Uterine fibroids are a common health concern among women, especially during the reproductive years. Affecting between 20 to 80 percent of women by the time they reach their 50s, these non-cancerous growths in the uterus can significantly impact a woman's life. While fibroids are known for causing symptoms like heavy menstrual bleeding, pelvic pain, and reproductive issues, many women also wonder whether fibroids can lead to weight gain or difficulty losing weight.
Understanding Uterine Fibroids
Before diving into the impact of fibroids on weight, it’s important to understand what fibroids are and how they develop. Uterine fibroids, also known as leiomyomas, are benign tumors that grow in or on the uterine walls. They are typically more common in women in their 30s or older, and particularly among African American women. Fibroids can vary in size, from very small (less than a centimeter) to large (several centimeters). In severe cases, a woman may even appear pregnant because of the excess weight in the area. A large fibroid cluster can measure to more than eight inches in diameter or larger, which is about the size of a small watermelon.
The Link Between Fibroids and Weight Changes
The relationship between fibroids and weight loss is straightforward: the larger your fibroids grow, the heavier they get. This directly influences abdominal weight growth and can make a woman’s stomach look wider and more full. The number and size of your fibroids also directly influence your weight. The more fibroids you have or the larger they are, the heavier they will be. As fibroids grow, they can also cause the uterus to enlarge, which can also increase your overall weight. "As fibroids themselves grow, their weight increases. Some fibroids can grow similar in size to a full-term baby. Such large fibroids can actually be visibly protruding from the abdomen," says Yana Markidan, MD, a board-certified ob-gyn with Antheia Gynecology in East Windsor, New Jersey.
While some women find that their fibroids make them gain weight, others struggle to lose weight. It is widely understood that hormones, such as estrogen and progesterone, influence fibroids. Fibroids tend to grow during times of increased hormones in the body, like during pregnancy. We also know that fat cells secrete hormones. It does appear that fibroid growth is related to increasing weight. So exercise and eating a nutritious diet to maintain a healthy weight can help.
Several factors can contribute to weight gain or difficulty losing weight in women with fibroids:
Read also: Diet and Uterine Fibroids
1. Physical Mass of Fibroids
The most straightforward way in which fibroids can lead to apparent weight gain is through their physical mass. Large fibroids can be quite weighty, with some of the largest weighing several pounds. You may be surprised to learn that large fibroids can weigh up to 20 pounds, roughly the size of a watermelon.
2. Abdominal Swelling and Bloating
Fibroids can cause bloating and abdominal fullness, which can make you feel heavier and larger. On average, women can gain 3-5 lbs just before their menstrual period due to bloating. Fibroids can also cause constipation, which can lead to weight gain or the inability to lose weight.
3. Anemia and Fatigue
Uterine fibroids can also cause heavy bleeding, which could possibly lead to anemia. And anemia can actually be a weight-gain culprit. Iron-deficiency anemia is a condition when your blood lacks enough iron to make healthy red blood cells, per the Office on Women's Health (OWH). Your body needs iron to help carry oxygen through your blood to various parts of your body to keep it functioning. And according to the University of New Mexico, you need sufficient oxygen to burn calories and fat. Once you are anemic, your body goes into a fight or flight mode to preserve energy. Your metabolism will slow down.
Weakness, shortness of breath and dizziness are also common symptoms of anemia, according to the OWH. The overeating can be a result of anemia from significant blood loss. This may also decrease their exercise because their iron deficiency makes them extremely lethargic.
4. Pain and Discomfort
For some women, the pain and discomfort from fibroids can lead to decreased physical activity. Many women with fibroids experience pain and fatigue, which can lead to a decrease in physical activity. Some women with fibroids turn to unhealthy foods for comfort.
Read also: The Link Between Fibroids and Weight
5. Hormonal Fluctuations
Hormonal imbalances associated with fibroids can also affect metabolism and body weight. Estrogen, which is often elevated in women with fibroids, is known to influence body weight. Fat cells make more estrogen, and sudden changes in hormones can lead to fibroid growth.
6. Stress
Fibroid symptoms can be very stressful and can prevent you from enjoying outdoor activities including your family and friends’ gatherings etc. The majority of patients suffering from fibroids are overall healthy and notice weight changes as their pelvic/fibroid symptoms worsen.
How to Lose Weight With Fibroids
When it comes to weight loss in general - whether or not you have fibroids - slow and steady is the way to go. The Centers for Disease Control and Prevention (CDC) recommends aiming to lose no more than 1 to 2 pounds per week. And rather than crash diets or detoxes, it's better to use sustainable methods that allow you to maintain your weight loss over time.
Here's how to get started:
1. Count (and Cut) Your Calories
To lose weight, you'll need to burn more calories than you take in on a daily basis - in other words, you'll create a calorie deficit. The CDC recommends finding your maintenance calories (the amount you're currently eating to maintain your weight) and subtracting between 500 and 1,000 calories per day.
Read also: Weight Fluctuations and Fibroids
There are a few ways to do this, but the easiest is to use a calorie-tracking app, which will help you figure out the right calorie target based on factors like your current weight, age, activity level and weight-loss goal.
Keep in mind that you shouldn't fall below 1,200 calories a day if you're AFAB, according to Harvard Health Publishing, or you'll put yourself at risk for nutritional deficiencies and other issues.
2. Adjust Your Diet
Calories aren't everything, though. To support a healthier body, you need a balanced diet that includes a variety of foods from all the food groups, according to the CDC.
Choose nutritious foods like:
- Lean meats and fish
- Fresh fruits and veggies
- Whole grains like oats, barley and brown rice
- Healthy fats like avocado and olive oil
And limit or avoid the following:
- Alcohol
- Trans fats in fast food and processed baked goods
- Added sugars (check ingredient labels)
- Refined carbs like white bread and white rice
- Soy-based products (think: soymilk, tofu)
- Red meat should be very limited as well, per the Mayo Clinic, as it may be linked to a higher risk of fibroid growth.
"There are some studies that show diets rich in green leafy vegetables help to slow down fibroid growth," says Dr. Markidan. Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage estrogen levels and overall health.
3. Exercise Regularly
Engaging in regular physical activity can help mitigate some of the weight gain indirectly caused by fibroids. We suggest aiming for at least 30 minutes daily, five days a week. Choose enjoyable activities and consider finding a workout partner or trainer when safe to do so in your region.
4. Find Support
We know that losing weight isn’t always easy. Ask your friends and family for help.
Medical Treatments for Fibroids
Various medical treatments are available for managing fibroids, including medication to help regulate menstrual cycles and hormones and minimally-invasive options like Fibroid Embolization for larger or symptomatic fibroids.
Uterine Fibroid Embolization (UFE)
Uterine fibroid embolization (UFE) is a safe and effective treatment for uterine fibroids. It involves inserting a thin tube (catheter) into the femoral artery in the groin and threading it up to the uterus. Once the catheter is in place, contrast dye is injected and X-rays are taken. Then, small particles are injected into the arteries that supply blood to the fibroids. These particles block the blood flow to the fibroids, causing them to shrink.
Uterine fibroid embolization is a minimally invasive procedure that can be done on an outpatient basis. First, it can shrink the fibroids. Depending on the size and amount of fibroids, this can lead to a significant amount of weight loss on its own. Second, it can help to improve symptoms such as pain and fatigue, which can lead to increased physical activity and a healthier lifestyle.
Important Considerations
If your symptoms are affecting your daily life or if you’re observing a bulge in your lower abdomen, it’s best to check in with a doctor to check on the growth. Women should definitely contact their doctor if they are experiencing a bulge that resembles but isn’t pregnancy. Beyond about four inches in diameter, or the size of a grapefruit, a doctor needs to be consulted, as this can impact other organs such as the bladder and the lungs. There is also an increased risk of blood clots or ruptures.
Natural Medicines and Supplements
There are some small studies looking into possible dietary and environmental factors that may promote fibroid growth. Foods like red meat, dairy, soy products, and exposure to BPA have been shown to have a possible link to fibroid development. But this data is weak and furthermore, avoiding these exposures has not been shown to treat, shrink or prevent fibroids. The best evidence we have for vitamin supplements is for vitamin D. Vitamin D deficiency, which is very common in people with dark skin, has been associated with fibroid growth in some studies. But we don't yet have enough information to recommend a certain dose of vitamin D supplements. Limited data does not support the use of herbal supplements like black cohosh or vaginal steaming. Additionally, because these supplements are not FDA regulated, they may be dangerous to your health. Acupuncture has shown promise for improving fibroid outcomes in small studies.
Fibroids and Menopause
Since fibroids are hormonally responsive growths, most people do experience a decrease in fibroid size and fibroid-related issues as they get closer to menopause and beyond. In fact, the whole uterus decreases in size after menopause. However, studies do show that fibroids can continue to keep growing after menopause because there are other tissues in our body that produce estrogen besides the ovaries. This ongoing growth does not mean the fibroids are cancerous or that they even need to be treated. But if you are having bothersome symptoms, treatment is absolutely an option. How much the fibroids grow and how fast varies from person to person. But it's more likely with increasing weight or obesity and more likely with smaller rather than larger fibroids.