Yes, fibroids can cause diarrhea, and it’s more common than most people realize. In a large U.S. survey of over 3,000 women with uterine fibroids, 63.3% reported experiencing constipation, bloating, or diarrhea at some point, and about 54% had these symptoms in the previous four weeks alone. While heavy bleeding gets most of the attention, bowel changes are one of the more frequent complaints among women living with fibroids.
How Fibroids Affect Your Bowels
The uterus sits directly in front of the rectum and close to the lower portion of the colon. When fibroids grow large enough, or grow in the right direction, they can physically press against the bowel. This compression can disrupt normal bowel function in several ways: slowing things down (constipation), speeding things up (diarrhea), or creating an unpredictable mix of both along with bloating.
The type of disruption you experience depends largely on how the fibroid interacts with surrounding tissue. Constant pressure on the rectum can irritate the bowel wall, triggering more frequent contractions that push stool through faster than normal. Some women notice their bowel habits shift back and forth, with constipation one week and loose stools the next, as the fibroid’s position subtly changes with movement, posture, or the menstrual cycle.
Which Fibroids Are Most Likely to Cause Problems
Not all fibroids cause digestive symptoms. Location and size matter far more than simply having a fibroid diagnosis. Subserosal fibroids, the type that grows on the outer wall of the uterus and extends outward into the pelvic cavity, are the most likely to press on nearby organs. When a subserosal fibroid grows from the back wall of the uterus (called a posterior fibroid), it points directly toward the rectum and colon. This is the combination most associated with rectal discomfort, constipation, and changes in bowel habits including diarrhea.
Smaller fibroids, even posterior ones, often cause no bowel symptoms at all. The trouble typically starts when fibroids reach a size where they begin competing for space in the pelvis. A single large fibroid or multiple fibroids that collectively enlarge the uterus can create enough pressure to affect how your intestines function day to day. Symptoms of subserosal fibroids also include a feeling of heaviness or fullness in the lower abdomen, frequent urination, pelvic pressure, and abdominal distension that looks like bloating but doesn’t come and go the way gas-related bloating does.
How Common Are Severe Bowel Symptoms
While the majority of women with fibroids report some digestive changes, the severity varies widely. In the same cross-sectional survey, 7.7% of women with fibroids reported severe constipation, bloating, or diarrhea, compared to 4.7% of women without fibroids. About 4.5% experienced severe difficulty having a bowel movement. So while mild bowel symptoms are very common, truly disruptive digestive problems affect a smaller subset of patients.
Among those who did have these symptoms, about 25.8% rated them as “extremely bothersome,” and 15% described them as a significant burden on daily life. That makes bowel symptoms roughly as bothersome as spotting between periods for this population. The numbers tell an important story: diarrhea and other bowel changes from fibroids are real, well-documented, and for some women, genuinely life-disrupting.
Fibroids vs. Other Causes of Diarrhea
One of the trickier aspects of fibroid-related diarrhea is that it can look a lot like irritable bowel syndrome (IBS) or other digestive conditions. Women sometimes spend months or years treating what they assume is a gut problem before learning that a growing fibroid is the actual cause. A few patterns can help distinguish fibroid-related bowel issues from other conditions:
- Timing with your cycle: If diarrhea worsens around your period, fibroids may be involved. Hormonal shifts during menstruation can cause the uterus to contract more, and an enlarged fibroid-containing uterus puts extra pressure on the bowel during these contractions.
- Accompanying pelvic symptoms: Diarrhea that comes alongside heavy periods, pelvic pressure, frequent urination, or a visibly distended lower abdomen points more toward fibroids than a primary digestive disorder.
- Gradual onset: Fibroid-related bowel changes tend to develop slowly as fibroids grow, unlike IBS flares that often correlate with stress or specific foods.
- Constipation mixed in: Many women with fibroid-related bowel issues experience both diarrhea and constipation rather than one or the other consistently.
If you’re experiencing chronic diarrhea and have a known fibroid diagnosis, or if you have unexplained bowel changes along with any pelvic symptoms, it’s worth connecting the two in conversation with your provider. Pelvic imaging can reveal whether a fibroid’s size and position could explain what’s happening in your gut.
When Bowel Symptoms Become Urgent
In rare cases, very large fibroids can cause mechanical compression of the small bowel, leading to a partial or complete bowel obstruction. This is uncommon but serious. Warning signs include severe cramping abdominal pain that comes in waves, vomiting, inability to pass gas or have a bowel movement at all, loss of appetite, and visible abdominal swelling. A bowel obstruction requires immediate medical attention. Large residual fibroids and adhesions from prior procedures like uterine artery embolization are known risk factors for this complication.
Treatment and Symptom Relief
The most reliable way to resolve fibroid-related diarrhea is to treat the fibroids themselves. When the source of pressure on the bowel is removed or reduced, digestive symptoms typically improve along with bleeding and pelvic pain.
Uterine artery embolization (UAE), a minimally invasive procedure that shrinks fibroids by cutting off their blood supply, reduces fibroid volume by about 70% on average. In clinical follow-up, about 61% of patients report improvement in bulk-related symptoms, the category that includes bowel pressure. Pain improves in roughly 70% of patients, and bleeding in up to 96%. Myomectomy, the surgical removal of fibroids while preserving the uterus, is another option, particularly when fibroids are large or few in number. For fibroids growing into the uterine cavity, a hysteroscopic approach allows removal through the vagina with no incisions.
While awaiting treatment or if your symptoms are mild, dietary adjustments can help manage day-to-day bowel irregularity. Soluble fiber can firm up loose stools, staying well-hydrated supports regular bowel function, and keeping a symptom diary can help you identify patterns tied to your cycle or specific triggers. These measures won’t address the underlying cause, but they can make the symptoms more manageable in the meantime.