Uterine fibroids (leiomyomas) are noncancerous growths composed of connective tissue and uterine muscle. Fibroids vary in size. Some are as small as a seed, while others are large enough to expand the uterus. You can have one or more fibroids at a time.
Up to 80% of uterine patients develop fibroids at some point in their reproductive years. Although many people with fibroids have no symptoms, about 30 percent experience symptoms including pelvic pain and pressure, back pain, and pain during intercourse.
This article will describe the possible pain and symptoms of uterine fibroids, risk factors, when to see a doctor, and treatment.
The severity of fibroids pain depends on the location, size, and number of fibroids present. If you have small fibroids, you may not notice them and experience no pain or discomfort. If you have large fibroids or many fibroids, you may experience discomfort and pain.
Fibroids pain may be chronic and felt all the time, or it may come and go. Fibroids can cause different types of pain, including:
- back pain
- pain during sex
- pelvic pain and pressure
- severe menstrual cramps
- Severe tingling in the abdomen
Other Fibroid Symptoms
In addition to causing pain and discomfort, fibroids can cause other uncomfortable symptoms, including:
- Anemia (blood loss due to menorrhagia)
- breakthrough bleeding (bleeding between periods)
- Complications during pregnancy and childbirth (increased likelihood of cesarean delivery)
- lower abdomen enlargement
- fullness in the stomach/pelvic area
- frequent urination
- heavy menstrual bleeding
Symptoms of Uterine Fibroids
There are some risk factors that increase your chances of developing fibroids, including:
- getting your first period at a young age
- late menopause
- family history of fibroids
- Race (more common in blacks)
Other fibroid risk factors that may increase the risk of fibroid-related pain include:
- vitamin D deficiency
- food additive consumption
- Soy milk consumption
- alcohol consumption
- Eat more red meat and less green vegetables and fruits in your diet
Treating Fibroid Pain
There are several ways to treat fibroids pain, including home remedies and over-the-counter medications that provide temporary relief. If your fibroid pain is severe enough to interfere with your daily life, your doctor may prescribe medication or recommend surgery to provide long-term or permanent relief.
Home Remedies and Lifestyle
You can manage your fibroids pain by offering home remedies for temporary relief, especially if you have mild symptoms. Using a heating pad or compress on the abdomen may help. You may also find it easier to deal with pain if you reduce stress through self-care like yoga or meditation.
Lifestyle changes may help reduce your risk of developing fibroids, such as:
- Eat a healthy diet rich in leafy green vegetables, fruits, whole grains, and fish; avoid processed and sugary foods
- avoid drinking alcohol
- exercise regularly
- maintain a healthy weight
Natural Alternatives to Uterine Fibroids
Over-the-counter medications can help temporarily reduce fibroid pain, including:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAIDs such as ibuprofen or naproxen can help reduce inflammation, swelling, and pain. They may also help reduce bleeding, but not the size of the fibroids themselves.
- Iron supplements: If your fibroids are causing heavy bleeding, this can lead to anemia (low red blood cells). Anemia can cause fatigue and weakness. If you have anemia, your healthcare professional may recommend iron supplements so your body can make more hemoglobin and red blood cells.
- Vitamins: Studies have shown that people with low levels of vitamins D and A have an increased risk of developing fibroids. If you don’t get enough of these through your diet, or don’t get enough sun exposure (vitamin D), you may consider adding vitamins and nutritional supplements.
Medications to treat uterine fibroids may be:
- Hormonal birth control: Hormonal birth control can reduce heavy menstrual bleeding and menstrual cramps. This can be delivered by pills, intravaginal devices such as rings, injections, or an intrauterine device (IUD).
- Gonadotropin-releasing hormone (GnRH) agonists: These drugs shrink fibroids and can be used before fibroids surgery. They are usually used for less than six months because of their side effects. They block the hormones that control the menstrual cycle, stopping your period. Lupron (leuprolide) is an example.
- Orilissa (elagolix): This newer GnRH receptor antagonist is indicated for patients with fibroids who have not yet reached menopause. It can be used for up to two years.
- Tranexamic acid: This oral medication can be used to treat heavy menstrual bleeding in people with fibroids.
Surgery and expert-driven procedures
If home remedies and medications don’t help relieve your fibroids pain, your doctor may recommend surgery to remove them. Surgery and expert-driven myomectomy include myomectomy, fibroid embolization, and hysterectomy.
Myomectomy is a surgical procedure to remove fibroids without removing any healthy uterine tissue. This option is best for those who wish to have children in the future or who wish to preserve the uterus.
It can be done using a hysteroscope, where a scope is inserted into the uterus through the vagina and cervix, so no incisions are made. The tools are then used to view and remove the fibroids.
However, it may need to be done using laparoscopy, where a small incision is made in the abdomen, or open surgery, which requires a larger incision.
Uterine fibroids embolization, or uterine artery embolization, is a procedure in which a thin tube is threaded into the blood vessels that supply the fibroids. Plastic or gel particles are injected to block the blood supply, causing the fibroids to shrink.
This is an option for people who have painful fibroids or fibroids pressing into the bladder or rectum and don’t want to have children.
Endometrial ablation can be done after the fibroids have been removed. This procedure can be used to remove the lining of the uterus and control heavy bleeding.
Some people experience only light bleeding during their period after endometrial ablation, and some never menstruate again. This option is only for people who do not want to have children in the future.
A hysterectomy—surgical removal of the uterus—is the only way to guarantee that the fibroids will not come back. Hysterectomy is only recommended for people whose fibroids have a significant impact on daily life (eg, chronic pain and/or heavy bleeding), are approaching or have reached menopause, and/or do not wish to have children.
when to see a doctor
Any pain and discomfort you experience is enough to send you to a doctor or gynecologist. Make sure to make an appointment to see your doctor if you have:
- Difficulty urinating or feeling like you always need to urinate
- heavy, long
- persistent pelvic pain or pressure
- severe pain that affects your daily life
- discoveries between periods
Your doctor will discuss with you the symptoms you are experiencing and your medical and family history. In some cases, pain associated with fibroids may be caused by another condition. Your doctor may perform diagnostic tests to determine your diagnosis and recommend effective treatment.
Uterine fibroids are common and may or may not be painful. When painful, they can cause pelvic pain and pressure, back pain, and painful intercourse.
Pain and other symptoms can be relieved with home remedies, over-the-counter, and prescription medications, including hormonal birth control pills. In cases of severe pain, surgery or surgery to shrink or remove the fibroids may be recommended.
Uterine fibroids are noncancerous and sometimes go away on their own. However, if your fibroids symptoms interfere with your daily life, talk to your doctor for a proper diagnosis and treatment plan. There is no “gold standard” for treating fibroids pain, and you and your doctor will work together to determine what works best for you.
Frequently Asked Questions
Why do fibroids hurt?
There are several causes of fibroids pain. When in the uterus, fibroids can put pressure on the uterine wall, causing abdominal pain and pressure.
Fibroids outside the uterus may compress the bladder, rectum, or spinal nerves, causing back pain and abdominal pressure. When fibroids begin to break down, some people experience fibroid pain, which can lead to abdominal pain.
Do fibroids hurt when they shrink?
When fibroids lose their blood supply, fibroids shrink – called fibroids. When the connected blood vessels no longer produce enough oxygen for the fibroids, the cells begin to die, causing the fibroids to shrink. Fibromatosis may cause abdominal pain and swelling for days to weeks.
Do fibroids hurt so much that you can’t walk?
They can. Large fibroids can put pressure on the pelvic or sciatic nerves, causing pain to radiate to the back, buttocks, buttocks, and legs. This can make walking painful and difficult.