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Benefits of Asking 7 Simple Questions About Painful Fibroids
January 19, 2022
Updated May 2023
In my experience, one of the major problems of women with painful fibroids is the absence of the right information. Understanding the condition and what is currently available to treat this condition can make a world of difference for many women with fibroids.
In this post, we’ve curated seven of the most common questions about uterine fibroids’ pain so that you can use these to speak with your primary care doctor or gynaecologist about your symptoms and treatment.
Fibroids are benign growths of the womb muscle that affect one in 3 women worldwide.
Some interesting facts about fibroids:
There’s a lot more to know about fibroids, so please check out the excellent playlist right here on our youtube channel.
So while this may sound like a needless question given that we are talking about Painful Fibroids, the point is that not all fibroids are painful.
Several things can make fibroids painful, but not every woman will experience fibroid pain, and many do not even have symptoms from their fibroids.
To answer the question then: Not all Fibroids hurt, and those that can hurt do not always do so.
And that takes us nicely into discussing the features of fibroid pain.
Whether or not a fibroid is painful – and how bad the pain gets depends on many things:
The more fibroids in the womb, then the more likely they can cause symptoms. However, let us look at the other factors in a bit more detail:
Growth
A fibroid is made of the same muscle as the womb. It relies on the blood supply to grow, but it dies when the Fibroid becomes too big for its blood supply.
When that happens, it is called degeneration, and the byproducts of fibroid degeneration (prostaglandins) cause pain in the abdomen and pelvis.
Location
If you have fibroids inside the womb, they can affect its shape, causing irregular menstrual bleeding and pain.
If the fibroids are outside the womb, they can press on organs like the bladder, rectum or the nerves around your spine. Doing so can cause pain or pressure in the abdomen, pelvis, and back.
Type
Subserosal fibroids grow under the outer layer of the womb. In this position, they can protrude outwards into the pelvis, pushing into or against nearby organs or tissues.
Intramural fibroids grow inside the wall of the womb. They can become very large and make the womb bulky so it exerts pressure on nearby organs.
Submucosal fibroids are the least common type. They grow under the womb lining (mucosa) and push into the womb’s inner cavity. They can make the womb lining irregular, thus increasing the chance of irregular bleeding and pain. Doctors have found they are most often related to difficulties getting pregnant compared to other fibroids.
Some fibroids located inside or outside the womb are painful because they are hanging by a stalk. These are known as pedunculated fibroids. If the stalk twists, it stops the blood supply to the fibroids, so the tissue dies, causing pain as it does so.
We have seen that fibroids can cause pain.
Pain can happen by the bulk of the fibroid pressing on organs (or nerves) close by.
Uterine fibroids pain can also happen when they are degenerating.
Large fibroids are more likely to do so; however, small fibroids can also cause pain if they are pedunculated.
A small fibroid that is degenerating or located close to structures that can cause pressure can also do the same.
Women with fibroid pain have different experiences.
For some, it can be mild or severe (comparisons to labour contractions included). Some women always have pain (chronic pelvic pain), but it can be occasional (from time to time) for others.
It could be a dull ache or quite sharp, even stabbing.
Where
The pain often starts in the pelvis and lower abdomen but could travel down your leg.
You might experience discomfort in the abdomen when the heavy womb with a fibroid presses on the bowels or bladder.
Women with fibroids often experience pressure on the bladder or the abdomen.
Many women often ask: can fibroids cause back pain?
Fibroids can most certainly cause back pain. Think of where fibroids are located.
There are large nerve networks throughout the body and in the pelvis (and abdomen) where fibroids grow.
Therefore, if your fibroid presses on a nerve in your lower back area (spinal nerves), your legs, hips, and back could all be affected.
This is in addition to the heavy bulk of fibroids placing pressure on the ligaments and other tissues that make up the back.
Fibroids pressing on the lower part of your spine can cause similar pain to sciatica. If you have sciatica, there is pain in your back that travels down your leg and into the foot.
Usually, sciatica happens because the sciatic nerve, the thickest nerve in humans, is irritated.
The sciatic nerve travels from around your buttock on either side and continues all the way down into the leg and foot.
Very large fibroids or several smaller ones in that same area can result in similar pain.
Timing
If you have fibroids, you may suffer more often from pain around the middle of your cycle. You may also get more pain during and after your menstrual period.
Pain during sex (dyspareunia) is a symptom that women with fibroids may have and it can be embarrassing to describe this. However, providing this to your doctor can be a helpful clue about the cause of your symptoms.
Now we’ve looked at how fibroid pain can develop, it’s clear that it may not always be present.
In other words, the pain symptoms can come and go.
In addition, certain activities trigger fibroid pain, including:
As fibroids grow, pain can develop because they are degenerating or, if they are pedunculated, have grown to the extent where their stalk begins to twist.
Many women with fibroids do not have any problems when they are pregnant. And yes – you can have fibroids and still fall pregnant.
Only a small percentage of women with fibroids do experience infertility – often related to the size and location of the fibroid.
However, while fibroids can co-exist with pregnancy, many women can have significant challenges:
Therefore, careful monitoring throughout your pregnancy and during/after your delivery is essential to prevent and promptly identify and treat these complications.
At this stage of pregnancy, your estrogen levels are elevated. You also have a higher blood volume as your body prepares your womb to grow and carry your baby.
These two factors also affect your fibroid, making them grow larger.
Studies tell us that not all fibroids grow in pregnancy, but one out of 3 women will find their fibroids do increase in size when they are pregnant.
The size changes affect large and small fibroids – but usually not more than a quarter of their original size.
But what about pain? Abdominal cramps and pain commonly happen from fibroids when you are pregnant.
Studies tell us nearly 6 out of 10 pregnant women experience pain from their fibroids – from their abdomen, pelvis, lower back, buttocks, hips and legs.
At this pregnancy stage, your womb grows larger as your baby grows within it. This means effects like pressure and challenge to the blood supply will affect the fibroid more.
As a result, pain is often reported from fibroids during later pregnancy.
Large fibroids can pressure the other organs within the pelvis and abdomen. If their position is on the back of the womb, they can place pressure on the nerves in the back (spinal nerves), leading to back and leg pain like sciatica.
If you have a pedunculated fibroid, it may have grown during your pregnancy. It can thus twist very suddenly, causing severe sharp pain or cramps in your abdomen or pelvis. This is Fibroid Torsion and is an emergency requiring prompt medical attention.
Fibroid degeneration which we described earlier, can also happen in the latter part of your pregnancy. Larger fibroids (usually more than 5 cm) outgrow their blood supply. As a result, they degenerate/die while releasing by-products in large amounts. These by-products are prostaglandins. They are responsible for painful menstrual cramps but also contractions during labour.
Fortunately, there are several measures you can take to help with uterine fibroids pain.
Short-term measures to deal with acute pain include:
Medium-term, you could have hormone treatments, including combined contraceptive drugs, hormone injections or sprays, more potent pain killers available only with a doctor’s prescription and uterine fibroid embolization, UFE.
UFE is a non-surgical method of removing fibroids by shrinking them after shutting off their oxygen supply.
You can also learn about more of these methods in these videos on my playlist.
When it comes to more permanent approaches, surgical options you may consider are Myomectomy – cutting the Fibroid out of the womb; or Hysterectomy, which means the removal of the womb.
Natural remedies are essential to Fibroids care and can be short, medium and long-term.
Though we have limited studies, evidence suggests diet and micronutrients play a part in developing Fibroids. Make sure you check out this video on my channel, where I talk extensively about natural fibroids remedies. However, to summarise:
Unfortunately, there is no exact, perfect or single answer to this question (as you commonly find in medicine).
Instead, you may find a method that removes the pain but has several side effects or is only temporary.
The method you choose may also depend on your age, whether you have kids or not. Often, it’s a combination of things.
For example, if you are yet to start a family and not keen on surgery, using OTC pain medicines or the combined pill may be suitably combined with natural measures of healthy eating and keeping active.
For someone else, Acupuncture may do the trick in addition to Yoga or other forms of regular exercise.
The best pain relief for you is what works best, with minimal side effects, and you can use it for short or more extended periods, depending on your needs.
You can address this best with your doctor, and you may not get it right the first time, but please don’t give up.
Getting The Best Treatment for Fibroid Pain
Many women whose fibroids cause troublesome symptoms often feel no one is listening to them. It often feels like the only option they have is surgery to remove the womb or the fibroids.
This is far from true – and if you suffer from Fibroid pain, please take make a list of the questions in this post you feel are most relevant when next you have a doctor’s appointment.
By discussing the available options, you and your doctor may be able to come up with a solution that best suits your needs.
Let us know in the comments section if you have questions about painful fibroids.
More Reading:
Editing by AskAwayHealth Team
Disclaimer
All AskAwayHealth articles are reviewed by practising Medical Practitioners on various healthcare conditions to help promote quality healthcare. The advice in our material is not meant to replace a qualified healthcare practitioner’s management of your specific condition.
To discuss your condition, don’t hesitate to get in touch with a health practitioner or reach us directly
Image Credits @Canva
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