How uterine fibroids can affect sex and intimacy

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How uterine fibroids can affect sex and intimacy

Any woman past the age of 50 reading this has most likely has had uterine fibroids and didn’t know it.  Up to 60-80% of women have uterine fibroids making it one of the most common gynecological conditions affecting a woman. 

Uterine fibroids are almost always benign, muscular tumors that grow in the wall of the uterus.  The medical term for them is leiomyoma or just “myoma.”  They can range in size from as small as an apple seed to as large as a watermelon and can either grow as a single tumor or there can be many distributed within the uterus.  They are most common in women in their 40s and early 50s.

Risk factors for uterine fibroids

There are certain factors that can increase a woman’s chance of developing uterine fibroids:

·      Age – As a woman ages, they become more common. After menopause, fibroids usually shrink.

·      Family history – If a woman’s mother had fibroids, the risk for developing them is three times higher.

·      Ethnic background – African-American women have a higher risk than white women.

·      Obesity – Women who are overweight are at a higher risk. Obese women have a two to three times greater risk.

·      Food choices – Too much red meat and ham is linked with increasing fibroids.  Consuming more vegetables appears to protect against their development.

Symptoms of uterine fibroids

The majority of women do not have any symptoms but some women will which may include the following:

·      Heavy bleeding – heavy enough to cause anemia or painful periods

·      A feeling of fullness in the pelvic or lower stomach area

·      Enlargement of the lower abdomen

·      Frequent urination

·      Pain during sex

·      Lower back pain

·      Complication during pregnancy and labor – women with uterine fibroids have a six times greater risk of cesarean section

·      Reproductive problems such as infertility

Fibroids and sex

One of the possible unfortunate side effects of fibroids is how it can disrupt sex.  Any woman who is not aware she even has fibroids and yet is experiencing uncomfortable symptoms such as discomfort during intercourse, pelvic pain, or increased menstrual bleeding, could actually have uterine fibroids interfering with her sex life. 

Large fibroids can produce pressure in the uterus leading to painful sex. When benign fibroids develop and grow at the end of the vaginal tract near the area of the cervix, they can make penetration in sex more uncomfortable for women.  If the fibroid starts to bleed, this disrupts intimacy leading a woman to not want to engage in sexual activities. 

For any woman who finds sex to be painful and is avoiding intimacy because of it, needs see her doctor.  Pain during intercourse can be due to a variety of issues which is why it is important for a woman to discuss this with her doctor. 

If a woman has no symptoms, how does she know for sure if she has uterine fibroids?

The main way would be if a woman’s gynecologist discovers them when a woman has a pelvic exam. The doctor can feel the fibroid with their fingers during the pelvic exam as a lump or mass on the uterus. 

To confirm if a woman has fibroids, there are imaging tests that can be used to diagnosis them.  These tests might include an ultrasound, magnetic resonance imaging, x-rays, or a cat scan.

Treatment of uterine fibroids

If a woman is having no symptoms, there is no need necessarily to treat them.  For women who are symptomatic, they should discuss with their doctor the best way to treat the fibroids.

·      Medications - If the fibroids are only causing mild symptoms, then a doctor may suggest over-the-counter medications of ibuprofen or acetaminophen for any mild pain.  Women experiencing heavy bleeding during her menstrual cycle may benefit from taking an iron supplement to prevent becoming anemic. 

Birth control pills can be another type of medicine to help control symptoms of fibroids.  Low-dose birth control pills do not make fibroids grow and they can also help with heavy menstrual bleeding. 

There are also drugs called gonadotropin releasing hormone agonists that can shrink fibroids.  The medication is given by injection, nasal spray, or implanted and they can cause side effects – hot flashes, depression, insomnia, reduced sex drive, and joint pain.  However, most women tolerate this medication well.  During the time a woman is using this drug they will not have a period which can allow women with anemia to recover to a normal blood count.  Other downsides of this drug is they can cause thinning bones, they are expensive and once a woman stops taking them, the fibroids can grow back rapidly.

·      Surgery - For women who have moderate to severe symptoms, surgery is another option for treatment.  Surgery could include a myomectomy, a hysterectomy, endometrial ablation, myolysis, or uterine fibroid embolization.