On the heels of new legislation surrounding women’s health, there has been a surge in social media commentary about the impact of potential changes to birth control and fibroids-related research and education. These forums have made it abundantly clear that a healthy ‘U’ starts with understanding how our body works, how will we be impacted and who is minding our ‘U.’
A separate yet related topic that has sparked conversation is birth control pills and how they and other forms of birth control affect fibroids. Peeling back the layers of this relationship can be especially helpful to women with fibroids as they make decisions about the future of their ‘U’.
To help aid all women in making an informed decision about hormone therapy treatments and other non-invasive procedures, I have generated 5 need to know facts about birth control and fibroids.
Birth Control and Fibroids
Whether birth control is prescribed for use in preventing pregnancy or for non-contraceptive purposes, almost every woman will use it in her lifetime. Birth control has many benefits especially for women living with fibroids. The relationship between birth control and fibroids depends on many factors including the severity of fibroid symptoms and whether or not the selected birth control method is appropriate to treat them.
| Fact #1. Birth control pills are the most commonly used contraceptives to treat fibroids among women of reproductive age. |
Uterine fibroids cannot be linked to a single factor, however, hormones play an important role in how they grow. Hormone-specific birth control methods can temporarily relieve heavy bleeding and pain. Of course, this approach can help to minimize fibroids, but it will not completely dissolve them. Let’s take a deeper dive into this relationship by learning about your birth control and fibroids.
Birth Control Pills and Fibroids
When discussing birth control and fibroids, the emphasis is often placed on the use of oral contraceptives or birth control pills.
The pill is easy to use, accessible and treats common fibroid and menstrual cycle symptoms. For example, women with fibroids commonly experience heavy bleeding. Thus, birth control pills are prescribed to help reduce a woman’s menstrual flow and cramping and most notably, to help prevent anemia (low blood count).
| Fact #2. Birth control pills DO NOT shrink uterine fibroids. |
Facts about Birth Control Pills
A few important facts to remember about birth control pills are:
- There are two different types: 1) progestin-only and 2) combination (progestin and estrogen).
- Combination birth control pills also reduce conditions such as acne, cysts, some cancers, female-specific infections, and anemia.
- Birth control pills are the most commonly used contraceptive method for women with fibroids.
- Women can get access to birth control pills for free or for a low cost.
- Birth control pills are 99% effective.
- Side effects of birth control pills can vary by person.
- Birth control pills increase clotting and reduce blood flow, prevent anemia, and help to reduce menstrual cramping.
“I did not begin using birth control for contraceptive purposes: they were prescribed to address severe fibroid-related symptoms. After my initial diagnosis, I inquired about birth control methods with girlfriends who had experience with them. I opted not to take birth control due to concerns about weight gain. Seven years after my diagnosis, I began noticing more severe symptoms, which let me make an appointment with my ObGyn to discuss and acquire birth control pills. I wasn’t sure that was the best method at that time, but it was the most common and most suitable method for me.”
Other Types of Birth Control and Their Effect on Fibroids
There is no perfect birth control method, so it is important to find the best method for you and your needs. Consider the following factors before selecting birth control:
- Method effectiveness
- Ease of use
- Your fibroid symptoms and history
- Your interest in childbearing
- Hormones levels
During your next Girlfriend’s Getaway, you can use this list to determine what things are the most important to you and your ‘U.’ Then schedule an appointment to talk with your health care provider.
The Shot (e.g. Depo-Provera and Lupron Depot):
- Depo-Provera is a shot that delivers a low dose of progesterone (female hormone) and decreases heavy bleeding.
- Lupron Depot is a shot that blocks the production of estrogen; it also stops heavy bleeding and shrinks fibroids.
The Ring (e.g. NuvaRing):
- A ring that is inserted into the vagina.
- NuvaRing contains both estrogen and progestin.
- It can improve acne and cramping.
The Patch:
- The Patch contains hormones placed on the body via the back, upper arm, stomach or butt.
- It helps to lessen cramps and regulate the menstrual cycle.
The Implant (e.g. Nexplanon):
- Implants are 99% effective and include progestin only.
- They are inserted by a physician under the upper arm.
The IUD:
- IUDs are small devices that release artificial hormones called progestin.
- They prevent the buildup of the uterine lining during a woman’s cycle.
- Hormonal IUDs can improve heavy bleeding from small central fibroids. When fibroids are too large, they change the shape of the uterus making IUDs impossible to insert.
- In addition, heavy bleeding with large amounts of clotting can expel an IUD.
- IUDs are not recommended for women interested in becoming pregnant.
| Fact #3. Hormonal IUDs treat smaller fibroids. Large fibroids reshape the uterus making IUDs impossible to insert. |
Does Birth Control Help with Fibroids?
Birth control can help with fibroids, but its usefulness depends on the type of birth control method used. There are benefits and the potential for unfavorable outcomes with any of these methods. For example, the implant is said to be best if a woman does not plan to become pregnant within the year. It has also been linked to irregular bleeding. If these are side effects that you are okay with then, this may be the method for you. If not, you want to be much wiser in your selection. Remember to always consult a healthcare provider and ask questions.
Fibroids and Birth Control Pills
Fibroids and birth control pills are connected in several ways. Women with fibroids can use birth control pills to regulate their menstrual period. Fibroids increase menstrual flow, while birth control pills decrease flow during a woman’s cycle as hormones are released. Birth control pills help decrease the level of hormone that causes the uterus to contract. Fewer contractions mean a reduction in cramping and thus improved symptoms. While each of these outcomes has been reported among women with fibroids, it is important to remember that every woman’s journey is different so the extent of these outcomes will vary.
Can Birth Control Shrink Fibroids?
There is no conclusive evidence that birth control pills, the patch, or ring shrink fibroids. In fact, the added estrogen in standard birth control pills will cause fibroids to grow at an increasing rate. While birth control pills can improve fibroid-related symptoms, the effect is often temporary. The accelerated growth of the fibroids will necessitate the woman to investigate alternative treatment options to control the fibroid-related symptoms. These are the women that are best suited for a nonsurgical procedure called Uterine Fibroid Embolization or UFE.
| Fact #4. Gonadotropin-release hormone analog (GnRH-a) reduces the size of fibroids temporarily. |
Depo-Provera and Lupron shots, on the other hand, have been linked to fibroid shrinkage. Gonadotropin-release hormone analog (GnRH-a) reduces the size of fibroids temporarily. Beyond birth control, when women reach menopause, fibroids typically begin to shrink.
Where Do We Go from Here?
Now that you have more details on birth control and fibroids, it is time to act! You do not have to go to fibroids alone. Use these facts and useful tips in this blog to inform discussions with your health provider, determine the best birth control method to treat your fibroids, better understand recommendations, and reduce confusion.
All of the methods discussed in this blog help to lessen the severe symptoms of fibroids, but they do not eliminate them. The same can be said for surgical procedures such as a myomectomy. I know this all too well.
“After having an abdominal myomectomy, I developed an ileus which left me in the hospital for a week with a nasogastric tube.”
A year and a half after my surgery, multiple fibroids were discovered in my uterus. My symptoms not only returned, but they became more severe. My Gynecologist left me with the impression that the myomectomy surgery would remove all of my fibroids, but I found out after surgery that that rarely happens. The vast majority of women who undergo myomectomy wake up from surgery with living fibroids still inside their uterus. These fibroids begin to grow and most of these women will need another procedure within 5 years; many within 3 years of surgery. Mine were a problem much sooner than that. I sought help from a fibroid study but was unable to meet the qualifications. After being rejected from the study, I searched for a uterine fibroid expert and learned about the Atlanta Fibroid Center. It is there that I learned about Uterine Fibroid Embolization (UFE).
Uterine Fibroid Embolization with an IUD
Uterine Fibroid Embolization is a non-surgical procedure that permanently treats fibroids regardless of their size or their number. Like most women struggling with fibroids, UFE was never recommended for me. I was told to try an IUD but proved impossible due to the shape of my uterus from the fibroids. The presence of an IUD does not prevent a woman from undergoing UFE.
| Fact #5. UFE can help shrink fibroids and reduce common fibroid symptoms such as heavy bleeding and severe cramping. |
If you are interested in learning more about any of the birth control methods discussed in this blog or UFE, schedule a consult with Dr. John Lipman at the Atlanta Fibroid Center. Dr. Lipman had been advocating for women with fibroids for the past 25 years. In the time that I have worked with him and his team, I have gained a wealth of knowledge about uterine fibroids and the benefits of UFE. You can learn more about fibroids and UFE at ATLii.com
About the Author: Dr. LaShanta J. Rice is the Founder and CEO of Synergy Empowerment Solutions LLC, a public health strategies and consulting company that offers tailored, in-depth trainings for individuals and organizations. She is also an adjunct professor at Liberty University Online. Previously, she served as an Assistant Professor in Psychiatry and Behavioral Sciences and as an Associate Member in the Hollings Cancer Center at the Medical University of South Carolina. She is a trained social and behavioral scientist and former Environmental Protection Agency Science to Achieve Results (STAR) Fellow. Dr. Rice was diagnosed with fibroids in 2007 and underwent a myomectomy in 2015.
