Can fibroids cause constipation? The surprising connection between the gut and uterus
May 26, 2026
Medically reviewed by Alex Kim, MD
If you’re a woman and have been dealing with stubborn constipation and can’t figure out why everything you’re trying isn’t working, the answer may point to your uterus!
For millions of women, the culprit behind chronic digestive discomfort is located in the uterus instead of the intestinal tract. The connection between fibroids and constipation is often overlooked in women’s health.
What are uterine fibroids?
Uterine fibroids are benign, non-cancerous growths in and surrounding the uterus. They’re far more common than women realize – approximately 70% of white women and 80% of Black women in the U.S. by the time they reach 50.¹ Despite being so common, fibroids are notorious for going undiagnosed because many women assume that the symptoms (like bloating, pelvic heaviness, digestive troubles) are “normal” for their menstrual cycle, or are caused by something else.
Can fibroids cause constipation?
The short answer is yes. The uterus sits close to the colon and rectum, so when fibroids grow large enough or develop in certain locations, they can press directly on the digestive tract.² If the fibroid is located toward the back of the uterus, it’s likely to press against the colon, making it harder for stool to pass normally. This abdominal pressure due to fibroids can range from uncomfortable to disruptive.
A specific type of fibroid, called a subserosal fibroid, grows on the outer surface of the uterus. When this type develops near the lower intestines, it can crowd the bowel and make passing stool physically difficult.³ Women with these fibroids often describe a sense of fullness or pressure in the bowel that doesn’t go away, regardless of how much fiber or water they consume.
The gut-uterus connection goes deeper than pressure
Beyond the obvious physical connection, there’s a more nuanced relationship between fibroids and digestive function worth understanding. Fibroids are significantly driven by estrogen and grow in response to it, and shrink after menopause when estrogen levels drop. Estrogen is also processed through the gut, which means that gut health and hormonal balance are more closely linked than many people expect.
When the gut isn’t functioning how it should, estrogen that should be eliminated gets reabsorbed into the bloodstream. This creates a feedback loop where poor gut health may contribute to higher circulating estrogen levels, which in turn can fuel fibroid growth. It’s a cycle that underscores why treating the digestive symptoms of fibroids isn’t just about comfort- it may also be relevant to overall fibroid management.
There’s also a secondary process at play. Heavy menstrual bleeding, one of the hallmark symptoms of fibroids, can lead to iron deficiency anemia. Iron supplements, which are commonly prescribed to address this anemia, are themselves a well-known cause of constipation. So even if a fibroid isn’t directly pressing on the colon, the cascade of symptoms can still land you in the same uncomfortable place.
What does fibroid-related constipation actually feel like?
Women dealing with abdominal pressure due to fibroids often report a persistent feeling of rectal fullness or a sense that they need to go but can’t. Straining becomes common. Bloating can be significant, sometimes making the lower abdomen visibly distended. Pelvic pain or pressure frequently accompanies constipation, which is a helpful distinguishing clue that something beyond diet or lifestyle is involved.
If your constipation gets worse around your menstrual cycle, feels localized to the lower pelvic region, or is paired with heavy bleeding or frequent urination, it’s worth raising the possibility of fibroids with your doctor.
What are the treatment options for fibroids?
Some of the most common fibroid treatment options include:
- Medications and hormone therapy
- Myomectomy: A surgical procedure that removes fibroids but doesn’t remove the uterus
- Hysterectomy: Surgical removal of the uterus
- Uterine Fibroid Embolization (UFE): A minimally invasive, non-surgical treatment that shrinks fibroids
Why more women are choosing UFE
For many women, Uterine Fibroid Embolization offers an effective middle ground between simply managing symptoms and undergoing major surgery. UFE is performed by an interventional radiologist through a tiny puncture in the wrist or groin, without removing the uterus and without the long recovery associated with surgery.
As the fibroids shrink after treatment, pressure on nearby organs like the colon and rectum often improves significantly. Many women notice relief not only from heavy bleeding and pelvic pressure, but also from constipation, bloating, and urinary frequency.
Benefits of UFE
- No large surgical incision
- Preserves the uterus
- Shorter recovery time compared to surgery
- Lower cost than surgery
- Performed in an outpatient center where patients go home the same day
- Return to normal activities quickly⁴
- Effective relief from heavy bleeding, pelvic pressure, bloating, and digestive symptoms
- Lower complication risk than many surgical alternatives
The important takeaway is that uncomfortable symptoms caused by fibroids, including constipation and pelvic pressure, are highly treatable. Women no longer have to assume these symptoms are “just part of life.”
When to see a doctor
If you’ve been managing what feels like chronic constipation and it hasn’t responded to typical dietary changes, it’s worth asking for a pelvic ultrasound. This is the standard first step for diagnosing fibroids and can quickly reveal whether uterine growths might be contributing to your symptoms.
If you have already been diagnosed with fibroids and are interested in learning more about UFE, contact National Vascular Physicians to schedule an appointment with our fibroid specialists. We have locations in National Harbor, Rockville, and Glen Burnie, MD, and in Roanoke and Lynchburg, VA.
Sources:
- Society of Interventional Radiology. Uterine Fibroids and Uterine Fibroid Embolization (UFE) Treatment.Reviewed September 2024. https://www.sirweb.org/for-patients/conditions-and-treatments/uterine-fibroids/
- Healthline. Fibroids and Constipation: What’s the Relationship? July 2023. https://www.healthline.com/health/constipation/constipation-and-fibroids
- Talking Fibroids. Can Uterine Fibroids Cause Digestive Problems? February 2023. https://talkingfibroids.com/medical/medical-medical/can-uterine-fibroids-cause-digestive-problems/
- Johns Hopkins Medicine. Is Uterine Fibroid Embolization (UFE) the Right Treatment for You? June 2024. https://www.hopkinsmedicine.org/health/wellness-and-prevention/is-uterine-fibroid-embolization-the-right-treatment-for-you
