Types of Uterine Fibroid Pain and Treatment Options

Uterine fibroid pain originates from non-cancerous tumors that grow in a person's uterus. The growths can vary in size and can cause different types of painful symptoms.

According to MedlinePlus, uterine fibroids are common. Out of the 26 million Americans who have uterine fibroids, less than half of them may not even be aware of it because they are asymptomatic, according to a 2017 review from the Comparative Effectiveness Review.

But, that still leaves more than half who do know about their fibroids, thanks to the challenging and often painful symptoms they cause.

Pain is one of the key symptoms of fibroids, said G. Thomas Ruiz, MD, an ob-gyn at MemorialCare Orange Coast Medical Center in Fountain Valley, California. Though Dr. Ruiz noted that the pain caused by uterine fibroids could 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 said, there are several different ways you might experience the pain associated with uterine fibroids. These are the most common.

Pelvic Pain

Pelvic pain is one of the primary symptoms of uterine fibroids, according to Johns Hopkins. You may also feel dull pressure in the pelvic region, or notice radiating pain in other parts of your body, said Shao-Chun Rose Chang-Jackson, MD, 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

The Johns Hopkins Medicine also tells us that some fibroids, depending on size and location, may cause pain in your lower back and down your legs. This is due to the effects on the other organs that Dr. Chang-Jackson referred to; when fibroids grow large enough, they can compress nerves along the spine that cause back and leg pain.

Abdominal Pressure

A feeling of fullness or pressure in the abdomen is a common symptom of fibroids when they are large, or there are multiple fibroids, says Johns Hopkins. However, sharp, sudden pain in the abdomen that isn't relieved by pain medication may be a cause for concern, and you should seek emergency treatment.

Pain During Intercourse

Johns Hopkins also said that fibroids could cause pain while having sex. Dr. Ruiz said they could also cause pain before and during your period—this may feel like the typical uterine cramping associated with menstruation. Still, it may last longer or be more intense if you have fibroids.

Rectal and Bladder Pressure

Depending on their location, fibroids can also cause uncomfortable pressure on your bladder and your rectum, according to the Office on Women's Health. Because of this, you may experience frequent urination or feeling like you can't empty your bladder fully, according to Johns Hopkins. There can also be problems with bowel movements, such as constipation or excessive straining.

Severe Fibroid Pain

While typical uterine fibroid pain can be pretty uncomfortable, severe or debilitating pain that is unrelenting could be a sign that something else is happening with your fibroids, according to 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," Dr. Ruiz explained. "It's a severe, stabbing pain that will probably leave you doubled over."

Dr. Chang-Jackson explained that fibroids degenerate when they outgrow their blood supply, essentially starving themselves and dying off. Sometimes these fibroids resolve on their own after several days, while others require surgery, according to the Brigham and Women's Hospital.

Other Common Uterine Fibroid Symptoms and Complications

According to the Office on Women's Health, other symptoms and complications of uterine fibroids include:

• Heavy or painful menstrual bleeding
• Enlargement of the lower abdomen
• Difficulty conceiving or infertility
• Complications during pregnancy and labor

Treatment

Treatment options vary widely for uterine fibroids, Dr. Chang-Jackson said, based on their size and location, whether or not they're causing symptoms, and whether or not they are affecting your fertility.

Waiting It Out

If your symptoms are tolerable, a healthcare professional will monitor your symptoms closely with follow-up visits and ultrasounds advised Johns Hopkins. Fibroid growth slows down the closer you reach menopause, so it is possible they will stop growing on their own.

Surgery

If your fibroids cause severe symptoms, there are surgical procedures to shrink or remove fibroids. But unfortunately, Johns Hopkins warned, they often regrow. The only way to eliminate the risk of fibroids is to have a hysterectomy—a surgical procedure that removes the uterus. In the US, fibroids are the number one cause of hysterectomies.

Anti-inflammatory Pain Relievers

If you're simply focused on managing your pain symptoms, you can try a few strategies. If you're experiencing occasional pain or discomfort from fibroids, anti-inflammatory pain relievers—like Ibuprofen and Naproxen—can reduce pain and menstrual bleeding, said Johns Hopkins.

Oral Contraceptives

There are a variety of hormonal treatment options available. 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, Dr. Chang-Jackson said. However, other forms of birth control have not been proven effective, Dr. Chang Jackson warned.

Gonadotropin-releasing Hormone Agonists (GnRH Agonists)

Gonadotropin-releasing hormone (GnRHa), like Lupron, can promote the shrinking of fibroids, according to the Office on Women's Health. Since GnRHa can cause bone loss, taking it for more than six months to one year is not recommended. Most people tolerate GnRHa well, but side effects can include hot flashes, depression, inability to sleep, decreased sex drive, and joint pain.

A Quick Review

Uterine fibroid pain varies with each person. Some people don't experience any symptoms, some experience only mild symptoms, and others may experience severe pain that interrupts their daily life. Treatment options can vary from pain management to surgery. Still, it is best to discuss these options with a healthcare professional to determine which course of treatment is the best for the uterine fibroid pain you are experiencing.