Pelvic Pain? Why Your Uterus Has Fibroids and Medically Approved Next Steps

Pelvic pain can be frustrating, confusing, and sometimes frightening. One common cause is uterine fibroids—noncancerous growths that develop in or on the uterus. While the word "tumor" can sound alarming, uterine fibroids are almost always benign (not cancer). In fact, they are one of the most common conditions affecting women of reproductive age.

If you are experiencing pelvic pressure, heavy periods, or unexplained lower abdominal discomfort, understanding uterine fibroids—and what to do next—can help you make informed, confident decisions about your health.

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What Are Uterine Fibroids?

Uterine fibroids (also called leiomyomas or myomas) are growths made of muscle and connective tissue that form in the wall of the uterus. They can vary greatly in:

• Size: From as small as a seed to as large as a grapefruit
• Number: A single fibroid or multiple growths
• Location: Inside the uterine wall, on the outer surface, or inside the uterine cavity

Fibroids are extremely common. Studies suggest that up to 70–80% of women will develop uterine fibroids by age 50, though not all will have symptoms.

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Why Do Uterine Fibroids Develop?

The exact cause of uterine fibroids is not fully understood, but medical research has identified several contributing factors:

1. Hormones (Estrogen and Progesterone)

Fibroids are hormone-sensitive. Estrogen and progesterone—hormones that regulate your menstrual cycle—stimulate fibroid growth. This is why:

• Fibroids are more common during reproductive years
• They often grow during pregnancy
• They tend to shrink after menopause

2. Genetics

If your mother or sister had uterine fibroids, your risk increases. Certain gene changes within uterine muscle cells may also play a role.

3. Growth Factors

Substances in the body that help tissues grow and repair may contribute to fibroid formation.

4. Other Risk Factors

Research shows higher risk among:

• Women over age 30
• Women who started menstruating at an early age
• Those with obesity
• Women with high blood pressure
• Black women (who are more likely to develop fibroids at younger ages and with more severe symptoms)

Importantly, nothing you did "caused" fibroids. They are not the result of stress, exercise habits, or sexual activity.

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Common Symptoms of Uterine Fibroids

Some women have no symptoms at all. Others experience symptoms that affect daily life.

The Most Common Symptoms Include:

• Heavy menstrual bleeding
• Periods lasting longer than 7 days
• Pelvic pain or pressure
• Lower back pain
• Frequent urination
• Difficulty emptying the bladder
• Constipation
• Pain during sex
• Abdominal bloating or enlargement

In severe cases, heavy bleeding can lead to iron-deficiency anemia, causing fatigue, weakness, or shortness of breath.

If you're experiencing any of these symptoms and want to understand what might be causing them, Ubie's free AI-powered symptom checker can help you evaluate whether Uterine Fibroids could be the underlying issue before your doctor's visit.

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When Pelvic Pain Is a Red Flag

While uterine fibroids are typically benign, certain symptoms require urgent medical attention:

• Sudden, severe pelvic pain
• Extremely heavy bleeding (soaking a pad or tampon every hour for several hours)
• Signs of anemia (dizziness, fainting, chest pain)
• Rapid abdominal swelling

These symptoms could signal complications and should prompt immediate medical evaluation.

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How Uterine Fibroids Are Diagnosed

If your doctor suspects uterine fibroids, they may recommend:

1. Pelvic Exam

Your doctor may feel an enlarged or irregularly shaped uterus.

2. Ultrasound

This is the most common imaging test. It uses sound waves to create pictures of the uterus.

3. MRI (Magnetic Resonance Imaging)

Used in some cases to better map fibroids and guide treatment decisions.

4. Blood Tests

If you have heavy bleeding, your doctor may check for anemia.

Diagnosis is usually straightforward and does not require invasive procedures in most cases.

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Medically Approved Treatment Options

Treatment depends on:

• Your symptoms
• The size and location of fibroids
• Your age
• Whether you want to become pregnant
• Your overall health

Not everyone needs treatment. If fibroids are small and not causing symptoms, monitoring may be enough.

1. Watchful Waiting

If symptoms are mild:

• Regular pelvic exams
• Periodic ultrasounds
• Monitoring bleeding patterns

Many fibroids grow slowly—or not at all.

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2. Medications

Medications can help manage symptoms but do not permanently remove fibroids.

Options include:

• Hormonal birth control (pills, patch, ring): Can reduce heavy bleeding
• Hormonal IUD: May significantly reduce menstrual bleeding
• GnRH agonists or antagonists: Temporarily shrink fibroids by lowering estrogen levels
• Tranexamic acid: Reduces heavy menstrual bleeding
• Iron supplements: Treat anemia

These treatments can be effective, but fibroids often return to their original size once medication stops.

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3. Minimally Invasive Procedures

If medication is not enough, less invasive procedures may help.

Uterine Artery Embolization (UAE):

• Blocks blood flow to fibroids
• Causes them to shrink
• No large incision required

MRI-Guided Focused Ultrasound:

• Uses high-energy ultrasound waves
• Destroys fibroid tissue

These options can preserve the uterus, but they may not be suitable for everyone, especially those planning pregnancy.

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4. Surgical Options

For more severe symptoms:

Myomectomy

• Surgical removal of fibroids
• Preserves the uterus
• May improve fertility

Fibroids can return after myomectomy.

Hysterectomy

• Removal of the uterus
• Permanent solution
• Ends menstrual periods
• Eliminates the possibility of pregnancy

This is typically reserved for severe cases or when other treatments fail.

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Can Uterine Fibroids Affect Fertility?

Sometimes. Many women with uterine fibroids conceive and carry healthy pregnancies. However, depending on size and location, fibroids may:

• Interfere with implantation
• Increase miscarriage risk
• Cause pregnancy complications

If you are trying to conceive and suspect fibroids, speak directly with a gynecologist about appropriate evaluation and treatment.

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Lifestyle Considerations

While lifestyle changes cannot eliminate uterine fibroids, they may help support overall health:

• Maintain a healthy weight
• Eat a balanced diet rich in fruits and vegetables
• Manage blood pressure
• Stay physically active

These steps support hormonal balance and cardiovascular health, both of which may play a role in fibroid growth.

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What You Should Do Next

If you are experiencing pelvic pain or heavy bleeding:

1. Track your symptoms (cycle length, bleeding intensity, pain level).
2. Use a free AI-powered symptom checker to evaluate your symptoms for Uterine Fibroids.
3. Schedule an appointment with a healthcare provider.

Be prepared to discuss:

• How long symptoms have been occurring
• Whether they are worsening
• Any impact on work, sleep, or daily life

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The Bottom Line

Uterine fibroids are common, often manageable, and usually not dangerous. However, they can significantly affect quality of life if symptoms are ignored.

Pelvic pain and heavy bleeding are not things you simply have to "live with." Effective medical treatments exist—from medication to minimally invasive procedures to surgery. The right choice depends on your symptoms, goals, and overall health.

If you experience severe pain, heavy bleeding, fainting, chest pain, or signs of anemia, seek medical care immediately. These could indicate a serious or potentially life-threatening issue.

For any ongoing pelvic pain, abnormal bleeding, or concerns about uterine fibroids, speak to a doctor. A proper evaluation is the safest and most reliable way to protect your health and peace of mind.