Anemia: The life-threatening risks of blood loss from fibroids

This article is sponsored by The Center for Innovative GYN Care

For many women, the feeling of being exhausted is constant, but that fatigue may not simply be a sign of being overworked. Other signs like difficulty climbing stairs, loss of concentration, or a feeling of vertigo are all signs of anemia, and if left unchecked, can lead to more severe problems.

Heavy bleeding from fibroids or other gynecological conditions can cause iron deficient anemia, but few women understand the extent of damage that anemia can cause. Potentially life-threatening complications such as congestive heart failure, arrhythmia, angina, and/or heart attack can all result from untreated anemia.

Symptoms vary depending on the cause of anemia, but may include:

  • Fatigue
  • Weakness
  • Pale skin
  • A fast or irregular heartbeat
  • Shortness of breath
  • Chest pain
  • Dizziness
  • Cognitive problems
  • Cold hands and feet
  • Headaches

Iron deficiency in the United States and Western Europe is almost always due to blood loss. Approximately 25 percent of reproductive age women have absent iron stores, and any amount of bleeding will result in anemia for them.

Red blood cells, which originate in bone marrow, have a life-cycle of 90-120 days. Excessive blood loss will ultimately lead to iron deficiency once the tissue stores within the bone marrow have been depleted. Iron deficiency associated with chronic bleeding leads to a reduced bone marrow response, worsening the degree of anemia.


Fibroids within the uterine lining (submucosal) can cause severe bleeding, even if they are small. These fibroids can increase the area of the lining, and also increase menstrual flow, while limiting the normal ability of the lining to stop the bleeding.

Fibroids within the uterine muscle (intramural) that are larger or close to the cavity will increase blood flow to the uterus and affect the normal systems that control bleeding in the uterus. These fibroids will also increase the size of the cavity of the uterus, thereby increasing bleeding.


Thoroughly removing fibroids from the uterus safely can only be performed by a highly skilled minimally invasive GYN specialist, without using a robot. Fibroids that are deep in the muscle, or are very small can be hard to find unless they are felt and removed by hand. Unless all of the fibroids are removed, they can continue to grow, and cause problems with heaving bleeding, pelvic pain and infertility. Standard laparoscopic or robotic techniques do not allow a surgeon to feel the fibroids, and those that are left behind can continue to become problematic. Open procedures have higher risks of infection and have long, painful recoveries.

Fibroid removal surgery can be performed as a myomectomy, removing the fibroids from the uterus, or as a hysterectomy, removing the uterus itself. A myomectomy is performed for women who wish to retain the ability to get pregnant. A hysterectomy for fibroid removal is performed for women who no longer wish to get pregnant, and who suffer from recurring fibroids.


It is important to find a surgeon who will work with you as a partner, and who can perform either procedure through advanced minimally invasive techniques, such as LAAM or DualPortGYN.

“A delicate procedure like a minimally invasive myomectomy requires the surgeon to feel the fibroids in order to create the best possible result,” said Rupen Baxi, MD. “A successful myomectomy requires the surgeon to remove fibroids often deep in the muscle of the uterus that cannot be easily seen. It also requires the surgeon to remove all of the fibroids, including smaller ones, which can only be located by feeling them. The LAAM technique is a minimally invasive fibroid removal technique that allows the surgeon to control the blood loss and feel all of the fibroids at any location in or around the uterus, and allows for their safe and effective removal no matter the size.

“Surgery performed with the DualPortGYN technique is one of the safest minimally invasive GYN surgery procedures available,” said Paul MacKoul, MD. “If fertility is not desired, a hysterectomy is the most effective way to eliminate fibroids. Once the uterus is removed, fibroids cannot regrow. A hysterectomy performed with the DualPortGYN technique allows women to recover in a week, and leaves virtually no scars after a month or two.”

“Once the cause of the heavy bleeding like fibroids is removed, a patient’s anemia can resolve relatively fast,” said Natalya Danilyants, MD. “Rather than going through multiple blood or iron transfusions which only treat the symptom, fibroid removal surgery treats the cause. After surgery, women are able to recover to a normal blood count and live symptom free, and in many cases, they feel better than they ever have.”

It is important to choose a skilled minimally invasive GYN surgeon who will explain in detail what will happen during and after the surgery.

The Center for Innovative GYN Care is dedicated to providing information and materials for women to help navigate the complicated healthcare system. CIGC minimally invasive GYN surgical specialists Dr. Paul MacKoul, MD and Dr. Natalya Danilyants, MD developed techniques to perform fibroid removal using only two small incisions. Dr. Rupen Baxi, MD is a minimally invasive GYN specialist at CIGC with extensive fellowship training and a respected speaker and researcher.

Our minimally invasive surgeons have seen firsthand the pain and anxiety women with fibroids face. We have also seen what delaying fibroid surgery can do to distort a woman’s uterus. The longer a woman suffers with fibroids, the likelihood of extensive damage to her reproductive organs increases.

If you are suffering with fibroids or are having trouble with fertility treatments, it is important to see a minimally invasive GYN specialist for an evaluation. Book a consultation at The Center for Innovative GYN Care or call 888-787-4379.

More from WTOP

Log in to your WTOP account for notifications and alerts customized for you.

Sign up