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Fibroids: Pain
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Fibroids can cause discomfort because of pressure symptoms. Heavier periods can lead to worse period pains. Severe pain is quite rare but can occur if a fibroid grows on a stalk, which then twists (torsion) or if a fibroid outgrows its blood supply causing it to break down (red degeneration).
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Low Back Pain -- Fibroids that press against the muscles and nerves of the lower back can cause back pain. It is important to look for other causes of back pain before attributing the pain to the fibroids.
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Symptoms depend on the number of fibroids present, their size, and their location in the uterus. Many fibroids, even large ones, do not cause symptoms. However, large fibroids, particularly those that grow in the wall of the uterus, may cause pain, pressure, or a feeling of heaviness in the pelvic area during or between menstrual periods. Fibroids may press on the bladder, making a woman need to urinate more frequently or more urgently. They may press on the rectum, causing discomfort and constipation. Large fibroids may cause the abdomen to enlarge.
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Other drugs used to treat fibroids are called gonadotropin releasing hormone agonists (GnRHa). These drugs can decrease the size of the fibroids. Sometimes they are used before surgery, to shrink the fibroids, making them easier to remove. Side effects can include hot flushes, depression, not being able to sleep, decreased sex drive, and joint pain. Anti-hormonal agents, such as a drug called mifepristone... can stop or slow the growth of fibroids. These drugs only offer temporary relief from the symptoms of fibroids; once you stop the therapy, the fibroids often grow back.
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In rare cases, fibroids can cause sudden and severe pain if the fibroid begins to break down (degenerate) or twist. Pain of this type may be associated with a mild fever, tenderness in the abdomen, and elevation in the white blood cell count. The pain usually resolves in a few days to weeks. Nonsteroidal anti-inflammatory drugs, such as ibuprofen, can be used to treat the discomfort.
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Pain is not a common symptom of fibroids. Most of these tumors are asymptomatic except when they increase in size, the weight alone causes pelvic discomfort. Leiomyomata can produce acute pelvic pain if they outgrow their blood supply. This is called degeneration of a leiomyoma and the pain lasts for several days to a week or more. Degeneration of smooth muscle can be like a heart attack of the uterus. Monthly menstrual pain or cramps is not characteristic of myomas and should signal a search for coexisting adenomyosis.
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