105. Fibroids Explained: From Infertility to Heavy Periods

You’ve been told it’s just stress, or maybe a hormonal imbalance. But what if the real reason behind your heavy bleeding, bloating, or infertility is a fibroid—and no one’s taken it seriously?

In this episode of Cycle Wisdom, Dr. Monica Minjeur unpacks how uterine fibroids can disrupt cycles, impact fertility, and go undiagnosed for far too long. Learn why fibroid location matters more than size, what types affect fertility most, and how a Restorative Reproductive Medicine approach can offer real answers without suppressing your cycle. If you’ve been brushed off or offered nothing but birth control or surgery, this episode offers hope—and a new path forward.

👉Book a free discovery call at radiantclinic.com to explore personalized care and uncover what your body’s been trying to say all along.

Transcript

Monica: 0:01

Welcome back to Cycle Wisdom, where we empower women to restore natural menstrual cycles, to improve health and promote fertility. I'm your host, Dr. Monica Minjeur, and I'm so glad you're listening today. What if the reason you haven't been able to conceive, or the reason that you're having painful periods or abdominal bloating isn't just about your hormones or stress, but a fibroid? That no one has taken really seriously. If you've ever been told it's just a small fibroid, don't worry about it. Or if you're navigating infertility, heavy bleeding or unexplained pelvic discomfort, this episode is for you. I am going to unpack what fibroids are, how they can impact your fertility and overall health, and why location matters more than size. I'll also share how restorative reproductive medicine takes a different, more personalized approach to diagnosis and treatment. One that looks at your whole cycle, not just a symptom. And as always, let's start with a real patient story that might sound a little bit like your own. For months, Alice had been battling with irregular cycles and increasing abdominal discomfort. Her periods came unpredictably, sometimes heavy, sometimes they weren't there at all, and the bloating was constant. She told us, I felt like I was six months pregnant all the time. None of my clothes fit right. I didn't feel like myself, and I thought I was just going through some hormonal changes or not eating right. Alice was frustrated and desperate for answers, and so prior to seeing our clinic, she turned to a well-known online hormone specialist company that she found through social media. Their website promised personalized testing and root cause solutions for hormone health. Within days, they had her submit stool samples and blood work to assess for problems with her gastrointestinal tract. Since most of her symptoms were related to her abdomen, she was given a diagnosis of gut microbiome, dysbiosis, and adrenal fatigue. She was started on a complicated regimen of six different supplements totaling over$400 a month. But four weeks after starting treatment, nothing had changed. The bloating still was there. She still had significant fatigue and issues with irregular bleeding in her cycle. Alice started to wonder if she was just imagining things or if something bigger was being missed. That's when she found our clinic and scheduled her consultation. During her first appointment, we talked through detailed questions, not just about her gut, but about her full health history, her cycles and her symptoms, and the very first thing we did was to order a pelvic ultrasound, something the other clinic had never suggested to her. The result was as expected, Alice had a large softball sized fibroid that was pressing on her uterus and her bowels. It was no wonder she felt so bloated and full. Her irregular bleeding and cycle disruption also made perfect sense. With this diagnosis, we were able to create a personalized treatment plan, not more supplements. In fact, we stopped all of her supplements and gave Alice a real path forward. Her story isn't unique and it's a powerful reminder that sometimes the problem isn't just your gut or your stress levels. Sometimes there can actually be something there. Now, it may not be a softball sized fibroid, but even smaller fibroids can cause issues, and you deserve a healthcare professional who knows the difference. So what are fibroids? Fibroids are benign tumors or masses of the uterine muscle. They can also sometimes be called a myoma or a oma. Fibroids are actually quite common. The US Department of Health and Human Services estimates that up to 70 to 80% of women will develop fibroids by the time they're 50 years old. They can be sensitive to both estrogen and or progesterone, and they typically will grow during your reproductive years, especially in environments where you have high estrogen levels or estrogen dominance. These situations oftentimes will be in place when you have low progesterone levels. Or in women who have been on hormonal birth control, have had multiple pregnancies or have unregulated cycles, because if you are not ovulating consistently, we have this estrogen dominance with no progesterone in sight. Now, most of the time, fibroids are non-cancerous, but we always want to check out any abnormal growth to ensure that there are no concerns. So there's multiple different types of fibroids and it really makes a difference as to the location because you can have a very small fibroid in a bad location, cause way more troubles than a larger fibroid in a location that doesn't matter as much. So fibroids can happen in multiple different places if they're on the outside part of the uterus. That's called a subserosal fibroid. These typically don't have too much issues and fertility unless they're quite large, or if they are also blocking off a part of the fallopian tube or pressing on the ovary. Intramural fibroids are within the uterine wall. Now remember, the uterus is a muscular wall, and so these intramural fibroids are on the inner part of that wall. Now, they typically don't have any impact when it comes to fertility, but if they are large, they can impact the uterus's ability to contract or can impair blood flow to the area which can create problems with implantation or fertilization. And then we can also have a submucosal fibroid. Now, a submucosal fibroid is most likely to affect fertility, even if they're small, and these bulge into the inner wall of the uterine cavity. Even small ones can cause some issues depending upon where they're located, especially if they're near fallopian tubes or at a place where implantation is trying to occur. And then the final type of fibroid is pedunculated. Now these can be either internal or external compared to the uterus, and it just means that they're attached by a stalk. So if you can imagine a small piece of tissue that's connecting it to the uterus, and then a larger fibroid that comes from that, and pedunculated fibroids, again, if they're external typically don't cause much issues, but if they are internal, can cause more problems and any of these fibroids can increase bleeding. Now fibroids can impact fertility in many ways, and one of the most common that we see is, is if they're actually anatomically pressing on or preventing implantation from occurring. Other signs that you might see can include heavy periods, painful cycles, pelvic pressure or abdominal discomfort, and abdominal bloating, and sometimes women will mistake this. Four gastrointestinal symptoms. Signs that your fibroids may be interfering with fertility are if you are just not having any success with getting pregnant in the first place. So again, inflammation of that uterine environment can prevent implantation from occurring. It can also create anovulatory cycles. So if the hormonal environment is disrupted, it can actually create problems with ovulating in the first place. And again, remember, anovulation oftentimes is an estrogen dominant state if you don't have progesterone, and this will then further increase your risk of fibroids. We can also see problems with fertility if you are having recurrent miscarriages. Again, sometimes fertilization can occur, but if implantation doesn't happen, we oftentimes will see those earlier miscarriages or earlier pregnancy losses prior to six weeks. And not all fibroids need to be treated, but it is important to image these and to understand where is my fibroid located? How big is it, and what else might it be impacting? Oftentimes more than just an ultrasound is needed. And in many cases, women will undergo what's called a saline infused sonogram, where we put saline or normal water inside the uterine wall itself to determine how big is that polyp? Because if the uterus, it does not have saline in it, the walls kind of smashed together and it's sometimes challenging to see how big is that polyp? Is it pedunculated? Does it extend further than we think? Some women will undergo additional imaging like an MRI or a CT scan, especially if they're considering surgical evaluation. And in some cases, a hysteroscopy is warranted and a hysteroscopy involves putting a camera inside the uterine cavity itself to take a direct look at that area and see what's going on. So what do we do about fibroids in restorative reproductive medicine that's different now? The most important thing is, is that we're not just suppressing the symptoms with birth control or immediately sending a woman for hysterectomy. We typically are always asking, why is that fibroid growing? What's the hormone situation that's causing it to be able to grow more? How can we treat or correct estrogen dominance? Do we have progesterone levels that are too low? Do we have too much excess estrogen for some reason? And really working to optimize those hormone levels to help prevent further growth from the fibroids, and ideally helping to prevent them from happening in the first place. Can we optimize what's going on with that endometrial lining in order to improve fertility outcomes? So again, if we've got a fibroid that maybe is intramural or inside the wall of the uterus itself, that may not be impacting the ability for implantation to occur, but we also want to make sure that it's not creating any inflammation or a hostile environment for implantation. And then finally, if surgical removal is appropriate. When do we want to do that? Who do we send our patients to see? And ideally if they're still trying to preserve fertility, sending them to somebody who is a restorative reproductive surgeon, who is able to still keep the uterus intact and utilize techniques that minimize scarring to be able to allow fertility to occur. In some cases, while we are helping to decrease inflammation or reduce the growth of the size of the fibroid, we are using bioidentical progesterone or other tools in order to help with that estrogen dominance. In some cases, we're talking through anti-inflammatory impacts, things like low dose naltrexone, decreasing the inflammatory foods in your diet, improving your lifestyle with reducing cortisol levels and managing stress. And in some cases we do talk about how do we help to manage the excess bleeding, because for many women that can be the most debilitating symptom is if these fibroids are bleeding. Most importantly, please know, fertility can oftentimes be restored even after fibroid treatment, and there are ways that we can monitor to ensure that the fibroids aren't continuing to grow. And if they are to understand what would be the most impactful technique in order to treat them. Even if fibroids, return cycle tracking and early intervention make a big difference. So if you've been told that you have a fibroid, I have five questions that I want you to ask for follow-up. So number one, where is the fibroid located and how big is it? Again, as we discussed, location matters more than size, especially when it comes to fertility impact. Question number two, could this fibroid be impacting my ability to get pregnant or stay pregnant again, even if you're not trying to conceive right now, it's worth it to understand the risks and to make sure that even if something is not impacting fertility, that you are doing everything you can to ensure that that fibroid doesn't grow. Again, remember that those submucosal or large intramural fibroids are more likely to interfere with implantation. Blood flow or development of an embryo. So it's really important to know what type of fibroid as far as location that you're dealing with. Question number three, to ask what kind of imaging was used to find the fibroid, and most importantly, do I need more detailed testing? In many cases, just a transvaginal ultrasound may not give the full picture. So it's important to ask if you would be indicated to get a saline infused sonogram or a pelvic MRI to help understand how the fibroid might be impacting your uterus. Now in some cases, if the ultrasound shows that it's a very small fibroid or is not located in the lining of the uterus itself, we may not need additional imaging on all of these, but it's important to at least ask the question. Question number four, what are my options other than birth control or surgery? Many women are only offered two extremes, go on birth control, which doesn't treat the root cause of the issue, and oftentimes makes things worse. Or get a hysterectomy and have the uterus removed completely. Now, in some cases, this is absolutely still the recommended and appropriate treatment, but many times in our practice we see women that are encouraged to get a hysterectomy without understanding the long-term implications of that or understanding that there are other things that you can do that are more restorative treatments like hormonal support. Anti-inflammatory options or conservative surgical approaches like just removing the fibroid tissue rather than removing the whole uterus. And the fifth and final question is, how will you monitor this fibroid over time? Fibroids oftentimes grow. They can remain stable, but we always want to know what the follow-up plan is and how we are going to continue to track changes in size, symptoms, fertility outcomes, and make sure that that fibroids still appears to be benign. If you've been told that your fibroids aren't a big deal, but your body is telling you otherwise, trust that instinct. Fibroids can be complicated, but with a restorative approach, you can get real answers and real support. Imagine if the symptoms you've been told to ignore were actually signals your body was trying to have heard Instead of suppressing your cycle, work with a care team who understands how to empower you, inform you, and help guide you on a path towards healing. You deserve a team that listens, investigates, and believes in your body's ability to heal in a restorative manner. If you're ready to work with our elite team of healthcare professionals, go to our website, radiant clinic.com to schedule a free discovery call and learn more about our package based pricing for comprehensive care. We are currently able to see people for in-person appointments in our Cedar Rapids, Iowa Clinic, or can arrange for a telehealth visit if you live in many different states across the us. Check out our website for current states that we can serve medical clients and let us know if your state is not listed to see if we can still cover you there as we are constantly expanding our reach. Please note that our fertility educators are able to take care of clients no matter where they live. Thank you so much for listening to this episode. Please share this podcast with someone in your life who would benefit from our services. Remember to subscribe to this podcast for more empowering content that I look forward to sharing with you on our next episode of Cycle Wisdom.