Many people with uterine fibroids have no symptoms, but others may experience pain and abnormal vaginal bleeding. For some people living with fibroids, the pain is intense enough to interfere with daily life.
Uterine fibroids are noncancerous growths that form inside the uterus. They can grow quite large and cause pain and pressure.
Fibroid pain usually occurs in the lower back or pelvis. Some people also experience stomach discomfort, intense cramps when menstruating, or pain during intercourse.
There is little evidence that home remedies can ease fibroid pain. However, there are a few methods that people can try.
- taking over-the-counter (OTC) medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs)
- using heating pads
- practicing yoga or stretching
- doing gentle exercise
- eating a healthful diet
Some people may be interested in trying herbal remedies to shrink the fibroids and ease the pain. A 2013 Cochrane review analyzed previous research on the use of common herbal remedies — including Tripterygium wilfordii and Guizhi Fuling — to treat fibroids and their symptoms.
The researchers concluded that the quality of the data in the reviewed studies was insufficient to support the use of these herbal remedies.
Making lifestyle changes may be a more effective way for people to ease their fibroid pain.
A person can take medication to help ease fibroid pain. However, medication will not cure fibroids, and a person may require surgery later on.
These types of drugs may help ease fibroid symptoms:
- Birth control pills: These can help reduce period pain. They may also make periods lighter, but they will not shrink fibroids.
- A hormonal intrauterine device (IUD): This device releases progestin, which can help with painful, heavy periods but will not shrink fibroids.
- Gonadotropin-releasing hormone (GnRH) agonists: These drugs counteract the effect of the hormones that regulate a person’s period. They can stop monthly bleeding and may help shrink fibroids.
The GnRH agonists may cause side effects, so doctors recommend that people take these for no longer than 6 months. After a person stops taking these drugs, the fibroids typically grow back.
When fibroids cause pain, and medication does not work, a person may consider surgery. Doctors may recommend one of the following surgical procedures:
- Myomectomy: A myomectomy is the removal of the fibroids from the uterus. This procedure does not remove the uterus, so it is still possible for the person to get pregnant afterward.
- Ablation: This procedure involves using heat to destroy the fibroids. It will not remove the fibroids altogether, but they may shrink.
- Laparoscopic power morcellation: For this procedure, a surgeon will make a tiny incision and insert a surgical instrument through it to break up fibroids. However, the Food and Drug Administration (FDA) caution that this treatment carries significant risks.
- Hysterectomy: A hysterectomy removes the uterus. Sometimes, the surgeon will also remove the ovaries.
In addition to pain, some people experience the following symptoms:
- very heavy bleeding
- anemia from heavy periods
- frequent bowel movements or urination
- swelling or pressure in the stomach
Many people find out that they have fibroids during a routine pelvic exam. A doctor can often feel the fibroids in the uterus during the exam.
A doctor can also detect fibroids by performing imaging tests, such as:
A doctor may sometimes recommend a hysterosalpingogram, which uses dye to see the uterus during an X-ray, or a sonohysterogram, which uses a saline solution to enhance the view of the uterus during an ultrasound.
Doctors do not fully understand what causes fibroids, but some possible causes and risk factors include:
- Genetics: Fibroids may run in families, and certain genetic mutations increase the risk of these growths.
- Hormones: Estrogen, progesterone, and growth hormones may increase the risk. Therefore, people who take hormonal birth control or have growth hormone injections may be more likely to develop fibroids.
- Nutritional imbalances: Some research suggests that there is an association between vitamin D deficiency and the development of fibroids.
- Race and ethnicity: African American women appear to be more likely than white women to develop fibroids.
- Obesity: People who have overweight or obesity are two to three times more likely to develop fibroids than those with a moderate body weight.
It is not possible for a doctor to diagnose fibroids based on a person’s symptoms alone.
Many other conditions, including infections, pregnancy loss, and cancer, may share some of the symptoms of fibroids, so it is important to see a doctor for unusual bleeding or pelvic pain.
A person who already knows that they have fibroids should see a doctor if they experience:
- sudden worsening of symptoms
- heavy bleeding
- pressure or swelling in the abdomen
- returning fibroid symptoms after fibroid surgery
Many people develop uterine fibroids without being aware of them. However, some individuals may experience severe pain and need surgery or other treatments.
A person experiencing fibroid pain can stretch, use heat, or take OTC medications, but if the pain does not improve, they should see a doctor.
A doctor can guide treatment decisions by helping a person weigh up the risks and benefits of various symptom management options.