Uterine fibroids (leiomyomas) are noncancerous growths made of connective tissue and muscle of the uterus. Fibroids range in size. Some are as small as seeds, and others are so big they can enlarge the uterus. You can have one fibroid or many at a time.
Up to 80% of people with a uterus experience fibroids at some point during their childbearing years. Though many people with fibroids experience no symptoms, approximately 30% will have symptoms that include pelvic pain and pressure, back pain, and pain during sex.
This article will describe the pain and symptoms you may experience with uterine fibroids, risk factors, when to see a doctor, and treatments.
The severity of fibroid pain depends on the location, size, and the number of fibroids present. If you have small fibroids, you may not notice they are there and feel no pain or discomfort. If you have larger fibroids or many in the uterus, you may feel discomfort and pain.
Fibroid 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
- Sharp, stabbing pains in the abdomen
Other Fibroid Symptoms
In addition to causing pain and discomfort, fibroids can also cause other uncomfortable symptoms, including:
- Anemia (due to blood loss from heavy periods)
- Breakthrough bleeding (bleeding between periods)
- Complications during pregnancy and labor (increased likelihood of cesarean section)
- Enlarged lower abdomen
- Feeling of fullness in the stomach/pelvic area
- Frequent urination
- Heavy menstrual bleeding
There are a few risk factors that increase your chances of developing fibroids, including:
- Getting your first menstrual period at a young age
- Late onset of menopause
- Family history of fibroids
- Race (more common in people who are Black)
Other risk factors for developing fibroids that may increase the risk of experiencing fibroid-related pain include:
- Vitamin D deficiency
- Food additive consumption
- Soy milk consumption
- Alcohol consumption
- Diet high in red meat and with fewer green vegetables and fruits
Treating Fibroid Pain
There are a variety of treatments for managing fibroid pain, including home remedies and over-the-counter medications that provide temporary relief. If your fibroid pain is severe enough to impact your day-to-day life, your doctor may prescribe medications or recommend surgical procedures to offer long-term or permanent relief.
Home Remedies and Lifestyle
You may be able to manage your fibroid pain with home remedies that provide temporary relief, particularly if you have minor symptoms. Using a heating pad or warm compress on your abdomen may help. You may also find it easier to deal with pain if you reduce your stress through self-care, such as yoga or meditation.
Lifestyle changes may help reduce your risk of fibroids, such as:
- Eat a healthy diet rich in leafy greens, fruits, whole grains, and fish; avoid processed and sugary foods
- Avoid alcohol
- Exercise regularly
- Maintain a healthy weight
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 decrease bleeding, but do not reduce the size of fibroids themselves.
- Iron supplements: If your fibroids cause heavy bleeding, this may 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 produce more hemoglobin and red blood cells.
- Vitamins: Research shows that the risk of fibroids increases in those who have low levels of vitamins D and A. If you don’t consume enough of these through your diet, or get enough exposure to sunlight (vitamin D), you can consider adding vitamins and nutritional supplements.
Medications may be prescribed in treating fibroids:
- Hormonal birth control: Heavy menstrual bleeding and menstrual cramps may be reduced by hormonal birth control. This may be delivered by pills, intravaginal devices (such as a ring), injection, or intrauterine devices (IUD).
- Gonadotropin-releasing hormone (GnRH) agonists: These drugs can shrink fibroids and may be used before fibroid surgery. They are usually used for less than six months as they have side effects. They block the hormones that govern the menstrual cycle, halting your period. Lupron (leuprolide) is an example.
- Orilissa (elagolix): This newer GnRH receptor antagonist is indicated for people with fibroids who have not gone through 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.
Surgeries and Specialist-Driven Procedures
If home remedies and medications don’t help reduce your fibroid pain, your doctor may suggest surgery to remove them. Surgical and specialist-driven procedures for fibroid removal include myomectomy, uterine fibroid embolization, and hysterectomy.
Myomectomy is a surgical procedure that removes fibroids without removing any healthy uterine tissue. This option is best for people who would like to bear children in the future or wish to keep their uterus.
It may be performed using a hysteroscope, in which a scope is inserted through the vagina and cervix into the uterus so no incisions are made. A tool is then used to view and cut away the fibroids.
However, it may need to be done with a laparoscope, in which small incisions are made in the abdomen, or with open abdominal surgery which would require a larger incision.
Uterine fibroid embolization or uterine artery embolization is a procedure in which a thin tube is threaded into the blood vessels that supply the fibroid(s). Plastic or gel particles are injected to block the blood supply, causing the fibroid to shrink.
It is a choice for people with painful fibroids or fibroids pressing into the bladder or rectum and who do not want to bear children.
Endometrial ablation may be done after removal of the fibroids. This procedure may be used to remove the lining of the uterus and control heavy bleeding.
Some people will experience only light bleeding during their menstrual periods after endometrial ablation, and some will never have a period again. This option is only for those who do not wish to bear children in the future.
Hysterectomy—the surgical removal of the uterus—is the only way to guarantee fibroids do not return. Hysterectomy is only recommended for people whose fibroids have a tremendous impact on daily life (e.g., chronic pain and/or heavy bleeding) are near or past menopause, and/or do not wish to bear children.
When To See a Doctor
Any pain and discomfort you are experiencing is reason enough to see your doctor or gynecologist. It’s important to make an appointment to see your doctor if you have:
- Difficulty urinating or feeling like you always need to urinate
- Heavy, prolonged periods
- Ongoing pelvic pain or pressure
- Severe pain that is impacting your day-to-day life
- Spotting between periods
Your doctor will speak with you about the symptoms you are experiencing and your medical and family history. In some cases, fibroid-related pain may be caused by another condition. Your doctor may run diagnostic tests to determine your diagnosis and recommend effective treatments.
Frequently Asked Questions
Why do fibroids hurt?
There are a few reasons why fibroids hurt. When inside the uterus, fibroids can put pressure on the uterine wall, causing abdominal pain and pressure.
Fibroids outside of the uterus may press on the bladder, rectum, or spinal nerves, causing back pain and abdominal pressure. Some people experience fibroid pain when the fibroids begin to disintegrate, causing abdominal pain.
Do fibroids hurt when they shrink?
Fibroids shrink—known as uterine fibroid degeneration—when the fibroid loses its blood supply. When the connecting blood vessels no longer produce enough oxygen for the fibroid, the cells begin to die, causing the fibroid to shrink. Fibroid degeneration may cause abdominal pain and swelling for a period of a few days to a few weeks.
Do fibroids hurt to the point where you can’t walk?
Large fibroids can put pressure on pelvic nerves or the sciatic nerve, leading to pain that radiates to the back, hip, buttocks, and down the leg. This can make it painful and difficult to walk.
Uterine fibroids are very common and may or may not cause pain. When painful, they may cause pelvic pain and pressure, back pain, and pain during sex.
The pain and other symptoms may be relieved through home remedies, over-the-counter medications, and prescription medications (including hormonal birth control). In cases of severe pain, procedures or surgery to shrink or remove the fibroids may be recommended.
A Word From Get Meds Info
Uterine fibroids are noncancerous and sometimes go away on their own. However, if your fibroid symptoms are impacting your day-to-day life, consult your doctor to get a proper diagnosis and treatment plan. There is no “gold standard” when it comes to treating uterine fibroid pain, and you and your doctor will work together to determine what is best for you.