Uterine fibroids are incredibly common. Up to 70% of women aged 30-50 experience uterine fibroids, whether they may know it or not. Yet despite how widespread they are, many people don’t fully understand the impact fibroids can have on overall pelvic health.

At our clinic, we work closely with patients navigating life with fibroids, and the relationship between fibroids and pelvic floor health is very real. We see it manifest in a variety of ways from changes in bladder and bowel function to discomfort during sex, even how the pelvic floor muscles adapt and behave in response.

In this post, we’ll explore how fibroids affect the pelvic floor and what you can do to manage symptoms, support your body, and feel more in control of your pelvic health.

So, what exactly can fibroids do to your pelvic health? Let’s break down some of the most common ways they show up in the body.

What Is A Uterine Fibroid?

Uterine fibroids (medically known as uterine leiomyomas) are non-cancerous growths that develop in or around the uterus typically growing when hormone levels are higher and decreasing in size when levels are low (and why we see less cases when women are in menopause).

They can vary widely in both size and number — one person may have several clustered fibroids the size of a dime, while another may have a single fibroid as large as a softball.

While they vary in size and shape, uterine fibroids also develop in different areas.

Intramural: inside the muscular wall of the uterus (the most common type found)
Subserosal: outer surface of the uterus (these fibroids have the potential to grow larger and push into the pelvic area)
Submucosal: inside the uterine cavity

While fibroids are almost always benign, that doesn’t mean they’re harmless. The size and location of the fibroids will affect the pelvic organs and their influence on the pelvic floor (the group of muscles, ligaments, and connective tissues that support your bladder, uterus and rectum).

Common Symptoms of Uterine Fibroids

Fibroids show up differently and so do their varying symptoms. Some people may not even know that they have them while other’s lives are fully disrupted. Here are some of the most common signs and symptoms associated with uterine fibroids.

Heavy or Prolonged Menstrual Bleeding

One of the most commonly reported symptoms of uterine fibroids is a heavy menstrual cycle. Fibroids cause the uterine lining to thicken and interfere with the uterus’s ability to contract properly. As a result, periods can become significantly heavier and longer, often lasting well beyond the typical 5 to 7 days and irregular bleeding outside of the menstrual cycle window.

Heavy bleeding can lead to fatigue, iron deficiency, and even anemia. Unfortunately, as it’s so often seen as part of the “normal” female experience, many people dismiss the symptoms.

Abnormal Bowel Habits

Urinary Urgency
Larger fibroids can place pressure on the bladder, leading to increased urinary urgency — the sensation of needing to urinate before the bladder is actually full. This pressure mimics the sensation of fullness and can result in more frequent trips to the bathroom, even when output is minimal.

Constipation and Bowel Changes
Similarly, fibroids located near the rectum or colon may contribute to constipation. As fibroids grow, they can press against the bowel, leading to a sensation of fullness, difficulty with evacuation, or even partial obstruction in more severe cases.

Low Back Pain

Up to 60% of individuals with fibroids report experiencing lower back pain. This can range from a dull, persistent ache to radiating discomfort that extends into the hips or down the legs. Larger fibroids, especially those located on the back side of the uterus, may exert pressure on surrounding tissues and structures, including muscles and nerves in the lower back and pelvis.

Painful Intercourse

Uterine fibroids located near the cervix or within the lower portion of the uterus can contribute to pain during penetrative intercourse, particularly with deeper insertion. This discomfort is often positional and may be more noticeable depending on the size and location of the fibroid. In some cases, the surrounding pelvic floor muscles may also respond with increased tension, further contributing to discomfort.

Abdominal Distension

Abdominal distension, or a feeling of bloating or visible abdominal enlargement, is another symptom that can occur with uterine fibroids. This may be due to the size and location of the fibroid itself. Larger fibroids can cause the abdomen to protrude or feel full, even in the absence of food intake. Distension can also be secondary to constipation, as the buildup of stool and gas in the intestines can contribute to a bloated appearance and discomfort. This symptom is often mistaken for weight gain or digestive issues, but in some cases, fibroids are a contributing factor.

What Fibroids Mean For Pelvic Floor Function

The pelvic floor muscles are constantly adapting to changes within the pelvis, including accommodating the presence of uterine fibroids.

Fibroid growth can alter or shift the position of pelvic organs, leading to compensation patterns in the pelvic muscles. This can result in:

· Pelvic floor tension or overactivity — muscles work harder to stabilize or respond to discomfort.

· Changes in muscle coordination — leading to abnormal bladder and bowel function.

· Pain or trigger points — contributing to lower back and pelvic pain.

· Altered core and postural support — since the pelvic floor works in tandem with abdominal and low back muscles.

What we know is that the pelvic floor does not work in isolation. When uterine fibroids disrupt the natural balance of pressure and positioning in the pelvis, the muscles respond accordingly. This is often when symptoms worsen or new pelvic floor dysfunctions arise.

**What You Can Do About It**

Working with a specialist trained in pelvic health is one of the most effective non-surgical interventions for fibroid-related symptoms. At our clinic, we assess how your muscles are adapting to the presence of fibroids and create a plan to:

· Decrease pelvic floor tension and reduce pain

· Improve muscle coordination for better bladder and bowel control

· Restore normal mobility to the pelvis and surrounding organs

· Teach you techniques for posture, breathing, and gentle core strengthening

Pelvic floor therapy doesn’t make the fibroids disappear—but it can drastically reduce the impact they have on your daily life. Patients often report less discomfort, more confidence with bowel and bladder function, and even improved intimacy.

Nutrition and Anti-Inflammatory Support

Certain dietary strategies can help reduce inflammation and support hormonal balance. Working with a nutritionist or functional medicine provider may help you reduce symptoms and possibly slow fibroid growth.

Explore Medical Options When Needed

If symptoms are significantly impacting your quality of life, there are medical and surgical options ranging from hormonal therapies to uterine artery embolization or myomectomy. A comprehensive evaluation can help you weigh your options wisely.

You’re Not Alone—And You’re Not Stuck

Fibroids can be a frustrating diagnosis, but they don’t have to control your life. Understanding their impact on your pelvic floor is the first step. Taking proactive steps—like pelvic floor physical therapy—can dramatically shift how you experience your body.

We’re here to help you get clear on what’s happening, ease your symptoms, and restore trust in your body again.

How Fibroids Affect the Pelvic Floor—and What You Can Do About It

What Is A Uterine Fibroid?