Skip to content
How It Works
Explore
Ask a Question Resources Pricing
Who It's For
Patients
Decode results, prep for appointments, weigh options.
Caregivers & advocates
Carry the research load for someone you love.
Providers & clinicians
Resources for patients in your practice.
Log In Sign Up
PubMed This is a summary of 25 peer-reviewed journal articles Updated
Gynecology · Uterine Fibroids

Can Fibroids Cause Constipation, Bloating or Urinary Issues?

At a Glance

Yes. Larger uterine fibroids can enlarge the uterus and press on the bladder, bowel, nerves, or pelvic blood vessels, causing urinary frequency, constipation, bloating, back pain, or leg pressure. Because other conditions can cause the same symptoms, imaging and medical evaluation are important.

In this answer

4 sections

01

How Size and Position Matter

02

Could It Be Something Else?

03

Options to Improve Bulk Symptoms

04

Seek Emergency Care For Red Flag Symptoms

Yes, uterine fibroids can cause constipation, bloating, frequent urination, back pain, and a feeling of leg pressure. Fibroids are common, noncancerous growths of uterine muscle [1]. While many people with fibroids experience no symptoms at all, larger growths can cause what the medical community calls bulk symptoms or compressive symptoms [1]. They occur because the solid masses of tissue enlarge the uterus, causing it to take up excess space and press heavily against surrounding pelvic organs like the bladder, bowel, blood vessels, and nerves [2].

How Size and Position Matter

The severity of bulk symptoms often depends on fibroid size and location, though the relationship is not always a perfect match [2]. As the total volume of the uterus increases, urinary symptoms and pelvic pressure tend to worsen [3]. However, the specific location of a fibroid is just as important as its size:

  • Anterior fibroids (on the front of the uterus): These may press directly against the bladder, reducing how much urine the bladder can hold and causing frequent urination [3]. Substantial obstruction can also cause a feeling that the bladder isn’t completely empty.
  • Posterior fibroids (on the back of the uterus): These may press against the rectum and lower bowel, which can contribute to constipation, bloating, and lower back pain [4].
  • Cervical or broad ligament fibroids (lower down or off to the sides): In uncommon cases, these can compress the ureters (the tubes carrying urine from the kidneys to the bladder) or major pelvic blood vessels, which may lead to leg pressure or radiating pain [5][6].

Could It Be Something Else?

Bloating, back pain, and leg pressure are common but non-specific symptoms. Do not assume every pelvic symptom is caused by your fibroids. To get the best care, your team will need to rule out other conditions:

  • Other gynecologic issues: Conditions like endometriosis, adenomyosis, and ovarian cysts can also cause severe pelvic pain, bloating, and a heavy sensation [7][8][9].
  • Spinal or nerve problems: Lower back pain or a feeling of leg pressure might actually stem from spinal issues, such as a compressed nerve, rather than the fibroid itself [10].
  • Vascular conditions: Persistent leg pressure or heaviness can be related to vein disease or, uncommonly, physical compression of pelvic veins by a very large uterus [11].

To evaluate these symptoms, your doctor will likely recommend a pelvic ultrasound as a first step [12]. If the anatomy is complex or if you are planning treatment, an MRI is often used to map out exactly where the fibroids are [13].

Options to Improve Bulk Symptoms

If symptoms are mild and manageable, observation may be an appropriate choice. Over-the-counter pain relievers can help with discomfort or menstrual cramps, but they will not shrink the physical bulk of the fibroids [1]. If active treatment is needed, options include:

  • Medical Management: Prescription medications, such as GnRH agonists or antagonists, temporarily suppress ovarian hormones to shrink fibroids and relieve symptoms [14]. Fibroid volume often returns when the medication is stopped [15]. Duration of use, potential side effects, and the need for “add-back” hormone therapy depend on the specific medication.
  • Fertility Considerations: It is vital to note that “uterus-preserving” procedures do not automatically mean “fertility-preserving.” If you plan to carry a pregnancy in the future, you must discuss this with your doctor, as treatments have different and evolving reproductive impacts.
  • Minimally Invasive Procedures: Uterine artery embolization (UAE) (blocking the blood supply), radiofrequency ablation (RFA) (using controlled heat to destroy tissue), and focused ultrasound can shrink fibroid volume over months, relieving pressure [16][17][18].
  • Myomectomy: This surgical option removes the fibroid tissue while leaving the uterus intact [19]. It is often the preferred choice when future pregnancy is a priority, though new fibroids can still develop later.
  • Hysterectomy: This major, irreversible surgery removes the entire uterus. It is the definitive treatment for uterine fibroids and prevents them from returning [20]. However, it permanently ends the ability to carry a pregnancy, and it cannot guarantee that every bulk symptom will resolve if another condition was also contributing. (Removing the uterus does not necessarily mean removing the ovaries or causing immediate menopause).

Seek Emergency Care For Red Flag Symptoms

While most fibroids develop slowly and do not cause emergencies, seek same-day urgent or emergency medical assessment if you experience:

  • Acute urinary retention: An absolute inability to urinate. A poorly positioned fibroid can physically block the urinary tract, which requires immediate relief to prevent kidney damage [4][21].
  • Suspected bowel obstruction: Severe constipation accompanied by intense vomiting and significant abdominal swelling [22].
  • Signs of a blood clot: New unilateral (one-sided) leg swelling, warmth, or pain. While very large fibroids rarely compress pelvic veins enough to cause a deep vein thrombosis (DVT), any new one-sided leg swelling requires emergency assessment [23][11]. Call emergency services immediately for chest pain, shortness of breath, coughing blood, or fainting.
  • Sudden, severe abdominal pain: Sharp, intense pain—especially with a rigid abdomen, fainting, fever, or heavy bleeding with dizziness—warrants urgent assessment. This can mimic other emergencies (like ovarian torsion or appendicitis) or indicate an uncommon fibroid complication like degeneration, torsion, or internal bleeding [24][25].

Common questions in this guide

Can uterine fibroids make me constipated or bloated?
Yes. A fibroid on the back of the uterus or a larger uterus can press on the rectum and bowel, contributing to constipation, bloating, or pelvic fullness. These symptoms are not specific to fibroids, so other causes may need to be checked.
Why am I urinating often or not emptying my bladder if I have fibroids?
Fibroids at the front of the uterus can press on the bladder, reducing the room available for urine and causing frequent urination or incomplete emptying. An inability to urinate at all is an emergency and needs immediate medical assessment.
Could fibroids be behind my back pain or heavy legs?
They can, especially if a fibroid presses toward the back or sides of the pelvis and affects nearby tissues, nerves, or blood vessels. Back pain and leg pressure can also come from spinal or vein problems, so persistent or one-sided symptoms should be evaluated rather than automatically blamed on fibroids.
What tests show whether fibroids are causing my pressure symptoms?
A pelvic ultrasound is commonly the first imaging test. An MRI may be used when the anatomy is complex or treatment planning requires a more detailed map. Your clinician may also assess gynecologic, bowel, bladder, spinal, or vascular causes.
Which fibroid treatments can reduce pressure on my bladder or bowel?
Observation may be reasonable for mild symptoms, and some prescription medicines can temporarily shrink fibroids. Procedures such as uterine artery embolization, radiofrequency ablation, and focused ultrasound can reduce fibroid volume; myomectomy removes fibroids while preserving the uterus, while hysterectomy removes the uterus. The choice depends on symptom severity, fibroid location, health, and whether you may want a future pregnancy. A hysterectomy is permanent and ends the ability to carry a pregnancy.
Which symptoms mean I need emergency help?
Get same-day urgent or emergency care if you cannot urinate, have severe constipation with vomiting and marked abdominal swelling, develop new one-sided leg swelling, or experience sudden severe abdominal pain. Call emergency services for chest pain, shortness of breath, coughing blood, fainting, or severe pain with fainting, fever, or heavy bleeding.
Will the pressure or bowel symptoms go away after fibroid treatment?
Not always. Symptoms may persist if another condition, such as endometriosis, a spinal problem, or a vein disorder, is also contributing. Ask your clinician what improvement is realistic based on the fibroids' size and position.

Questions For You

Answer a question to get research tailored to you. Your answers are private.

Related questions

What Do Hybrid FIGO 2-5, 3-5, or 2-6 Uterine Fibroids Mean? When is Heavy Bleeding from Uterine Fibroids an Emergency? When Should I Have MRI, SIS, or Hysteroscopy for Fibroids? Can Uterine Fibroids Cause Fatigue and Shortness of Breath? When Is Severe Uterine Fibroid Pain or Fever an Emergency?
Show more
Can Uterine Fibroids Cause Painful Sex or Sexual Changes? Can Fibroids Cause Abdominal Enlargement or Weight Gain? Do I Need an Endometrial Biopsy for Fibroid Bleeding? Does Rapid Fibroid Growth Mean Uterine Cancer? Signs to Know How Is Postmenopausal Bleeding Evaluated With Fibroids? How Are Cavity-Distorting Fibroids Treated Before IVF? What Blood Tests Are Needed for Anemia From Fibroids? Do Uterine Fibroids Become Cancerous or Raise Cancer Risk? Can Asymptomatic Uterine Fibroids Be Safely Left Untreated? Do Uterine Fibroids Run in Families? Screening Advice Do Uterine Fibroids Shrink Before or After Menopause? Can Diet, Exercise, or Supplements Shrink Fibroids? How Are Fibroids Distinguished from Other Pelvic Conditions? Why Are Fibroids More Common and Severe in Black Women?

Get notified when new evidence is published on uterine corpus leiomyoma.

We monitor PubMed for new peer-reviewed studies on this topic and email a short summary when something meaningful changes.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Based on my ultrasound or MRI, are my fibroids positioned in a way that explains my symptoms, or should we evaluate for other causes?
  2. 2.What are the alternatives if I want to preserve the option for a future pregnancy?
  3. 3.How much shrinkage can I realistically expect from treatments like embolization or ablation, and what are the recovery times and risks?
  4. 4.Could my pressure or bowel symptoms remain even after treating or removing the fibroids?
  5. 5.Would it be beneficial to see a urologist, gastroenterologist, or physical therapist before we decide on a fibroid surgery?

References

References (25)
  1. 1

    Uterine Fibroids: Diagnosis and Treatment.

    De La Cruz MS, Buchanan EM

    American family physician 2017; (95(2)):100-107.

    PMID: 28084714
  2. 2

    Fibroids and Urinary Symptoms Study (FUSS).

    Bochenska K, Lewitt T, Marsh EE, et al.

    Female pelvic medicine & reconstructive surgery 2021; (27(2)):e481-e483 doi:10.1097/SPV.0000000000000967.

    PMID: 33105342
  3. 3

    The relationship between uterine and fibroid volume with urinary symptoms as reported in the King's Health Questionnaire.

    Bernadette L, Miriam T, Islam A, et al.

    European journal of obstetrics, gynecology, and reproductive biology 2026; (321()):115050 doi:10.1016/j.ejogrb.2026.115050.

    PMID: 41795480
  4. 4

    Urinary retention and uterine leiomyomas: a case series and systematic review of the literature.

    Wu CQ, Lefebvre G, Frecker H, Husslein H

    International urogynecology journal 2015; (26(9)):1277-84 doi:10.1007/s00192-015-2665-1.

    PMID: 25752469
  5. 5

    Giant cervical uterine leiomyoma associated with bilateral ureterohydronephrosis and retroperitoneal perinephric urinoma at the left kidney: A case report and.

    Thanasa A, Thanasa E, Xydias E, et al.

    Medicine international 2025; (5(5)):57 doi:10.3892/mi.2025.256.

    PMID: 40777594
  6. 6

    Fertility preservation in a large broad ligament leiomyoma: a case report.

    Aljoudeh J, Deeb A, Ranjous Y, et al.

    Journal of medical case reports 2025; (19(1)):318 doi:10.1186/s13256-025-05384-y.

    PMID: 40616185
  7. 7

    Exploring Self-Reported Symptoms for Developing and Evaluating Digital Symptom Checkers for Polycystic Ovarian Syndrome, Endometriosis, and Uterine Fibroids: Exploratory Survey Study.

    Wickham AP, Hewings-Martin Y, Goddard FG, et al.

    JMIR formative research 2024; (8()):e65469 doi:10.2196/65469.

    PMID: 39666967
  8. 8

    GnRH antagonists for the treatment of fibroids and adenomyosis, current evidence and future perspectives.

    Ferrero S, Gazzo I, Perrone U, et al.

    Expert opinion on pharmacotherapy 2026; (27(11)):1163-1178 doi:10.1080/14656566.2026.2695094.

    PMID: 42360331
  9. 9

    Ultrasound-Guided Diagnosis of Multiple Uterine Fibroids in a Patient With Polycystic Ovaries and Treatment With Relugolix, Estradiol, and Norethisterone Acetate.

    Acchiardo J, Maita E, Jobanputra K

    Cureus 2023; (15(5)):e39055 doi:10.7759/cureus.39055.

    PMID: 37323302
  10. 10

    Sciatica in Early Pregnancy With Coexisting Uterine Leiomyoma and‌ ‌Tarlov‌ ‌Cyst:‌ ‌A‌ ‌Case Report.

    Disi ES

    Cureus 2022; (14(8)):e27855 doi:10.7759/cureus.27855.

    PMID: 35968245
  11. 11

    Uterine fibroids as an underrecognized risk factor for venous thromboembolism: a narrative review.

    Megahed M, Shah ZZ, Razvi KA, Abdeen Y

    Blood coagulation & fibrinolysis : an international journal in haemostasis and thrombosis 2026; (37(6)):283-287 doi:10.1097/MBC.0000000000001436.

    PMID: 42261740
  12. 12

    Diagnosis and classification of uterine fibroids.

    Lakabi R, Harth S, Meinhold-Heerlein I, et al.

    International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics 2025; (171(2)):566-573 doi:10.1002/ijgo.70538.

    PMID: 40970558
  13. 13

    MRI-based pictorial review of the FIGO classification system for uterine fibroids.

    Gomez E, Nguyen MT, Fursevich D, et al.

    Abdominal radiology (New York) 2021; (46(5)):2146-2155 doi:10.1007/s00261-020-02882-z.

    PMID: 33385249
  14. 14

    New treatment options for nonsurgical management of uterine fibroids.

    Lee S, Stewart EA

    Current opinion in obstetrics & gynecology 2023; (35(4)):288-293 doi:10.1097/GCO.0000000000000880.

    PMID: 37144584
  15. 15

    The management of uterine leiomyomas.

    Vilos GA, Allaire C, Laberge PY, et al.

    Journal of obstetrics and gynaecology Canada : JOGC = Journal d'obstetrique et gynecologie du Canada : JOGC 2015; (37(2)):157-178 doi:10.1016/S1701-2163(15)30338-8.

    PMID: 25767949
  16. 16

    Efficacies of uterine artery embolization for symptomatic uterine fibroids using gelatin sponge: a single-center experience and literature review.

    Toda A, Sawada K, Osuga K, et al.

    International journal of women's health 2016; (8()):397-404 doi:10.2147/IJWH.S107367.

    PMID: 27574469
  17. 17

    Clinical Performance of Radiofrequency Ablation for Treatment of Uterine Fibroids: Systematic Review and Meta-Analysis of Prospective Studies.

    Bradley LD, Pasic RP, Miller LE

    Journal of laparoendoscopic & advanced surgical techniques. Part A 2019; (29(12)):1507-1517 doi:10.1089/lap.2019.0550.

    PMID: 31702440
  18. 18

    Ultrasound-guided high-intensity focused ultrasound for symptomatic uterine fibroids: clinical outcome of two European centers.

    Dohmen S, Recker F, Ivanova Y, et al.

    European radiology 2025; (35(6)):3638-3648 doi:10.1007/s00330-024-11230-4.

    PMID: 39613955
  19. 19

    Uterine-Artery Embolization or Myomectomy for Uterine Fibroids.

    Manyonda I, Belli AM, Lumsden MA, et al.

    The New England journal of medicine 2020; (383(5)):440-451 doi:10.1056/NEJMoa1914735.

    PMID: 32726530
  20. 20

    Long-term health-related quality of life and symptom severity following hysterectomy, myomectomy, or uterine artery embolization for the treatment of symptomatic uterine fibroids.

    Anchan RM, Spies JB, Zhang S, et al.

    American journal of obstetrics and gynecology 2023; (229(3)):275.e1-275.e17 doi:10.1016/j.ajog.2023.05.020.

    PMID: 37244458
  21. 21

    A 30-Month Complete Urinary Obstruction Resulting from Trapped and Incarcerated Uterus: A Case Report.

    Nam G, Lee SR, Kim SH, Chae HD

    Medicina (Kaunas, Lithuania) 2021; (57(3)) doi:10.3390/medicina57030207.

    PMID: 33652746
  22. 22

    Small bowel obstruction secondary to uterine fibroids: a case presentation.

    Antzoulas A, Verras GI, Leivaditis V, et al.

    Przeglad menopauzalny = Menopause review 2024; (23(4)):225-228 doi:10.5114/pm.2024.145956.

    PMID: 39811391
  23. 23

    Venous Thromboembolism Associated with Uterine Fibroids: A Review of Reported Cases.

    Sparić R, Stojković M, Šarac M, et al.

    Journal of clinical medicine 2026; (15(2)) doi:10.3390/jcm15020444.

    PMID: 41598382
  24. 24

    Intra-abdominal haemorrhage from uterine fibroids: a systematic review of the literature.

    Lim WH, Cohen SC, Lamaro VP

    BMC surgery 2020; (20(1)):70 doi:10.1186/s12893-020-00736-5.

    PMID: 32293414
  25. 25

    Hemoperitoneum caused by spontaneous rupture of a leiomyoma: A case report.

    McKendrick M, Rajadurai V, Weishaupt J, Kasina V

    Case reports in women's health 2024; (42()):e00609 doi:10.1016/j.crwh.2024.e00609.

    PMID: 38646503

This page is for informational purposes only and does not constitute medical advice. A gynecologist can help determine whether fibroids explain your symptoms and whether you need urgent evaluation.