Uterine fibroids are a common condition affecting a significant portion of women, particularly as they approach their 50s. These non-cancerous growths in the uterus can lead to various symptoms, including weight gain. This article explores the connection between uterine fibroids and weight changes, what to expect after fibroid removal procedures like myomectomy or hysterectomy and provides guidance on managing weight and health post-surgery.
Understanding Uterine Fibroids
Uterine fibroids affect between 20 to 80 percent of women by the time they reach their 50s. They are more common in women in their 30s or older and are also more prevalent among African American women. Fibroids can occur alongside or be confused with endometriosis. They frequently cause anemia due to heavy bleeding, leading to general lethargy. In rare cases (less than 1 in 1,000), a fibroid may be cancerous (leiomyosarcoma).
Fibroids are benign tumors that grow in and around the uterus. They are removed to eliminate the symptoms they cause that affect a woman’s health and impact her quality of life. These symptoms can include heavy and prolonged menstrual bleeding, which can lead to anemia, severe pelvic pain, and pressure on the bladder or bowel, causing frequent urination or constipation.
How Fibroids Can Cause Weight Gain
Large uterine fibroids can directly impact a woman’s weight. Very large fibroids can weigh several pounds or even push on other organs. Women often experience more than one fibroid. A large fibroid cluster can measure more than eight inches in diameter, about the size of a small watermelon. 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. In extreme circumstances, they have been known to grow even larger. Women should definitely contact their doctor if they are experiencing a bulge that resembles but isn’t pregnancy. Many women experience fibroids that are less than a pound altogether. A fibroid may not be the only explanation of weight gain.
It’s a fairly common question: Can fibroids make you gain weight? Often, they can. Fibroids cause weight gain in the abdomen when the fibroids themselves grow large in size. In severe cases, a woman may even appear pregnant because of the excess weight in the area.
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Other Factors Contributing to Weight Gain
Beyond the physical mass of fibroids, several other factors can contribute to weight gain:
- Bloating: The presence of large or numerous fibroids can change the shape of your uterus causing it to protrude outward as if you were pregnant. Gynecologists will often use this comparison to monitor the growth of the uterus. The uterine length in centimeters (cm) roughly corresponds to the similar size pregnant uterus in weeks.
- Constipation: Depending on where they are located and how large or numerous they are, they can exert pressure on nearby organs. Constipation can coincide with bloating and make it feel like you’re gaining weight when you’re not. Similarly, the relief felt following moving your bowels might make it seem like you have dropped some weight as well.
- Lethargy & Anxiety: The bigger the fibroids grow, the more weight they can add to your body, and most likely, the more intense your fibroid symptoms may become. When we do not feel well, we tend to be much less active, which means we are not burning calories like we should to maintain a healthy weight. Dealing with fibroid symptoms may also cause anxiety, which often leads to stress-eating high calorie or “comfort foods”, which adds to the weight gain issue.
Types of Fibroids
Many women may experience more than one type of fibroid. One type is:
- Intramural: The fibroid grows inside the wall of the uterus.
Weight Loss After Fibroid Removal: Surgical Options
If you have gained weight due to the growth of uterine fibroids, it might seem that if the fibroids shrink or are eliminated, it would decrease your symptoms, and also reflect on the scale as well. There are surgical and non-surgical methods for treating fibroids. Surgical options include myomectomy and hysterectomy.
Myomectomy
A myomectomy is surgery to take out fibroids from the uterus. During a myomectomy, a surgeon attempts to remove fibroids by cutting them away from or out of the uterus. Fibroids can grow in a variety of locations and can be deeply embedded within the muscular layer or lining of the uterus. When they are removed, the integrity of the uterus is compromised.
Depending on the type of myomectomy, the visible scarring can be mild or more prominent. A laparoscopic myomectomy can leave 4 or 5 small scars in different places on the abdomen, and an open or traditional one can leave a larger, extended scar along the bikini line.
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Recovery After Myomectomy
After a myomectomy, you can expect to feel better and stronger each day. However, you may tire quickly and need pain medicine for a week or two. You may need about 4 to 6 weeks to fully recover. It's important not to lift anything heavy while you are recovering to give your incision and your belly muscles time to heal.
Home Care Tips:
- Activity: Rest when you feel tired, and get enough sleep. Try to walk each day, gradually increasing the amount you walk. Avoid lifting anything that would make you strain for 4 to 6 weeks, including heavy bags, children, or a vacuum cleaner. Avoid strenuous activities like biking, jogging, weightlifting, and aerobic exercise for 4 to 6 weeks.
- Diet: You can eat your normal diet. If your stomach is upset, try bland, low-fat foods. Drink plenty of fluids unless your doctor tells you not to. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement every day.
- Medicines: Take pain medicines exactly as directed. If the doctor gave you a prescription medicine for pain, take it as prescribed. If you are not taking a prescription pain medicine, take an over-the-counter medicine such as acetaminophen (Tylenol), ibuprofen (Advil, Motrin), or naproxen (Aleve). If your doctor prescribed antibiotics, take them as directed.
- Incision Care: If you have strips of tape on the cut (incision) the doctor made, leave the tape on for a week or until it falls off. Wash the area daily with warm, soapy water and pat it dry. Keep the area clean and dry.
- Other Instructions: Talk to your doctor if you want to try to get pregnant soon. If you don't want to get pregnant, talk with your doctor about birth control. Wear sanitary pads if needed for light vaginal bleeding. Wear loose, comfortable clothing and avoid anything that puts pressure on your belly for a few weeks.
Potential Body Changes After Myomectomy
- Swollen Belly: Many women experience a swollen belly after myomectomy surgery that may take several weeks to dissipate.
- Weight Gain: Weight gain after a myomectomy has also been reported by many women.
- Scar Tissue: Scar tissue can form after a myomectomy, which reduces the chances of conception.
- Uterine Compromise: During a myomectomy, the integrity of the uterus is compromised.
- Risk of Hysterectomy: Each year, 3 or 4 women out of every 100 who are put under general anesthesia for a myomectomy wake up without their uterus.
- Fibroid Regrowth: Many women who undergo fibroid removal surgery end up needing another surgery to treat the regrowth of fibroids or new fibroid growth.
Hysterectomy
A hysterectomy is the surgical removal of the uterus. It is sometimes recommended if fibroids are large, numerous, or causing severe symptoms.
Will You Lose Weight After Hysterectomy?
The short answer: Possibly, but not always significantly. Here’s why:
- Removal of fibroids and uterus: Fibroids can weigh several pounds if they are large. Removing them (and the uterus) may lead to some immediate weight loss. However, most fibroids aren’t heavy enough to cause dramatic changes.
- Reduced bloating and swelling: Fibroids can cause abdominal bloating, making your stomach appear larger. After surgery, this swelling may decrease, giving the illusion of weight loss.
- Hormonal changes (if ovaries are removed): If your ovaries are also removed (oophorectomy), hormonal shifts may affect metabolism and weight. Some women experience weight gain due to menopause-like symptoms.
- Recovery and activity levels: Post-surgery, you may be less active during recovery, which could lead to temporary weight gain. Once healed, returning to exercise can help manage weight.
Managing Weight After Hysterectomy
Whether you lose weight or not, maintaining a healthy lifestyle is key. Here are some tips:
- Eat a Balanced Diet: Focus on fibre-rich foods (vegetables, whole grains) to prevent constipation, a common post-surgery issue. Include lean proteins (chicken, fish, beans) to support healing. Limit processed foods, sugar, and excess salt to avoid bloating.
- Stay Active (When Cleared by Your Doctor): Start with gentle walks and gradually increase activity. Strength training can help maintain muscle mass, which supports metabolism.
- Monitor Hormonal Changes: If your ovaries were removed, discuss hormone replacement therapy (HRT) with your doctor to manage symptoms like weight gain.
- Manage Stress and Sleep Well: Stress can lead to emotional eating-practice relaxation techniques like yoga or meditation. Prioritise sleep, as poor sleep can disrupt metabolism.
- Track Your Progress: Weigh yourself occasionally, but focus more on how you feel rather than just the number on the scale.
Non-Surgical Options: Uterine Fibroid Embolization (UFE)
Uterine Fibroid Embolization (UFE) is a minimally invasive, non-surgical procedure performed by an Interventional Radiologist. UFE blocks the blood flow “feeding” these fibroids, so they begin to soften, shrink, and eventually die.
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How UFE Can Help with Weight Loss
If you have experienced weight gain due to uterine fibroids, you may be wondering if fibroid treatment can help you lose those unwanted pounds. Although there are never any guarantees, it is possible that weight loss can occur after Uterine Fibroid Embolization (UFE).
- Shrinking Fibroids: Depending on the size and amount of fibroids, this can lead to a significant amount of weight loss on its own.
- Improved Symptoms: It can help to improve symptoms such as pain and fatigue, which can lead to increased physical activity and a healthier lifestyle.
Benefits of UFE
Uterine Fibroid Embolization offers additional health benefits compared to fibroid removal surgeries:
- Less risk
- Less pain
- No hospital stay
- Shorter recovery period
- No general anesthesia or post-op stitches
Recovery After UFE
As the fibroids die, the painful symptoms will be alleviated, the bloating will subside, and you will start feeling more energetic. After having the UFE procedure, many patients say they got their lives back, and their only regret is not having the procedure done sooner!
The Connection Between Uterine Fibroids and Weight Gain
Uterine fibroids affect about 40% to 80% of women. Risk factors like a higher body weight, not having children and a family history of fibroids can increase your chances of getting uterine fibroids.
“Uterine fibroids are benign tumors or growths from the muscle wall of the uterus,” explains Dr. Valentine. “They can grow inside the uterus or they can grow on the outer surface of the uterus.”
Hormones like estrogen and progesterone, which are prevalent during childbearing years and start to decrease during menopause, can increase your risk of uterine fibroids.
You may have one uterine fibroid or you may have many that grow in a cluster.
“The size of a single fibroid can vary greatly. It can be really small - a couple of millimeters, which is the size of a pea or marble - or a larger fibroid could be the size of an orange or grapefruit,” Dr. Valentine further explains. “Or in rare situations, a uterine fibroid can be greater than 10 centimeters, which is the size of a melon.”
And as uterine fibroids grow, they can cause abdominal bulge or bloating.
“That can certainly give an appearance of weight gain or increased abdominal girth,” notes Dr. Valentine. “If someone has larger fibroids, it can create a visible abdominal bulge.”
How Much Weight Can You Gain From Uterine Fibroids?
Uterine fibroids don’t typically cause weight gain.
“Smaller fibroids typically don’t weigh much, maybe a few grams,” Dr. Valentine clarifies. “But in rare cases, large fibroids could weigh maybe four or five pounds.”
An important distinction: The mass and size of a uterine fibroid can cause weight gain, meaning it’s unlikely that a uterine fibroid is causing other metabolic or systemic changes that lead to true weight gain.
Common Symptoms of Uterine Fibroids
Smaller uterine fibroids may not cause any symptoms, but you may experience the following if you have larger uterine fibroids:
- Excessive or painful bleeding during your period.
- Bleeding between your periods.
- Pelvic pain, discomfort and pressure.
- Pain during sex.
- Bloating.
- Constipation.
- Frequent urination.
- Fatigue.
Can Uterine Fibroids Make Your Stomach Bulge?
Yes.
“Especially with larger fibroids or a larger cluster of fibroids, they can increase or stretch the size of the uterus,” states Dr. Valentine. “You can experience a lower stomach bulge or pressure along with an increased abdominal girth. It can be accompanied by a feeling of fullness or bloating. And if the uterine fibroids start to get larger, you can even look like you’re pregnant.”
Will I Lose Weight After a Uterine Fibroid Is Removed?
Probably not.
“Once you remove a uterine fibroid, the weight of the fibroid itself and that pressure should be gone, and then any of the subsequent pressure on your bowel, bloating and fullness also should decrease after removal,” says Dr. Valentine.
There are many treatment options for uterine fibroids, including removing them during a surgical procedure, but it all depends on the size, location and number of fibroids. Your healthcare provider will also take into consideration your wishes for future pregnancies, as certain operations can damage the uterus.
But many small fibroids don’t cause any problems. And if you experience symptoms, your provider may suggest trying over-the-counter pain medication to help with pain as well as hormonal medications like birth control, which can help control heavy bleeding. There are other medications that can help shrink your fibroids, too.
“Even with large uterine fibroids, significant weight loss is not typical after surgery,” reiterates Dr. Valentine.
When to Consult a Doctor?
If you experience any of the following it's best to consult your doctor as they can check for hormonal imbalances or other underlying conditions:
- Unexpected weight gain or loss
- Severe bloating or digestive issues
- Mood swings or fatigue