Pelvic Pain Caused By Fibroids

What Is Pelvic Pain?

Numerous conditions can cause pelvic pain in women, which makes it a complex issue. Pelvic pain is pain that is felt in the lower part of the abdomen between your belly button and your groin. Pelvic pain can result from a number of causes including menstrual cramps, ovulation, uterine fibroids, endometriosis, or gastrointestinal issues. It can also be a result of something more serious like appendicitis, ovarian cancer, an STD, etc.

What Does Pelvic Pain Feel Like?

Pelvic pain can be described as a dull ache or pressure anywhere in the abdomen below the navel. Some women describe the pressure as feeling bloated or “full”.

Note: If you are experiencing sharp, stabbing pains, you should be examined immediately!

The pain may be constant or intermittent and can be accompanied by other symptoms, such as pain in the lower back or abnormal vaginal bleeding or discharge.

If you are experiencing chronic pelvic pain (even mild), it is important to make an appointment with your OB-GYN to determine the cause. Make an appointment with your doctor right away if pelvic pain is accompanied by any of the following:

• Heavy periods that last a long time;
• Breakthrough bleeding between periods;
• Difficulty urinating;
• Frequently needing to urinate or constantly waking up during the night to empty your bladder.

What Conditions Can Cause Pelvic Pain?

Many health conditions ranging from normal menstrual cramps to cancer can cause pelvic pain in women. Because of the wide scope of health concerns that present with pelvic pain, it is important to see an OB/GYN if you are in pain.

Some conditions that cause pelvic pain in women are:

• Endometriosis;
• Uterine fibroids;
• Adenomyosis;
• Appendicitis;
• Pelvic inflammatory disease (PID);
• Mittelschmerz (ovulation pain);
• Ovarian cancer;
• Ovarian cysts;
• Ectopic pregnancy;
• Sexually transmitted diseases (STDs);
• Polyps;
• Urinary tract infection;
• Other conditions.

What Does Pelvic Pain Caused By Fibroids Feel Like?

Women with large or numerous fibroids may feel a “heaviness” or pressure in the lower abdomen or pelvis. It is often described as a dull ache that is vaguely uncomfortable. Uterine fibroids will often distend the uterus into the abdominal cavity and crowd other nearby organs, exerting pressure on them, causing other symptoms. Constipation, frequent urination, discomfort while exercising, painful intercourse, and lower back and leg pain can all be caused by uterine fibroids.

Why Do Fibroids Cause Pelvic Pain?

The pressure and pain symptoms caused by uterine fibroids normally result from the weight and/or location of the fibroid that is pressing or resting on abdominal organs, rather than the fibroid itself hurting. Fibroid sizes can range anywhere from the size of a pea to a pumpkin, and they can change the shape of your uterus.

If there was a grapefruit-sized fibroid sitting on your intestines or your bladder, you would most likely experience constipation or the frequent need to urinate coupled with abdominal discomfort. A large fibroid located on the back of the uterus could exert pressure on the spinal column and cause lower back pain or shooting pain down the legs like sciatica.

There have been cases when an actual fibroid became twisted on the stalk that attaches it to the uterus and caused severe sharp pain in the abdomen. This is a medical emergency and requires immediate attention.

What Other Types Of Pain Can Fibroids Cause?

Uterine fibroids often cause pain which is worse than the typical period cramps. This is often associated with significant bloating, and an inability to wear tight-fitting clothes. There can be pain during sexual intercourse, discomfort while trying to lie on your stomach, lower back pain, pain that runs down one or both legs, or pain that is associated with passing blood clots.

Leg pain caused by subserosal or large intramural fibroids is almost identical to the pain that is caused by a herniated disk in the lower part of the spine. Fibroids can compress the sciatic nerve and present symptoms mimicking that of a herniated disk, making it one of the most overlooked and misdiagnosed fibroid symptoms.

How Do I Know If My Pain Is Caused By Uterine Fibroids?

The pain associated with uterine fibroids may be sharp or dull. Symptoms will vary for each woman depending on the type of fibroids and where they are growing.

If you have a combination of these symptoms, you may be experiencing uterine fibroids and you should consult your OB/GYN to determine the cause.

• Heavy, painful, and prolonged periods;
• Dull ache in the abdominal cavity;
• Chronic pelvic pressure and pain;
• Lower back pain;
• Pain radiating down your legs;
• Abdominal swelling or bloating;
• Pain during sexual intercourse.

Unless fibroids are felt on physical exam, they can be overlooked. This is because ultrasound imaging is not routinely used and instead is used to corroborate the presence of fibroids on a physical exam.

The gold standard in pelvic imaging is Magnetic Resonance Imaging or MRI. It is the most accurate diagnostic test because it can reveal the size, location, and a number of fibroids. It is not used routinely as it is not as readily available as ultrasound and in the past was a lot more expensive. The price of an MRI in an independent imaging center (i.e. not owned by a hospital) is very comparable to a pelvic ultrasound and should be utilized more frequently in the workup of pelvic pain and/or heavy menstrual bleeding.

Video: What You Should Know About Fibroid Pain

How To Relieve Pain Caused By Uterine Fibroids?

The best, most effective way to relieve pain from uterine fibroids is to eliminate the fibroids. However, there are many treatments that you can try to temporarily alleviate the discomfort from fibroid symptoms.

• Over-the-counter non-steroidal anti-inflammatory pain relievers such as ibuprofen, especially during your cycle;
• Heating pads or warm compresses;
• Massage;
• Yoga/Stretching;
• Gentle exercise/walking;
• Bathing in Epsom salts to help alleviate lower back and leg pain.

How Are Fibroids Treated?

Fibroids and fibroid pain can be treated in many different ways and your options will depend on the type of fibroids, their size, and their location. There are non-surgical and surgical ways to treat fibroids, hormone therapies, and holistic approaches.

Hormone therapies include birth control pills, IUDs, and other options that we previously described in detail [link to hormone therapies post] is often the first-line therapy that is done.

With hormone therapies, the results are often temporary, and many patients will need to address the fibroids directly with Uterine Fibroid Embolization (UFE) or surgery.

Natural Remedies For Fibroids

There are no known natural cures for fibroids but studies have highlighted some things we know to be true. Fibroids grow when increased estrogen levels are present. Anything you can do to lower estrogen dominance in your body, such as making lifestyle and diet changes, may help keep fibroids from thriving and help minimize fibroid pain.

Request your Fibroid Diet eGuide and Exercises With Fibroids eGuide.

Surgical Options For Treating Fibroids

Myomectomy – fibroids are removed from the uterus through an abdominal incision (open myomectomy), or via laparoscopy through small abdominal incisions. Laparoscopic fibroid removal can also be performed robotically.

Hysterectomy – the entire uterus is removed and potentially the cervix, one or more ovaries, and possibly the fallopian tubes. For fibroids, this is most commonly done with an open abdominal incision, hip to hip, like a Cesarean section. It can also be done laparoscopically/robotically and very rarely vaginally due to the size of the fibroids.

Endometrial ablation – the outermost layer of the uterine lining is removed. This does not remove fibroids, but it is often used inappropriately to stop heavy bleeding due to fibroids. While this may address the bleeding, it does nothing to the fibroids which are often also causing bulk-related symptoms, e.g. pelvic pain, pressure, increased urinary frequency, nocturia, etc.

Nonsurgical Fibroid Treatment Options

Uterine Fibroid Embolization (UFE) – a nonsurgical, minimally invasive outpatient procedure that is 90% effective in relieving fibroid symptoms. When performed by an experienced Interventional Radiologist like Dr. John Lipman, it’s a 30-minute procedure that stops the blood flow to the fibroids and causes them to shrink and/or die off. Most patients can go home just a few hours after the procedure with a typical recovery time of 5-7 days.

Dr. John Lipman has over 20 years of experience in treating uterine fibroids. He is one of the top UFE experts in the country and has performed over 9,000 UFE procedures. To learn more about UFE and to find out if you are a candidate, contact Atlanta Fibroid Center® for a consultation. To make an appointment with Dr. John Lipman or his associate Dr. Mitchell Ermentrout, please call (770) 953-2600 or request an appointment online at ATLii.com.