Living With Uterine Fibroids

Uterine fibroids can be difficult to live with. These benign (noncancerous) growths in your uterus can cause frustrating symptoms like heavy bleeding, pain, pressure and fatigue. And then there’s the fact that dealing with these life-altering symptoms day after day can significantly impact your mental health.

Minimally invasive gynecologic surgeon Megan Billow, DO, shares her advice on how to live with fibroids and when you should see a healthcare provider.

Do fibroids always need treatment?

If your provider found uterine fibroids during a pelvic exam or imaging test, you might be wondering what’s next. Do fibroids require medication or surgery? Can eating certain foods reduce your uterine fibroid symptoms? And if you don’t treat them, will they cause other health problems?

“Fibroids are typically not life-threatening, and many people have mild symptoms or no symptoms at all. But they can significantly impact your quality of life if your symptoms are severe,” Dr. Billow says. “It’s always best to speak to your healthcare provider about your symptoms to determine the best treatment plan.”

She outlines a few strategies that can help you cope with fibroids.

Handling heavy periods

One of the hallmarks of uterine fibroids is heavy menstrual bleeding. If standard tampons and pads aren’t cutting it for your heavy periods, consider turning to a reusable period product instead.

“Some people with fibroids find that using a menstrual cup or period underwear — or both — helps prevent leaks,” says Dr. Billow. “These products can sometimes absorb or collect more blood than disposable products, which allows you to go longer between changes.”

But heavy bleeding isn’t just an inconvenience. High blood loss each month can also deplete your body’s iron stores over time.

“Low iron can lead to iron-deficiency anemia, which affects the oxygen supply to your organs,” Dr. Billow says. “Anemia can make you feel weak, tired and out of breath. In severe cases, it can even be life-threatening.”

If you have heavy periods, get regular blood tests to be sure your iron levels are within healthy limits. “If your iron levels are low, your provider may recommend an iron supplement,” she continues, “and if your levels are very low, you could need iron infusions.”

Relieving pelvic pain and pressure

Uterine fibroids can hurt — badly. You might feel pressure in your lower abdomen, low back pain or severe abdominal cramps. Some people also experience pain during intercourse, which can impact mental health and relationships. And dealing with frequent pain can be exhausting, depleting your energy levels.

For mild or occasional fibroid pain, you might get some relief from:

• Applying a heating pad or a hot water bottle on your abdomen or lower back.
• Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen.
• Trying acupuncture or meditation, although there isn’t solid proof that they work for fibroid pain management.

Just be sure to use over-the-counter pain relievers with caution, as taking ibuprofen too often can be harmful.

“If you rely on pain medications for everyday use, ask your provider about your other options for managing fibroid pain,” advises Dr. Billow. “Prescription medications that control hormone levels can make your periods lighter and also help with cramping and pain.”

Managing your mental health

If you feel like your mental health is negatively affected by dealing with uterine fibroids, you’re not alone. A large research study found higher rates of depression, anxiety and self-harm among people who were diagnosed with fibroids.

“Pain, heavy bleeding or painful intercourse can all have an effect on your quality of life, so uterine fibroids may trigger or worsen mental health conditions,” Dr. Billow states. “If you are not able to participate or enjoy your daily activities, your mental health may be impacted.”

But don’t just dismiss mental health problems or assume that your only option is to live with them. “Depression and anxiety can interfere with your personal, social and professional life,” she stresses. “And if you feel the urge to hurt yourself, it’s important that you reach out for immediate medical care.”

If your mental health symptoms are mild, though, some of these strategies may help you cope:

1. Cut back on caffeine: Avoid or limit your intake of coffee, tea, energy drinks and other forms of caffeine, which can make anxiety symptoms worse.
2. Get help from your diet: Eat foods that may help reduce stress and anxiety, like those that are high in omega-3 fats and B vitamins.
3. Get regular exercise: Even walking can help reduce stress and fight mild or moderate depression.
4. Make sleep a priority: Lack of sleep can affect your mood and mental health, so aim to get seven hours or more each night.
5. Practice de-stressing: Try yoga, meditation or deep breathing exercises when you feel stressed or anxious.

When to seek care for fibroids

Keep a close eye on your health and your menstrual cycle. Even if you feel fine, talk to your provider if you experience:

• Bleeding between periods or any bleeding after menopause.
• Digestive problems, like constipation or diarrhea.
• Pain during urination or a frequent urge to urinate.
• Passing large blood clots.
• Signs of anemia, like shortness of breath, dizziness and weakness.

With many treatment options available, there’s no reason to live with fibroids that harm your quality of life. If you consistently miss work or don’t attend social events because of fibroids, those are red flags to seek medical treatment.

“There are many treatment options available, and you do not need to suffer,” Dr. Billow says. “Treatment options range from medications to procedures and minimally invasive surgeries like myomectomy and hysterectomy.”

To treat or not to treat?

Deciding whether to live with uterine fibroids or pursue treatment is a personal choice. Start by talking with a healthcare provider so together, you can decide which treatment — if any — is right for you. And you can always change your mind later if you decide you want to try treatment, or stop or switch treatments. But always work with your provider when making any changes to medications you’re taking.

Regardless of the path you take, continue to see your provider for checkups and to discuss your overall health.

“Fibroid symptoms can mimic other conditions that need treatment,” Dr. Billow explains. “Tell your provider about pain, heavy bleeding and other symptoms so that they can determine what’s causing the symptoms and help you explore all your options.”