How Fibroid Pain Is Treated

Magnetic Resonance Images of Woman with Uterine Fibroids

Getty Images / radiologist

Fibroids are growths that develop in the uterus. They do not necessarily cause symptoms but, in some cases, can cause pain. Treatment depends on symptoms, the location of the fibroids, their size, and whether a person wants to get pregnant in the future. 

If you have severe pain or bleeding, your doctor may recommend making some lifestyle changes to better manage your symptoms. If these changes do not help, your doctor may suggest prescription medication or surgery. If you have fibroids but do not have any symptoms, your doctor might take a “wait and see” approach.

Here's an overview of some of the ways that fibroids can be treated.

Magnetic Resonance Images of Woman with Uterine Fibroids

Getty Images / radiologist

Home Remedies and Lifestyle

Home remedies do not eliminate fibroids, but they may help some people get relief from fibroid symptoms such as abdominal pain.

Remedies that you might want to try include:

  • Heat therapy: Applying a heating pad or bottle on the abdomen, pelvis, or back may provide temporary relief from fibroid-related pain. 
  • Regular exercise: Exercise has many benefits and may help control fibroid-related symptoms. However, it’s important to acknowledge that it can be difficult to take part in physical activity if you’re experiencing debilitating pain.
  • Stress-relief strategies: Breathing exercises, yoga, and visualization exercises can help relax the body and may help people cope with fibroid pain. 
  • Lying down in the fetal position: The curled-up position can help relieve pressure and make it easier to cope with painful flares.

Over-the-Counter (OTC) Therapies

The first treatment you can try for discomfort and pain from fibroids is over-the-counter pain relievers such as ibuprofen.

If you have bowel-related symptoms from fibroids, you might prefer to avoid nonsteroidal anti-inflammatory drugs (NSAIDs) because they can have gastrointestinal side effects.

Excessive bleeding caused by fibroids may require you to take iron supplements. However, you should talk to your doctor before taking any OTC supplements, including iron.

Prescriptions

If your fibroids are accompanied by severe bleeding or pain, your doctor may prescribe medication that specifically addresses these symptoms.

Medications that might be prescribed to treat bleeding and pain caused by fibroids include:

  • Hormonal birth control pills: Birth control pills may help limit bleeding caused by fibroids. However, contraceptives do not affect the fibroids themselves. 
  • Intrauterine device (IUD): An IUD is a contraceptive device that is inserted into the uterus to prevent pregnancy. Some IUDs also release hormones that can help reduce bleeding caused by fibroids. Once the IUD is removed, however, the symptoms may come back. 
  • GnRH agonists: Medications in this class, like Lupron, can reduce bleeding and the size of fibroids‚ but only temporarily. Doctors typically prescribe Lupron for people with heavy bleeding or to shrink very large fibroids before surgery. However, a significant side effect associated with Lupron is bone loss.

A recent trial showed that taking a daily combination of the GnRH agonist relugolix and estradiol and norethindrone acetate is an effective treatment for bleeding caused by fibroids without causing bone loss. However, more research is needed to confirm the results.

Surgeries and Specialist-Driven Procedures

If you have very large fibroids that are causing severe symptoms, your doctor might recommend that you have surgery. However, depending on the procedure, fibroids may come back and more surgeries might be necessary.

Types of surgeries and procedures for treating fibroids include:

  • Myomectomy: This surgery removes fibroids without removing the uterus. With this type of surgery, fibroids can regrow. 
  • Hysterectomy: This surgery involves removing the uterus, which guarantees that fibroids won’t come back. However, it also means that a person loses their fertility. 
  • Uterine artery embolization (UAE): This procedure involves stopping blood flow to fibroids, which keeps them from growing. Eventually, the lack of blood flow causes the fibroid tissue to die, but that process can take months. The procedure does not provide relief for everyone, and in some cases, the fibroids return. Compared with other procedures, UAE is minimally invasive.
  • Radiofrequency ablation (RFA): This treatment uses heat to shrink the fibroids. While it can be an effective treatment and is minimally invasive, it only reduces the size of the fibroids; it does not get rid of them.
  • Magnetic resonance imaging–guided focused ultrasound: This procedure involves using ultrasound to damage fibroids. It’s noninvasive but can cause heavy periods and irritate the sciatic nerve.

All surgical and nonsurgical procedures carry a risk of complications. More-invasive surgeries that require an abdominal incision have higher risks, such as infection.

Some laparoscopic surgeries involve cutting the tissue into small pieces for easier removal (morcellation). There is a risk that the cancerous tissue will spread with laparoscopic power morcellation; therefore, only contained morcellation should be performed in appropriately selected patients.

Complementary and Alternative Medicine (CAM)

There’s very little research on the effectiveness of CAM therapies for fibroids and fibroid symptoms.

Most of the studies that exist involve small sample sizes. However, some research suggests that CAM therapies, such as acupuncture, may help some people cope with chronic pain.

Some people find relief from heavy bleeding and cramping with acupuncture, but there’s no evidence that acupuncture can shrink fibroids.

Shrinking Fibroids vs. Easing Symptoms

Doctors may prescribe Lupron, a medication that shrinks fibroids, before surgery. Shrinking the fibroids makes it easier to remove them.

Shrinking fibroids can temporarily help with symptoms, but it’s not a long-term solution. There are ways to treat the symptoms of fibroids, including pain and bleeding, but they cannot cure fibroids and will need to be used continuously. 

Currently, surgery is the only option for permanently removing fibroids. Even so, not all surgeries guarantee the permanent removal of fibroids. If the uterus is left intact, fibroids can grow back.

While a hysterectomy ensures that fibroids won’t return, it also results in loss of fertility. Some people may choose other treatment options because they still wish to get pregnant. 

Fibroid Pain and Pregnancy

It’s possible to get pregnant if you have fibroids. However, pregnancy hormones may cause the fibroids to get bigger and having fibroids increases the risk of a complicated pregnancy.

Fibroids can also cause pain during pregnancy. However, not all treatment options are safe for pregnant people. Birth control cannot be used to treat fibroids if you’re pregnant, and some OTC supplements and medications are unsafe to take while pregnant or breastfeeding. 

During pregnancy, the typical treatment plan for fibroid pain involves bed rest and hydration.

Using NSAIDs

While OTC pain relievers called nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to treat fibroid pain, these medicines can be harmful to a fetus. If you are pregnant, you should only take NSAIDs under the close supervision of your doctor.

Some pregnant people may require prescription pain medication. In rare cases, it is possible to get fibroids surgically removed during the first half of pregnancy.

A Word From Verywell

If you’re experiencing heavy menstrual bleeding and pelvic pain, it's important to tell your doctor. These symptoms can be caused by many conditions, but if they are related to fibroids, you will want to learn about your treatment options.

You and your doctor can talk about different treatments, which could include medication and surgery. There are also lifestyle changes and techniques you can try at home that might help you cope with fibroid pain.

Frequently Asked Questions 

How do you relieve fibroid pain during pregnancy?

Treating fibroid pain during pregnancy usually involves OTC pain relievers, bed rest, and hydration. You should talk to your doctor before taking any OTC products, however, because it is not safe to expose a fetus to some of them.

How long does it take for pain from a fibroid to go away after removal?

You'll have pain after any surgical procedure and while you are healing. You might need to take pain medication for at least a day after your procedure. The total recovery time can take two weeks to several months. 

How big does a fibroid have to be to cause back pain?

The pain from fibroids depends on where they are located and how big they are. Large fibroids are more likely to cause pain than small ones, but small fibroids can also cause symptoms.

What does fibroid pain feel like?

Fibroid pain can cause acute pelvic pain, but it can also cause vague sensations of discomfort in the pelvic area. Fibroids can also cause lower back pain, rectal pressure, and pain during sex.

Some people have fibroids and do not have any pain or discomfort. They might not even realize they have them.

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12 Sources
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