Illustration of C-section scar and uterine fibroids.

C-Section Scars: An Unexpected Link to Uterine Health?

Elliot Brynn in Health & Wellness September 2025 • 4 min read.

"Research suggests a surprising connection between cesarean sections and the risk of abnormal uterine bleeding in women with uterine leiomyomas."

Uterine leiomyomas, also known as fibroids, are common non-cancerous tumors that develop in the uterus. While many women experience no symptoms, others suffer from a range of issues, with abnormal uterine bleeding being a significant concern.

For years, researchers have been trying to understand the factors that contribute to abnormal uterine bleeding in women with fibroids. The size, number, and location of fibroids have all been considered, but the complete picture remains unclear.

Now, a recent study published in the Saudi Medical Journal is shedding light on a surprising potential risk factor: a history of cesarean section. This research suggests that women who have had a C-section and also have uterine leiomyomas may be at an increased risk of experiencing abnormal uterine bleeding.

The C-Section-Fibroid Connection: What the Study Found

Illustration of C-section scar and uterine fibroids.

The study, conducted at Etlik Zubeyde Hanim Women's Health Training and Research Hospital in Ankara, Turkey, retrospectively analyzed the medical records of 865 patients who underwent hysterectomies due to uterine leiomyomas. Researchers compared women with abnormal uterine bleeding to those without, looking for potential risk factors.

The results revealed a statistically significant association between a history of cesarean section and abnormal uterine bleeding in women with fibroids. Specifically, women with a prior C-section were more than twice as likely to experience abnormal bleeding compared to those without a history of C-section.

Increased Risk: Women with a history of C-section were 2.1 times more likely to experience abnormal uterine bleeding.
Submucosal Leiomyomas: The presence of submucosal leiomyomas (fibroids located just under the uterine lining) also significantly increased the risk.
Adenomyosis: Coexisting adenomyosis (a condition where the uterine lining grows into the muscular wall of the uterus) was identified as another independent risk factor.
Lower Age in Case Group: Average age of women in group with abnormal uterine bleeding was slightly less than the control group.

The researchers also explored other potential contributing factors, such as the size and location of the fibroids. They found that submucosal leiomyomas were more common in women with abnormal uterine bleeding, while subserous leiomyomas (fibroids on the outer surface of the uterus) were more frequent in the control group.

What Does This Mean for Women's Health?

This study highlights a previously underappreciated connection between cesarean sections and long-term uterine health. While C-sections are often life-saving procedures, they can also have long-term consequences, including potential effects on uterine bleeding patterns. Women with a history of C-section who are experiencing abnormal uterine bleeding should discuss these findings with their healthcare providers to determine the best course of action.

About this Article -

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Everything You Need To Know

What are uterine leiomyomas, and why is it important to understand them?

Uterine leiomyomas, commonly known as fibroids, are non-cancerous tumors that develop in the uterus. Many women may not experience any symptoms, but for others, they can lead to issues such as abnormal uterine bleeding. Understanding uterine leiomyomas is crucial because their presence, particularly when combined with other factors like a history of C-sections or the presence of submucosal leiomyomas, can significantly impact a woman's uterine health and quality of life. Other important aspects of uterine leiomyomas not covered here include the various treatment options available, ranging from medication to surgery, and the potential impact on fertility.

What did the study discover about the relationship between C-sections and uterine leiomyomas?

The study found a statistically significant association between a history of cesarean section and abnormal uterine bleeding in women who also have uterine leiomyomas. Specifically, women with a prior C-section were more than twice as likely to experience abnormal bleeding compared to those without a C-section history. This suggests that a previous C-section could be a contributing factor to uterine issues later in life, particularly when fibroids are present.

What are submucosal leiomyomas, and how do they relate to abnormal uterine bleeding?

Submucosal leiomyomas are fibroids that are located just under the lining of the uterus. Their location is significant because they are more likely to cause abnormal uterine bleeding compared to fibroids located in other parts of the uterus, such as subserosal leiomyomas (fibroids on the outer surface of the uterus). The study also mentions adenomyosis as an independent risk factor. Adenomyosis is a condition where the uterine lining grows into the muscular wall of the uterus, further contributing to bleeding issues.

What do these findings mean for women who have had C-sections and also have uterine leiomyomas?

The findings suggest that women with a history of cesarean section may face an increased risk of abnormal uterine bleeding if they also have uterine leiomyomas. It highlights the importance of considering a patient's obstetrical history when evaluating and managing abnormal uterine bleeding, especially in the presence of fibroids. Women should discuss their history of C-sections with their healthcare providers if they are experiencing abnormal bleeding. Further research is needed to fully understand the underlying mechanisms behind this connection.

Besides having had a C-section, what other factors can contribute to abnormal uterine bleeding in women with uterine leiomyomas?

Several factors besides cesarean section history can contribute to abnormal uterine bleeding in women with uterine leiomyomas. These include the size, number, and location of the fibroids, with submucosal leiomyomas posing a higher risk. Additionally, the presence of adenomyosis can also contribute to the issue. Hormonal imbalances, age, and other underlying medical conditions can also play a role. Understanding these factors is essential for comprehensive diagnosis and treatment planning.