Last reviewed: 7 May 2026
Key Facts: Fibroids can cause bleeding between periods (intermenstrual bleeding) by distorting the uterine lining, increasing local blood supply and disrupting hormonal signalling. Submucosal fibroids most commonly cause spotting. See a specialist if bleeding is heavy, persistent, painful or occurs after menopause.
Fibroids Bleeding Between Periods| Causes, Symptoms & When to See a Specialist
Fibroids bleeding between periods can be worrying for many women. In some cases, the cause may be uterine fibroids – non-cancerous growths that develop in or around the womb.
Bleeding when a period is not due worries most women. Fibroids bleeding between periods is one of the most common causes of unexpected spotting or bleeding that continues longer than expected.
Fibroids are very common and many women have them without realising. However, in some cases they can cause symptoms such as heavy periods, pelvic pressure or unexpected bleeding between menstrual cycles.
Understanding why fibroids can cause bleeding between periods can help women recognise symptoms early and seek appropriate medical advice.
What are fibroids?
Fibroids are very common non-cancerous growths of the womb. According to the NHS, many women develop fibroids during their reproductive years, although some never experience symptoms.
They can vary greatly in size, from very small growths to larger fibroids that change the shape of the womb. Fibroids are most commonly diagnosed in women during their reproductive years and are influenced by hormones such as oestrogen and progesterone.
Some women have fibroids without experiencing symptoms, while others develop symptoms including heavy periods, pelvic pressure or abnormal bleeding between cycles.
If symptoms occur, a specialist fibroid assessment can help determine the cause and identify the most appropriate treatment options.
Why do fibroids cause bleeding between periods?
Fibroids can interfere with the normal function of the uterus and disrupt the regular menstrual cycle.
Several factors contribute to irregular or intermenstrual bleeding.
Disruption of the uterine lining
Fibroids located close to the lining of the womb (submucosal fibroids) can interfere with the normal growth and shedding of the uterine lining.
This can lead to small areas of the lining breaking down outside of the normal menstrual cycle, causing spotting or bleeding between periods.
Increased blood supply
Fibroids require a strong blood supply in order to grow. They develop new blood vessels that can sometimes be fragile and prone to bleeding.
This increased blood flow can contribute to irregular bleeding patterns.
Hormonal influences
Hormones such as oestrogen and progesterone regulate both the menstrual cycle and fibroid growth. When hormone levels fluctuate, fibroids may respond by enlarging slightly or affecting how the uterine lining behaves.
This can lead to unexpected bleeding during the menstrual cycle.
Pressure effects
Larger fibroids may put pressure on surrounding areas of the uterus. This pressure can sometimes irritate the uterine lining and trigger bleeding at unusual times.
What symptoms occur alongside fibroid bleeding?
Women who experience bleeding between periods due to fibroids may also notice other symptoms.
Common symptoms include:
- very heavy periods
- periods that last longer than usual
- pelvic pressure or a feeling of heaviness in the lower abdomen
- abdominal bloating or swelling
- pain during or after intercourse
- lower back pain
- fatigue caused by iron deficiency
Persistent or heavy bleeding can lead to iron-deficiency anaemia, which may cause tiredness, dizziness or shortness of breath.
If these symptoms occur, a gynaecology consultation can help identify the cause and recommend appropriate investigations.
When Does Fibroid Bleeding Need Urgent Attention?
If you are bleeding heavily and feel faint, dizzy or unwell, call 999 or go to your nearest A&E.
The list below covers urgent (but non-emergency) symptoms that should be assessed promptly:
- Bleeding lasting more than 7 days
- Soaking through a pad or tampon every hour
- Dizziness, light-headedness or persistent fatigue
- Bleeding after sex
- Any bleeding after menopause
Concerned about fibroid symptoms? You do not need a GP referral to be seen at Ovara Health. Call us on 0207 751 4488 or book online for a prompt private assessment in Chelsea.
How are fibroids diagnosed?
Fibroids bleeding between periods should always be properly assessed, as several conditions can cause similar symptoms.
A specialist will usually begin by discussing symptoms and medical history before performing an examination. Imaging tests are then used to confirm the diagnosis.
A pelvic ultrasound scan is typically the first investigation used to identify fibroids and determine their size and location. In some cases, additional imaging or investigations may be recommended to gain a clearer picture of the uterus.
Blood tests may also be used to check hormone levels or identify iron deficiency caused by heavy bleeding.
Once fibroids are confirmed, a personalised treatment plan can be created depending on:
- the size and number of fibroids
- the severity of symptoms
- age and reproductive plans
Can fibroids cause bleeding between periods?
Yes. Fibroids can disrupt the normal uterine lining and lead to spotting or bleeding between menstrual cycles.
The lining of the uterus may become thicker or uneven due to the presence of fibroids. As the lining breaks down irregularly, bleeding may occur outside the normal period.
For some women this appears as light spotting, while others experience heavier bleeding that may last for several days.
The pattern may change over time depending on hormone levels or fibroid growth.
What are the treatment options for fibroids?
Treatment for fibroids depends on several factors, including symptom severity and whether fertility preservation is important.
Medication
Hormonal treatments such as progesterone therapy or intrauterine devices can help regulate the menstrual cycle and reduce heavy bleeding.
Certain medications may also help reduce blood loss during periods.
Minimally invasive procedures
Some procedures can shrink fibroids by reducing their blood supply.
Other treatments focus on removing fibroids while preserving the uterus.
Surgical options
In more severe cases, surgery may be recommended if symptoms significantly affect quality of life.
A specialist consultation helps determine which treatment approach is most suitable.
Women experiencing ongoing symptoms may benefit from discussing treatment options with a fibroid specialist.
Treatment options at a glance
| Option | Examples | Best for | Recovery | Fertility-preserving? |
|---|---|---|---|---|
| Medication | Tranexamic acid, mefenamic acid, levonorgestrel IUS, GnRH analogues | Mild to moderate bleeding; first-line treatment | None (ongoing use) | Yes |
| Minimally invasive procedures | Uterine artery embolisation (UAE), MRI-guided focused ultrasound, hysteroscopic resection | Symptomatic fibroids when medication is insufficient | 1–2 weeks | Often (case-dependent) |
| Surgical – Myomectomy | Robotic, laparoscopic or open removal of fibroids | Women wishing to preserve fertility | 2–6 weeks | Yes |
| Surgical – Hysterectomy | Removal of the womb (definitive cure) | Severe symptoms when family is complete | 4–6 weeks | No |
How do you stop fibroid bleeding?
Treatment to stop or reduce fibroid-related bleeding is chosen based on the severity of bleeding, the size and position of the fibroids and whether you wish to preserve fertility. Several effective options are available, ranging from medication to minimally invasive surgery.
Tranexamic acid
Tranexamic acid is a non-hormonal medication taken during heavy bleeding episodes. It works by helping the blood to clot more effectively, reducing menstrual blood loss by up to 50% in many women (NICE NG88). It does not shrink fibroids but can significantly improve quality of life.
Mefenamic acid
Mefenamic acid is a non-steroidal anti-inflammatory (NSAID) that reduces both bleeding and period pain. It is most useful when heavy bleeding is accompanied by cramping and is taken only on bleeding days.
Levonorgestrel intrauterine system (IUS)
The levonorgestrel-releasing IUS (commonly known as Mirena) releases a low dose of progestogen directly into the womb. It thins the uterine lining, dramatically reducing bleeding for most women, and remains effective for up to five years. It is often the first-line option for fibroid-related heavy bleeding when fibroids are not distorting the uterine cavity (NICE NG88).
When is surgery needed?
Surgery may be recommended when medical treatment fails, when fibroids are large or rapidly growing, or when symptoms significantly affect quality of life. Options include myomectomy (removal of fibroids while preserving the uterus), uterine artery embolisation, and, in selected cases, hysterectomy. Robotic-assisted myomectomy offers a minimally invasive route with faster recovery.
Discuss your treatment options →
What does heavy bleeding caused by fibroids (menorrhagia) involve?
Menorrhagia is the medical term for menstrual blood loss that is heavy enough to interfere with daily life (see RCOG patient information). Fibroids, particularly those located within or close to the uterine cavity, are one of the most common causes.
Typical features of fibroid-related menorrhagia include:
- Soaking through one or more pads or tampons every hour for several consecutive hours
- Bleeding lasting longer than 7 days
- Passing large blood clots (often described as bigger than a 50p coin)
- Needing double sanitary protection (pad plus tampon)
- Disrupted sleep due to night-time changes of protection
Sustained heavy blood loss carries a real risk of iron-deficiency anaemia, which can cause persistent tiredness, breathlessness, dizziness, headaches and pale skin. A simple blood test (full blood count and ferritin) can confirm anaemia, and iron supplementation may be needed alongside treatment of the underlying fibroids.
What colour is fibroid bleeding?
Fibroid-related bleeding can range in colour from bright red (fresh, fast-flowing blood, often during the heaviest days of a period) to dark red or brown (older blood that has taken longer to leave the body). Many women also notice blood clots, particularly during heavy days, and may see brown spotting between periods or before a period properly starts. Colour alone does not indicate severity, but a sudden or persistent change in colour, flow or pattern should be assessed by a specialist.
When should you seek medical advice for fibroid bleeding?
Bleeding between periods should always be assessed if it becomes frequent, heavy or persistent.
You should seek medical advice if:
- bleeding occurs repeatedly between periods
- periods become very heavy or prolonged
- pelvic pain or pressure develops
- fatigue or dizziness occurs due to blood loss
Early assessment allows doctors to identify the cause of abnormal bleeding and begin appropriate treatment.
Sources and further reading
- NHS: Fibroids
- NICE Guideline NG88 – Heavy menstrual bleeding: assessment and management
- Royal College of Obstetricians and Gynaecologists (RCOG) – Patient information on heavy menstrual bleeding
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Frequently Asked Questions
Why does fibroid bleeding between periods happen?
Fibroids can disrupt the uterine lining and lead to spotting or bleeding outside the normal menstrual cycle. Submucosal fibroids that sit just under the lining are the most common culprit.
How are fibroids diagnosed?
Fibroids are typically diagnosed using pelvic ultrasound imaging combined with a specialist examination and a review of symptoms. In some cases, MRI or hysteroscopy is recommended for further assessment.
When should bleeding between periods be checked?
Bleeding between periods should be assessed promptly if it occurs frequently, becomes heavy, lasts more than a few days, is accompanied by pain or occurs after sex or after menopause.
Can fibroids cause heavy bleeding?
Yes. Fibroids are one of the most common causes of menorrhagia (heavy menstrual bleeding) and can also cause bleeding between cycles, particularly when they affect the uterine lining.
How do you stop fibroid bleeding?
Bleeding can often be controlled with non-hormonal medication (tranexamic acid, mefenamic acid), hormonal options (the levonorgestrel IUS or combined contraceptives), or definitive treatment of the fibroids themselves through myomectomy, embolisation or, rarely, hysterectomy. The right choice depends on your symptoms, fibroid characteristics and reproductive plans.
What colour is fibroid bleeding?
It varies from bright red (fresh blood) to dark brown (older blood), often with clots. Brown spotting between periods is also common with fibroids.
Is fibroid bleeding dangerous?
Most fibroid-related bleeding is not immediately dangerous, but prolonged or heavy bleeding can cause iron-deficiency anaemia and significantly affect quality of life. Sudden very heavy bleeding, dizziness or signs of shock require urgent medical attention.
Can fibroids cause constant bleeding?
Yes. Larger or submucosal fibroids can occasionally cause near-continuous bleeding or prolonged spotting that lasts most of the month. Constant bleeding should always be assessed to rule out other causes.
Do fibroids bleed when they shrink?
Fibroids that begin to degenerate (often after menopause or following uterine artery embolisation) can sometimes cause changes in bleeding pattern, including spotting. Pain is more typical than fresh bleeding when a fibroid is degenerating.
Can fibroids cause bleeding after sex?
Submucosal or pedunculated fibroids near the cervix may bleed after intercourse. Postcoital bleeding can also have other causes (such as cervical changes), so it should always be evaluated by a specialist.
Can fibroids cause bleeding after menopause?
Fibroids usually shrink after menopause and rarely cause bleeding. Any postmenopausal bleeding should be urgently investigated to exclude endometrial cancer or polyps, even if you have known fibroids.
When should I see a doctor about fibroid bleeding?
Book an assessment if you have heavy or prolonged periods, bleeding between periods, pelvic pain or pressure, fatigue suggesting anaemia, bleeding after sex or any postmenopausal bleeding. Early assessment improves treatment options and outcomes.
This article is for general information only and is not a substitute for personalised medical advice. If you are concerned about your symptoms, please book a consultation with a qualified clinician.
By Kerry Archer
Medically reviewed by Mr Amer Raza, MBBS MRCOG, GMC 5205372 – 7 May 2026