Why Endometriosis and Fibroids Often Show Up Together—And What That Means for You

Living with endometriosis is never straightforward. Between the pain, the heavy periods, and the frustration of waiting for diagnosis or relief, you may already feel overloaded. But what if your symptoms could be caused by something else on top of endometriosis—something like uterine fibroids? You’re not alone in thinking it’s unfair, or even impossible, to have both. Yet, new evidence points to an unfortunate yet important truth: if you have endometriosis, you’re much more likely to also have uterine fibroids compared to other women.

Understanding this link could change how you—and your doctor—approach your care. Let’s look at what this means for your symptoms, your diagnosis, and the way forward.

Why Does It Matter If You Have Both Endometriosis and Fibroids?

Both endometriosis and uterine fibroids can significantly affect quality of life, particularly around the menstrual cycle. Because these conditions share many features, their symptoms often overlap, making it difficult to tell one from the other. Common issues include heavy or prolonged menstrual bleeding, painful periods, pelvic pressure or bloating, pain during intercourse, and difficulties with getting or maintaining a pregnancy.

If you’re suspicious that something else is behind your never-ending cramps or sudden changes in your bleeding patterns, knowing about this increased risk can help you get the answers—and treatment—you deserve.

How Common Is It to Have Both?

Recent research tells us that women with endometriosis are about three times more likely to have fibroids than women without endometriosis. To put it simply: if you have endometriosis, your chances of also having fibroids are significantly higher than you might expect.

That risk can be even greater. When researchers looked specifically at women with endometriosis compared to women who have no gynecological symptoms at all, they found women with endometriosis had up to seven times the odds of having fibroids.

Symptoms: When Should You Suspect Fibroids, Too?

It’s easy to dismiss new or changing symptoms as “just my endo," or the other way around in some cases in case you already know you have fibroids. But because endometriosis and fibroids often show up together, especially if you have a higher body mass index (BMI) or have had children, it’s important to pay attention if your symptoms change or worsen.

Some key changes can signal fibroids as well:

• Sudden increase in heavy or prolonged bleeding
• Worsening pelvic pressure or visible abdominal swelling
• Frequent urination or constipation, especially if you didn’t have those issues before
• Sudden changes in pain pattern

Not everyone will notice a dramatic shift. In fact, many women with both conditions end up undiagnosed or dismissed for years. If things feel different, advocate for yourself. Ask your healthcare provider: “Could I have fibroids, too?”

Why Does This Happen? (And What Can You Do About It?)

Doctors aren’t entirely sure why endometriosis and fibroids so often go hand-in-hand. Both conditions depend on estrogen, but the exact overlap isn’t clear. Just like endometriosis, it is probably polygenic and multifactorial in the final analysis and we will eventually unravel that code. What the recent research does tell us, though, is that certain factors—like having a higher BMI—do make it more likely you’ll have both conditions.

Managing your BMI (aiming for a healthy weight) may help decrease your risk of developing fibroids. While you can’t control every risk factor, small steps toward a healthy lifestyle can make a difference, not just for your gynecological health but for your overall wellbeing.

How Does This Change Your Treatment Options?

If you have both endometriosis and fibroids, treatment can be more complicated—but also more tailored to your needs. Some approaches, like hormonal medications, may help both conditions. Others, like surgical removal of fibroids, might be necessary if symptoms are severe or impacting your fertility.

It’s crucial your doctor takes the possibility of both conditions into account when:

• Evaluating unexplained pelvic pain or heavy bleeding
• Discussing fertility treatments
• Planning surgery (to avoid missing hidden problems); compared to endo excision, myomectomies can be easier and demand a lesser skill set unless they are large or of certain configuration. With both, the required skill set is likely going to have to be at a higher level.
• Considering hormonal therapies

Missing one diagnosis can mean missing out on the most effective relief. That’s why awareness—yours and your doctor’s—matters.

Practical Takeaways: What to Ask and Watch For

Next time you’re talking with your healthcare provider—or even just tracking your symptoms—keep these points top of mind:

• Could my symptoms be caused by both endometriosis and fibroids?
• Should I have an ultrasound or MRI to check for fibroids if my bleeding or pain is getting worse?
• How might having both conditions influence my treatment options or fertility planning?
• What lifestyle changes could help lower my risk, especially regarding BMI?
• Are there warning signs I should watch for, like sudden rapid growth of my abdomen, severe changes in bleeding, or unmanageable pain?

The Practical Overview

Here’s what we don’t know yet: Having endometriosis doesn’t mean you’re guaranteed to get fibroids, or that you’ll suffer more. Odds ratios and risk numbers can’t predict what will happen to you as an individual. Some women with both conditions manage well with medication and self-care, while others may need more involved treatments.

And while recognizing the link between these conditions is crucial, don’t let statistics cause unnecessary anxiety—use this information to give yourself another tool for advocating for your health.

Other options like MRI, seeking a second opinion, or making lifestyle adjustments remain important if the answers you’re getting don’t add up with the way you feel.