Endometriosis and Fibroids

Two different conditions

Endometriosis and fibroids both involve the uterus and can cause pain or heavy bleeding, but they are different. This page is educational. It does not replace evaluation, because symptoms overlap with other conditions.

Endometriosis

What it is. Endometriosis is where cells similar to those in the lining of the uterus grow in other parts of the body, often around the ovaries, fallopian tubes and pelvic lining. Sometimes it affects the bladder or bowel, and rarely areas outside the pelvis. [1] It can affect anyone who has or had a uterus. [1]

Common features. The NHS lists severe period pain, heavy periods, pelvic pain, pain when urinating or having a bowel movement, pain during or after sex, extreme tiredness, difficulty getting pregnant, and low mood or anxiety. [1]

Getting a diagnosis. It can take a long time, because symptoms resemble other conditions such as adenomyosis, fibroids, pelvic inflammatory disease and irritable bowel syndrome. [1] Evaluation can include an exam, blood tests, ultrasound, MRI, and sometimes laparoscopy, a keyhole procedure that can confirm it. [1]

Established care. There is no cure, but treatment can manage symptoms. [1] First-line options include pain relievers and hormonal medicines that ease pain; hormones are not used if you are trying to get pregnant. [1] Surgery may be offered if other treatments are not working or fertility is affected. [1] Symptoms usually stop after menopause, although they can continue. [1]

Fibroids

What they are. Fibroids are common, non-cancerous growths in or around the uterus. [2] The Office on Women's Health says about 20 to 80 percent of women develop fibroids by age 50. [3] They do not always cause symptoms. [2]

Possible symptoms. Heavy or painful periods, belly or low back pain, needing to urinate often, bowel problems, discomfort during sex, and difficulty getting pregnant. [2]

Risk factors listed by the NHS include not having been through menopause, never having had a full-term pregnancy, higher weight, high blood pressure or diabetes, being of Black or Asian background, and a family history. [2]

Care. No treatment may be needed if there are no symptoms. [2] Options include pain relievers, tranexamic acid or hormonal medicine for heavy bleeding, and procedures such as myomectomy, hysterectomy, endometrial ablation or uterine artery embolization. [2] Some treatments can affect the ability to have children, so discuss plans first. [2] Heavy bleeding can lead to iron deficiency anemia. [2] See heavy and irregular periods and nutrition for women.

Diet, supplements and complementary approaches

Evidence labels: insufficient evidence, proper evidence not found.

The guideline does recommend that clinicians discuss non-medical strategies to support quality of life and psychological well-being. [4] Heavy bleeding with iron deficiency may need iron; the Office on Women's Health says an iron supplement can prevent or correct anemia. [3]

When to get help

See a clinician if symptoms affect daily life, treatment is not helping, or they are getting worse. [1][2] Sudden severe pelvic pain needs urgent care. [5] Check medication interactions before adding supplements. See when to get help and period pain.