Fibroids and Hair Loss: What Does One Have to Do With the Other?

Fibroids. You’d be surprised how often that word comes up during a hair loss assessment. And if you’re wondering what something happening in your uterus could possibly have to do with what’s happening on your scalp, that’s actually a very fair question. The answer is...maybe nothing directly.

Having fibroids does not automatically mean they’re causing your hair loss. But some of the things happening because of them may be important, and this is where we have to start following the breadcrumbs.

Let’s Start With the Fibroids

Uterine fibroids are noncancerous growths that develop in or around the uterus. Some women have fibroids and barely know they’re there, while others experience symptoms, including heavy or prolonged menstrual bleeding. For our hair conversation, that bleeding is where things start getting interesting.

Every time we lose blood, we lose iron. Normally, the body replaces what’s being lost through the iron we get from food and, when medically appropriate, supplementation. But if someone is experiencing heavy periods month after month, she may be losing iron faster than she’s replacing it. Eventually, the body’s iron stores can begin to decline. Heavy menstrual bleeding is a recognized cause of iron deficiency and, when it progresses far enough to affect red blood cell production, iron-deficiency anemia.

And now we’ve made our way from the uterus a little closer to the hair.

Okay, But What Does Iron Have to Do With Hair?

Iron has some pretty important jobs in the body. One of the ones most people are familiar with is its role in hemoglobin, the protein in red blood cells responsible for carrying oxygen throughout the body. Hair follicles are also incredibly active little structures, and growing hair requires ongoing cellular activity and access to adequate nutrients.

This is one reason iron status can become part of the conversation when someone is experiencing increased shedding or diffuse hair loss. Iron deficiency has been investigated as a possible contributor to certain types of nonscarring hair loss, including telogen effluvium. But I want to stop here for a second because this is where the internet can make things WAY too simple.

Low iron does not automatically mean we have found the cause of your hair loss.

The research on ferritin, iron deficiency and hair loss isn’t as simple as “low ferritin equals hair loss.” Some studies have found lower ferritin levels in women experiencing certain types of hair loss, while others haven’t found the same association. So I’m not looking at one number and declaring, “THAT’S IT!” We have to look at the whole picture.

“But My Doctor Said I’m Not Anemic.”

This is another conversation I have pretty often. Someone will tell me that her bloodwork was normal or that her doctor told her she wasn’t anemic, so she assumes iron has already been completely ruled out. Not necessarily.

A CBC, or complete blood count, gives us valuable information about things like hemoglobin, hematocrit and the characteristics of your red blood cells. But when a healthcare provider is evaluating iron status, there are other labs they may consider too, including ferritin, serum iron, total iron-binding capacity or transferrin, and transferrin saturation. Ferritin is commonly used as an indicator of the body’s stored iron, although inflammation and certain other conditions can affect how that number should be interpreted.

This is an important distinction because iron deficiency and iron-deficiency anemia are related, but they are not exactly the same thing. Iron stores can become depleted before the deficiency progresses far enough to produce iron-deficiency anemia.

Now, that does NOT mean everybody experiencing hair loss needs to run out and request every iron test available. It means your history matters. If someone tells me she has fibroids, very heavy periods, increased shedding and a history of low iron, I’m going to pay attention to that combination of information. Those are breadcrumbs.

And Please Don’t Just Start Taking Iron

If you’re reading this thinking, “Okay, I have fibroids AND my hair is shedding, so I’m going to buy some iron,” that is not the takeaway. Iron supplementation should be based on an appropriate medical evaluation. Too much iron can be harmful, and hair loss has many possible causes. There also isn’t one universally accepted ferritin number that tells us whether someone’s hair will or won’t grow, so this isn’t something I want people trying to self-treat based on a number they saw online.

This is where your healthcare provider comes in. If you have heavy or prolonged menstrual bleeding, known fibroids, previous anemia or concerns about your iron status, those are things to discuss with the medical professional managing your care. They can determine what testing is appropriate and whether treatment is needed.

And if the bleeding itself is significant, that deserves attention too. We don’t want to become so focused on replacing iron that we forget to ask why so much is being lost in the first place.

So Why Am I Asking About Your Period During a Hair Appointment?

This is exactly why a Hair & Health Assessment goes beyond, “What shampoo are you using?” If you’re experiencing hair loss, I want to know what else has been happening in your body. I may ask about your menstrual cycle, fibroids, pregnancies, hysterectomy, other surgeries, medications, changes in weight, nutrition, stress, digestive health and bloodwork. Not because I’m trying to diagnose or treat those things. I like to stay in my lane. I’m asking because hair doesn’t exist separately from the person growing it.

Sometimes a detail that seems completely unrelated to your scalp gives us a reason to ask another question, look at something more closely or send you back to your healthcare provider for the appropriate evaluation. That’s part of looking at the whole person instead of only looking at the place where the symptom happens to be showing up.

Sometimes We Have to Follow the Breadcrumbs

So if you have fibroids and you’re experiencing hair loss, I don’t want you leaving this blog thinking, “My fibroids are making my hair fall out.” That’s too simple, and it may not be true.

What I do want you thinking about is your own history. Do your fibroids cause heavy bleeding? Have you ever been told that your iron was low? Do you know whether your iron stores have actually been evaluated? Did your shedding change around the same time something else changed with your menstrual cycle or overall health? And could there be other things contributing to your hair loss too?



Those questions give us somewhere to start. Because sometimes what we see happening on the scalp really does begin somewhere completely different, and my job isn’t to assume I know where.

It’s to follow the breadcrumbs.