasound.

For many women, they influence everyday life in ways that aren’t always obvious to others. Heavy bleeding can make it difficult to plan work, travel or social events. Pelvic pressure may affect exercise, bladder or bowel habits, while ongoing blood loss can leave you feeling tired long before your next period arrives.

Symptoms often develop gradually and become your “normal”, making it easy to underestimate just how much they’re affecting your quality of life.

No two women experience fibroids in exactly the same way. Understanding your individual symptom pattern is an important first step in deciding the most appropriate management approach.

What drives fibroid symptoms (and why addressing drivers matters)

Fibroids rarely develop or behave because of a single factor.

Instead, they reflect a complex interplay between hormone signalling, tissue growth, blood vessel development, bleeding mechanics and whole-body influences. This is one of the reasons fibroids can look and behave so differently from one woman to the next.

While medication or surgery may be appropriate for some women, understanding the factors that may be influencing fibroid growth, bleeding patterns and symptom severity can help guide a more personalised approach to long-term management.

Not every driver below will apply to every woman, but together they form the framework I use when assessing fibroids clinically.

Vascular growth and blood supply (angiogenesis)

Fibroids don’t simply grow larger over time – they also develop their own blood supply.

This process, known as angiogenesis, allows fibroids to receive the oxygen and nutrients they need to continue growing. It may also contribute to heavier menstrual bleeding and ongoing symptom progression in some women.

When assessing fibroids, I consider whether excessive vascular signalling may be contributing to persistent symptoms, particularly when bleeding has become progressively heavier or fibroids continue to increase in size. Understanding this process can help explain why fibroids don’t always remain stable over time.

Bleeding mechanics: surface area, uterine contractility, and clot formation

Heavy menstrual bleeding isn’t always explained by hormone levels alone.

Fibroids can change the physical structure of the uterus by increasing the surface area of the uterine lining, disrupting coordinated uterine muscle contractions and affecting how effectively blood vessels constrict during menstruation.

This helps explain why some women experience heavy bleeding, flooding, prolonged periods or passing large clots, while others with fibroids have very different symptoms.

Understanding these mechanical factors is important because they influence both symptom severity and the most appropriate treatment approach, regardless of whether you’re pursuing conservative management or considering surgery.

Bleeding patterns and iron: when low iron isn’t straightforward

Heavy or prolonged bleeding is one of the most common reasons women with fibroids develop iron deficiency. Over time, this can affect energy, mood, exercise tolerance, concentration and recovery between periods.

Managing iron isn’t always as simple as taking a supplement. I interpret your bleeding pattern alongside a full iron panel, inflammatory markers, symptoms and, where relevant, gut health, because inflammation can influence how iron is stored and utilised. This broader context helps guide more appropriate treatment decisions.

Fibroid location and why it matters

When it comes to fibroids, size isn’t the only thing that matters. Their location within the uterus can have a significant impact on the symptoms they cause.

For example, fibroids that grow into the uterine cavity are more likely to contribute to heavy bleeding, prolonged periods and fertility challenges. Fibroids growing within the muscular wall of the uterus may cause heavy bleeding, pelvic pain or pressure, while those growing on the outside of the uterus are more likely to press on nearby organs, contributing to bladder frequency, constipation or a feeling of pelvic heaviness.

Understanding the location of your fibroids helps explain why two women with similarly sized fibroids can have very different symptoms, and why treatment recommendations vary from one person to the next.

Oestrogen metabolism and clearance

Fibroids are hormonally responsive, particularly to oestrogen. However, it’s not always about how much oestrogen your body produces. How efficiently it’s metabolised and cleared may also influence hormone signalling.

When oestrogen is metabolised less efficiently or recirculated through the gut, it may contribute to prolonged oestrogen exposure in some women. This is why I often consider liver function, gut health and hormone metabolism as part of the broader clinical picture.

Progesterone signalling (beyond “low progesterone”)

Progesterone plays a far more complex role in fibroids than simply being “low”.

Research suggests fibroid tissue may respond differently to progesterone than healthy uterine tissue. This means symptoms aren’t always explained by hormone levels alone, but also by how the tissue responds to those hormonal signals.

Understanding this helps explain why hormonal treatments don’t work the same way for every woman and why a more individualised approach is often needed.

Pressure effects on bowel and bladder

Depending on their size and location, fibroids can place pressure on nearby organs. This may lead to bladder frequency or urgency, difficulty fully emptying the bladder, constipation, bloating, pelvic heaviness or abdominal discomfort.

Because these symptoms are often caused by the physical presence of the fibroid rather than inflammation, they don’t always improve with gut-focused treatments alone. Understanding where your fibroids are located can help explain why these symptoms occur and guide the most appropriate management.

Growth factors and why fibroids behave differently

Fibroids don’t all grow at the same rate. Some remain stable for years, while others grow more rapidly or begin causing symptoms after being present for a long time.

Research suggests this variation is influenced by differences in growth factors, hormone receptor activity, blood supply and the local tissue environment. This helps explain why two women with similar fibroids can have very different experiences, and why treatment decisions should always be individualised.

Oxidative stress related to tissue growth

Oxidative stress occurs when the body’s production of free radicals exceeds its ability to neutralise them with antioxidants.

Research suggests oxidative stress may contribute to the development and growth of fibroids by influencing cellular signalling, tissue repair and the local uterine environment. While it’s unlikely to be the sole driver, it forms part of the broader picture and may interact with hormonal and inflammatory pathways.

Environmental exposures and fibroids

It may not be a coincidence that fibroids have become increasingly common during the same decades that our exposure to synthetic chemicals has risen dramatically.

Researchers are investigating whether endocrine-disrupting chemicals (EDCs), found in products such as plastics, pesticides, fragrances and some personal care products, may influence hormone signalling and fibroid development in susceptible women. While these exposures are unlikely to be the sole cause of fibroids, they may contribute to the overall hormonal and environmental load.

The goal isn’t to eliminate every chemical from your life. It’s to identify the exposures that may be most relevant to you and reduce them where practical.