Living with uterine fibroids
Uterine fibroids are tumors that grow in a woman's womb (uterus). These growths are not cancerous.
Uterine fibroids are tumors that grow in a woman's womb (uterus). These growths are typically not cancerous (benign).Read Article Now Book Mark Article
No one knows exactly what causes fibroids.
You may have seen your health care provider for uterine fibroids. They can cause:
- Heavy menstrual bleeding and long periods
- Bleeding between periods
- Painful periods
- An urge to urinate more often
- Feeling fullness or pressure in your lower belly
- Pain during intercourse
Many women with fibroids have no symptoms. If you have symptoms, you may receive medicines or sometimes surgery. There are also certain things you can do to help relieve fibroid pain.
Uterine fibroids - Animation
Uterine fibroids are common, non-cancerous or benign tumors that can grow in a woman's womb, or uterus. You might be surprised to learn that one in five women may have this sometimes painful problem during their childbearing years and half of all women will probably have them by age 50. So, let's talk about uterine fibroids. Fibroids are abnormal growths made of smooth muscle cells. The cause of uterine fibroids is unknown, but their growth has been linked to estrogen, a hormone that plays a vital role in pregnancy and how your body uses calcium and maintains healthy cholesterol levels. As long as a woman with fibroids is menstruating, a fibroid will probably continue to grow, usually slowly. As many as 40% though will shrink on their own. Fibroids can be tiny, detectable only by microscope, or they may grow very large, even filling the entire uterus. Most fibroids are small and cause no symptoms at all. If you do have symptoms, the most common symptoms of fibroids is heavy or prolonged periods. Bleeding between periods is not typical of fibroids. Fibroids can also cause fullness, pressure, or pain. For instance, a fibroid pressing on the bladder can make the bladder seem smaller, or more difficult to empty. A fibroid pressing on the rectum, can cause constipation. Particularly painful periods are often reported by many women with fibroids, especially those who pass blood clots or who have very heavy flow. Fibroids that change the shape of the inside of the uterus can make it difficult to conceive, or to carry a baby to term. To treat uterine fibroids, your doctor will first perform a pelvic exam to see if you have a change in the shape of your uterus. You may need an ultrasound or a pelvic MRI to confirm the diagnosis of fibroids. Your doctor may take a sample of tissue called a biopsy to rule out cancer. Once your doctor diagnoses fibroids, treatments may include birth control pills to manage heavy periods, intrauterine devices that release the hormone progestin to help reduce heavy bleeding and pain, or iron supplements to prevent or treat anemia due to heavy periods. Women who have fibroids growing inside the uterine cavity may need an outpatient procedure to remove the tumors. A procedure called uterine artery embolization can stop the blood supply to a fibroid, causing it to shrink and die. Surgery called myomectomy removes fibroids, especially for women who want to have children. Finally, some women may need a hysterectomy, or the removal of the uterus, if medicines do not work and other surgeries and procedures are not an option. Most women with fibroids may have no symptoms at all and may need no treatment at all. During pregnancy, existing fibroids may grow due to increased blood flow and estrogen levels. But they usually return to their original size after the baby is born. Call your health care provider if you have changes in your periods, including heavier bleeding, increased cramping, or a feeling of fullness or heaviness in your lower belly area.
Medicines to Treat Uterine Fibroids
Your provider may prescribe different types of hormone therapy to help control extra bleeding. This may include birth control pills or injections. Be sure to follow provider's directions for taking these medicines. Do not stop taking them without talking to your provider first. Be sure to tell your provider about any side effects you have.
Over-the-counter pain relievers can reduce the pain of uterine fibroids. These include:
- Ibuprofen (Advil)
- Naproxen (Aleve)
- Acetaminophen (Tylenol)
To help ease painful periods, try starting these medicines 1 to 2 days before your period begins.
You may be receiving hormone therapy to prevent the endometriosis from becoming worse. Ask your doctor about side effects, including:
- Birth control pills to help with heavy periods.
- Intrauterine devices (IUDs) that release hormones to help reduce heavy bleeding and pain.
- Medicines that cause a menopause-like state. Side effects include hot flashes, vaginal dryness, and mood changes.
Iron supplements may be prescribed to prevent or treat anemia due to heavy periods. Constipation and diarrhea are very common with these supplements. If constipation becomes a problem, take a stool softener such as docusate sodium (Colace).
Learning how to manage your symptoms can make it easier to live with fibroids.
Apply a hot water bottle or heating pad on your lower stomach. This can get blood flowing and relax your muscles. Warm baths also may help relieve pain.
Lie down and rest. Place a pillow under your knees when lying on your back. If you prefer to lie on your side, pull your knees up toward your chest. These positions help take the pressure off your back.
Get regular exercise. Exercise helps improve blood flow. It also triggers your body's natural painkillers, called endorphins.
Eat a balanced, healthy diet. Maintaining a healthy weight will help improve your overall health. Eating plenty of fiber can help keep you regular so you do not have to strain during bowel movements.
Techniques to relax and help relieve pain include:
- Muscle relaxation
- Deep breathing
Some women find that acupuncture helps ease painful periods.
When to Call the Doctor
Call your provider if you have:
- Heavy bleeding
- Increased cramping
- Bleeding between periods
- Fullness or heaviness in your lower belly area
If self-care for pain does not help, talk with your provider about other treatment options.
John D. Jacobson, MD, Professor of Obstetrics and Gynecology, Loma Linda University School of Medicine, Loma Linda Center for Fertility, Loma Linda, CA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Dolan MS, Hill C, Valea FA. Benign gynecologic lesions: vulva, vagina, cervix, uterus, oviduct, ovary, ultrasound imaging of pelvic structures. In: Lobo RA, Gershenson DM, Lentz GM, Valea FA, eds. Comprehensive Gynecology. 7th ed. Philadelphia, PA: Elsevier; 2017:chap 18.
Moravek MB, Bulun SE. Uterine fibroids. In: Jameson JL, De Groot LJ, de Kretser DM, et al, eds. Endocrinology: Adult and Pediatric. 7th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 131.