Out of the 26 million American women who have uterine fibroids, nearly 50% of them may not even be aware of it because they are asymptomatic, per a 2017 review on uterine fibroid management. But that still leaves more than 50% who do know about their fibroids, thanks to the challenging and often painful symptoms they cause.
In fact, pain is one of the key symptoms of fibroids, says G. Thomas Ruiz, MD, ob-gyn lead at MemorialCare Orange Coast Medical Center in Fountain Valley, California, though he notes that the pain caused by uterine fibroids can manifest in many different ways: from dull pressure to sharp pain to period-style cramping, making it tricky to recognize or distinguish from other conditions that cause similar kinds of pain.
To help you identify uterine fibroid-related pain, here are all the ways you might experience it—and what you can do to feel better.
Types of uterine fibroid pain
As Dr. Ruiz notes, there are several different ways you might experience the pain associated with uterine fibroids. These are the most common.
Johns Hopkins Medicine includes pelvic pain as one of the primary symptoms women with uterine fibroids may experience.
You may also feel dull pressure in the pelvic region, or notice radiating pain in other parts of your body, says Dr. Rose Chang-Jackson, an ob-gyn at Austin Regional Clinic in Austin, Texas: "Many times, fibroids are associated with pelvic pressure symptoms, and sometimes a fibroid is so large, it impinges on other organs and you may feel pain symptoms elsewhere."
Lower back pain
Some fibroids may cause pain in both your lower back and down your legs, says the Mayo Clinic. This is due to the effects on other organs Dr. Chang-Jackson referred to; when fibroids grow large enough, they can compress nerves along the spine that cause back and leg pain.
According to the Cleveland Clinic, a feeling of fullness or pressure in the abdomen is a common symptom of fibroids.
Pain during intercourse
Fibroids can cause pain while having sex; according to UCSF Health, this may be intermittent enough to only occur when having sex in certain positions. Dr. Ruiz says they can also cause pain before and during your period—this may feel like the typical uterine cramping associated with menstruation, but it may last longer or be more persistent if you have fibroids
Rectal and bladder pressure
Depending on their location, fibroids can also cause uncomfortable pressure on your bladder and your rectum, reports the Office on Women's Health.
What if my uterine fibroid pain becomes severe?
While typical uterine fibroid pain can be quite uncomfortable, severe or debilitating pain that is unrelenting could be a sign that something else is happening with your fibroids, per Dr. Ruiz.
"If you have what's called a degenerating fibroid, when the live fibroid tissue begins to die off from the inside-out, it will feel like the worst pain you've ever had," he explains. "It's a severe, stabbing pain that will probably leave you doubled-over."
Dr. Chang-Jackson explains that fibroids degenerate when they outgrow their own blood supply, essentially starving themselves and dying off. Sometimes these types of fibroids resolve on their own after several days, while others require surgery, explains Brigham and Women's Hospital. If you experience a sudden increase in pain or vaginal bleeding, the Mayo Clinic advises you to see your doctor ASAP.
Other common uterine fibroid symptoms
According to the Cleveland Clinic, other symptoms of uterine fibroids include:
- Heavy or irregular menstrual bleeding
- Breakthrough bleeding between periods
- An increased need to urinate or difficulty voiding
- Vaginal discharge
- A clearly distended or enlarged abdomen
- Difficulty conceiving, or infertility
How is uterine fibroid pain treated?
Treatment options vary widely for uterine fibroids, says Dr. Chang-Jackson, based on their size and location, whether or not they're causing symptoms, and whether or not they are affecting your fertility.
There are surgical procedures to drain or remove fibroids, but unfortunately they often regrow, says the Mayo Clinic, which adds that the only way to eliminate the risk of fibroids for good is to have a hysterectomy.
How can I managed my uterine fibroid pain?
If you're simply focused on managing your pain symptoms, there are a few strategies you can try:
- OTC pain relievers, like Tylenol and Motrin, can work on the spot to reduce pain caused by fibroids, per NYU Langone Health.
- Some forms of hormonal birth control, such as the combination estrogen-progesterone pill or the progesterone-only IUD, can treat symptoms of fibroids like heavy bleeding, pain, and menstrual cramping, says Dr. Chang-Jackson. However, other forms of birth control have not been proven effective, she warns.
- Gonadotropin-releasing hormone (GnRH) agonists like Lupron can promote shrinking of fibroids, reports the Office on Women's Health, but this is often recommended for women who experience heavy bleeding; it may or may not be as useful for women who experience pain and pressure related to their fibroids.
- Home remedies that tend to work for traditional menstrual cramps, which includes heating pads, vitamin supplements, and mild exercise may help you with uterine fibroid pain, but these strategies have not been proven as effective treatments, so you should check with your doctor before implementing them.
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