During their lifetime, up to 80% of women will develop fibroids, however, about 25-50% will have symptoms that will affect their daily lives. At Pelvic Rehabilitation Medicine (PRM), we help women who experience pelvic pain and pelvic floor dysfunction as a result of fibroids to find the relief they need.
Uterine fibroids refer to the overgrowth of muscle cells within the uterine wall. Fibroids are benign tumors comprising the uterine muscle and connective tissue in the uterus, and may result in heavy, painful, or irregular periods and local pressure symptoms such as difficult defecation, frequent urination, and pain in the lower back. Uterine fibroid pain is pain associated with uterine fibroids, also known as leiomyomas or myomas.
While many women may go through their lives with uterine fibroids and not experience any pain or discomfort, some of them will suffer with a variety of symptoms. Uterine fibroids can cause pain from pressure on surrounding structures such as the bladder and nerves or from secondary pelvic floor muscle spasm and guarding, which can cause other problems.
Uterine fibroids, also known as leiomyomas, are noncancerous growths that develop in the uterus. These growths vary in size and quantity; some women may have one fibroid, while others may have multiple. While the exact cause of uterine fibroids remains unknown, data shows us that certain factors correlate with fibroid development and growth.
Although some women may suffer from fibroids and be asymptomatic, the location, size, and number of fibroids can all contribute to the severity and frequency of pelvic pain.
Hormonal stimulation, such as progesterone and estrogen
Studies show that women of African American descent are three times more likely to suffer from uterine fibroids in their lifetime than other ethnicities
Genetics: Fibroids tend to be hereditary, so if a mother or sister has fibroids, her daughter or sister will also be at an increased risk of having fibroids
While many women will have a uterine fibroid in their lifetime, there are certain risk factors which may cause their growth, and furthermore, the severity of symptoms experienced.
Women who have a family history of fibroids
Pre-menopausal women have a greater risk of having symptoms
Obesity
Alcohol use
High red-meat diet
Diagnosis of Chronic Prostatitis
African-american females tend to have a higher likelihood of having uterine fibroids and are often more symptomatic, with development at an earlier age and having larger-sized fibroids.
Diagnosing a uterine fibroid requires a medical history, exam and imaging.
Here’s what you can expect when you are a patient at Pelvic Rehabilitation Medicine:
Step One – First, our providers will ask questions about your medical history and listen to your symptoms to get a full picture of what is going on with you.
Step Two – Next, an external exam of your hips, abdomen, and posterior sacrum.
Step Three – Next, your pelvic nerves are evaluated externally with a soft cotton tip.
Step Four – Next, with your consent, gel is placed on a gloved finger and an internal exam is performed to allow us to evaluate the nerves and muscles within the pelvis. There is no speculum required as we are evaluating the pelvic floor muscles and nerves not the organs.
Step Five – Sometimes patients will need Imaging to help us understand if there is an associated cause of the pelvic nerve and muscle pain and dysfunction found on exam.
Step Six – Oftentimes, treatment can be started the same day as there is no down time. Our patients have been suffering with pelvic pain symptoms for 6+ months. We like to get them on the road to feeling better as soon as we can as the longer the symptoms are present the harder it is for us to resolve them.
Once a proper diagnosis has been given, we offer a proprietary office-based procedure to treat the secondary pelvic floor hypertonia and pelvic nerve irritation caused by fibroids. Reversing the pelvic floor spasm and pelvic nerve irritation will often help the many of the pelvic pain symptoms associated with fibroids. This treatment consists of a series of pelvic nerve and muscle treatments to directly target the spastic pelvic floor muscles, inflammation in the pelvis, and nerve pain. Depending on the severity of your uterine fibroid growth, other medical therapy or modalities may be needed in conjunction with our treatment.
One of the most common treatment options presented to patients for uterine fibroids is Uterine Fibroid Embolization (UFE) treatment or even hysterectomies and myectomies. However, in some cases due to the location or size of the fibroid, those treatment options are not an option. Pelvic Rehabilitation Medicine offers non-surgical treatment for fibroid pain no matter the size or location. The PRM protocol is also an option for fibroid patients who need symptom relief pre-operatively or who are approaching menopause and want to avoid an invasive procedure or surgery. As symptoms usually resolve at menopause on their own.
More FAQs needed; list below
In certain cases fibroids can shrink on their own, but this generally happens after menopause due to a decrease in hormone production. This can also occur after pregnancy secondary to a decrease in hormone stimulation.
There is little evidence regarding preventative measures of developing fibroids. However, maintaining a healthy lifestyle and using hormonal contraceptives may be associated with a lower risk of fibroids.
Fibroids can cause a disruption to quality of life, particularly if they are large enough to cause pelvic discomfort. Oftentimes, fibroids are the cause of heavy bleeding. This can cause anemia from excessive bleeding and if severe enough, women may require a blood transfusion. If fibroids become large enough and are in a certain location, they can sometimes press on the bladder, causing urinary urgency or frequency. In some cases, if the fibroid is located inside the uterine cavity, it can lead to difficulty in getting pregnant and/or recurrent miscarriages.
We recommend scheduling an appointment with one of our pelvic pain specialists if your desired daily function is affected and if you are experiencing pain.
You’ll meet with one of our pelvic pain specialists, who focus solely on pelvic pain. We’ll start with reviewing your full health history, including a discussion of your symptoms. This will help us to understand what you’ve been experiencing, so we can work to identify the source of your pain.
Next, we’ll conduct a full pelvic exam. Externally, we will look at your hips, abdomen, and posterior sacrum. Internally, we will evaluate the nerves and the muscles within the pelvic area. This full exam is necessary , as it will help our pelvic pain specialists understand the connection between your symptoms, and your nerve and muscle pain and dysfunction. There is no speculum, so the exam is gentle and more comfortable than that of, for example, gynecological exams you may have experienced in the past.
We will discuss our findings with you and come up with a comprehensive treatment plan TOGETHER. We want you to know that your pain is validated and that we are here to work with you on getting you back to the life you deserve.
