Depending on the fibroids location, pain is different.

Dear Fibroids: I’m Tired of Being in Pain Each Month

Uterine fibroids are very hard and firm tumors. They cause symptoms based on their location in the uterus. The subserosal fibroids (image below) are found just underneath the outer covering of the uterus. As they enlarge they grow away from the uterus and will press on whatever structures lie next to them. The lateral and posteriorly located fibroids will often press on pelvic nerves to cause abdominal and pelvic pain, but can also cause the same sciatica pain in the back, buttock, hips that radiates down the legs seen with a lower back strain. Not being aware of this latter point can lead healthcare providers to look for a source of pain in the lower back, when it is actually from the fibroids.

Depending on location, fibroids cause different pain

The intramural fibroids are the most common type and are located in the muscle in between the other two locations for fibroids (image above). They too can enlarge and grow outwardly like the subserosal fibroids and cause the same pain as the subserosal variety.

The third type of fibroids is the submucosal ones. They are located underneath the uterine lining and are responsible for the heavy menstrual periods. While they don’t directly cause pain like the other two types, they can be responsible for pain. The submucosal fibroids can cause extremely heavy and lengthy periods; often with blood literally gushing and flooding out with large clots. As these clots pass through the cervix and into the vagina, this will cause pain; particularly in women who have not had a vaginal birth. If the blood and clots come out immediately, the woman recognizes the correlation between the two. However, sometimes the blood and clots can sit in the vagina for a period of time before coming out, and the two events may not seem to be related (i.e., her pain from an hour or two ago and the passage of the blood and clots from her vagina).

Once it is discovered that the pain is due to fibroids, seeking out experts in the management of uterine fibroids is important. This will include a Gynecologist, but it will also be important to seek an opinion from an experienced Interventional Radiologist so that all treatment options are explained to the patient. All too often only the surgical options are discussed which is only part of what is available for treatment. In addition, lifestyle changes are often needed and the input from dieticians, exercise trainers, and naturopathic providers can also be useful.

Uterine Fibroid Embolization (UFE) has transformed the lives of patients who were tired of suffering and wanted their lives back without surgery. If you’re tired of suffering the pain from fibroids, please contact the fibroid experts at the Atlanta Fibroid Center today. To schedule an appointment, please call 770-953-2600 or online at

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