Sex and fibroids: everything you need to know

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While heavy menstrual bleeding is the symptom most mentioned when discussing uterine fibroids, the list of symptoms unfortunately doesn’t end there. Far from it, in fact. Included on that list is pain during sexual intercourse. In fact, one study found that 23.5% of women with fibroids report pain during sex, as opposed to 9.1% in the general adult female population.  

Why can sex be painful with fibroids? 

The human body wasn’t designed to comfortably accommodate anything that doesn’t belong in it, at least on a long-term basis. Fibroids vary in both size and location. Those located near the cervix are more likely to be affected by impact and pressure during intercourse, with larger fibroids sometimes creating a constant pressure that only increases during intercourse.  

In addition to the physical presence of fibroids causing problems, hormonal changes that come together with fibroids can cause a loss of libido and potential vaginal dryness as well. Affected women can have excessive amounts of estrogen, causing issues in these areas.  

That best-known symptom — heavy bleeding with abnormal, sometimes exceedingly long periods – can also sap a woman’s strength due to developing anemia from blood loss, and exhaustion is rarely conducive to an active sex life.    

Talk with your partner 

First and foremost, discuss this issue with your partner. Be open and honest. Inform your partner. It’s even recommended to share that it hurts. Your partner cares about you! There are solutions, so working out options as a couple can provide for a united team toward better quality of life.  

The smaller issues 

If exhaustion due to low iron levels is part of the problem, taking iron supplements religiously can be part of the solution. If vaginal dryness is an issue, find a good lubricant. Body image and confidence can be boosted through strategic lighting and lingerie. Changing sexual positions could also help alleviate a measure of pain, so it is likely worthwhile to have a few brainstorming sessions as a couple to see if this may be at least part of the solution.  

Alternative intimacy 

Pre-teen giggles aside, sex IS part of a normal adult life and most of us would prefer an immediate solution to symptoms keeping us from this part of a relationship. However, sometimes alternative forms of intimacy are necessary.

Rediscover romance. Candlelit meals set in nature, a visit-for-two to a spa, rowboat on a calm lake, dancing, stroll on the beach, go back and re-live your first date… Find different ways [link to older post on similar topic] to recognize your special relationship. Likely, this will even enhance the relationship once sex can be reintroduced. 

Sex without penetration. Touch is an amazing thing. With a successful discussion behind you and intercourse temporarily off the table, touch that may otherwise lead to intercourse becomes non-threatening. Enjoy that touch and explore each other. Having nothing to do with fibroids at all, sensate focus has been found to be an effective tool to draw couples closer together.  

Medical solutions 

Hysterectomy, myomectomy, embolization, medication (GnRH agonists and antagonists, Tranexamic acid, IUD, oral contraceptives, NSAIDs) and watchfully ignoring the issue under medical supervision are all generally legitimate treatment (or non-treatment) options. Do your own consultations and research to check the advantages and disadvantages of each option vis-à-vis your own priorities, preferences and life situation. Then, map out a plan together with your doctor for better steps moving forward.  

We’re thrilled to see the recent international rise in fibroid awareness and with it the increase in research, knowledge and treatment options toward a better life for women everywhere.