Fibroids are non-cancerous growths in or around the uterus; they’re fairly common and can affect fertility. However, that doesn’t mean you cannot get pregnant if you have them; many women with fibroids successfully conceive with the right support. Read on to learn actionable tips and insights for navigating pregnancy with fibroids.
What are Uterine Fibroids?
Uterine fibroids are small growths made up of muscle and fibrous tissue; they can vary in size–from as small as a seed to as large as a melon. Though they are fairly common, affecting approximately 35-77% of reproductive-age women, everyone’s experience is different.
Some women do not experience any symptoms of fibroids, but many women do. Fibroids can affect a woman's quality of life, as well as her fertility outcomes. We may never know the true prevalence of fibroids as some women are asymptomatic and unaware they even have them.
Types of Fibroids
Fibroids can vary in number and size. You can have a single fibroid or many. Some fibroids are too small to see with the naked eye, while others can grow to the size of a grapefruit or larger. There are also several different types of fibroids, characterized by where they grow in and around the uterus:
-
Intramural Fibroids: Grow within the uterine wall; the most common type
-
Subserosal Fibroids: Grow on the outer wall of the uterus; very common
-
Pedunculated Fibroids: Grow on a stalk that attaches to the uterus; moderately common
-
Cervical Fibroids: Form on the cervix; uncommon
-
Submucosal Fibroids Grow inside the muscle layer of the uterus; the least common type
Fibroid Symptoms
Some women experience no symptoms at all, but many experience one or more of the following common symptoms:
- Heavy menstrual bleeding
- Menstrual clots
- Period that lasts longer than normal
- Pain in the pelvic or lower back region
- Pressure or heaviness in the lower abdomen.
- Abdomen swelling or expansion
- Increase in urination
- Discomfort during intercourse
In addition, fibroids can cause other symptoms you may not feel, such as disrupted uterine shape and implantation issues. These are the issues that may lead to fertility issues.
Causes of Fibroids
- The exact cause of uterine fibroids isn't fully understood. However, the following factors may play a role:
- Age: those between the ages of 30 and 50 are more likely to have fibroids.
- Weight: being overweight or obese may increase the risk of fibroids.
- Race: fibroids are three and two times more common in African American and Hispanic women, respectively.
- Genetics: many fibroids contain changes in genes that differ from those in typical uterine muscle cells.
- Hormone changes: estrogen and progesterone cause the tissue that lines the inside of the uterus to thicken during each menstrual cycle to prepare for pregnancy. These same hormones also seem to contribute to fibroid growth.
Diagnosis of Fibroids
An accurate diagnosis is critical for a proper treatment plan, even if you are not looking to get pregnant. There are various tools available to diagnose fibroids. A healthcare practitioner can determine which of the following are appropriate for you:
-
Pelvic exam: a physical examination during which a healthcare practitioner feels for the presence of fibroids. They can feel whether they exist, but not the type or size.
-
Transvaginal ultrasound: an imaging test that can confirm the presence of fibroids. It can approximate their size and location.
-
Magnetic resonance imaging (MRI): A noninvasive imaging technique that uses radio waves and a magnet to generate detailed photos of the inside of your body. This method can provide a more detailed picture of the fibroids, which can be necessary if they are small or located in a complex area.
-
Hysteroscopy: allows a healthcare practitioner to examine and view the inside of the uterus and get a detailed look at fibroids by passing a thin, lighted scope through the vagina and cervix.
Fibroids and Pregnancy
If you’re worried about how uterine fibroids may impact your ability to get pregnant, there’s a good chance you’ll be fine. Many women have successful pregnancies despite fibroids. However, some fibroids can cause infertility, pregnancy complications or loss. Submucosal fibroids are the most common type that causes complications.
- Fibroids also may increase the risk of certain pregnancy complications, including the following:
- Placental abruption: A condition where the placenta separates from the inner wall of the uterus so it cannot provide nutrients and oxygen to the baby.
- Fetal growth restriction: when a fetus doesn't grow as expected.
Preterm delivery: when a baby is born before the 37th week of pregnancy.
When Should You See a Doctor?
Seek the support of a healthcare practitioner if you are having severe symptoms, difficulty conceiving, or recurrent miscarriages.
Non-Surgical Approaches and Tips to Managing Fibroids
Not all fibroids require surgery; you may be able to manage smaller ones and any associated symptoms with lifestyle changes and medication.
Lifestyle Changes
Certain lifestyle changes can help manage the progression of and symptoms associated with uterine fibroids.
-
Diet and nutrition: A diet rich in whole foods, especially fruits, vegetables, and preformed Vitamin A, can support fertility and help manage fibroid growth. Research also highlights the role of a vitamin D deficiency, which is linked to the development of larger fibroids, while higher vitamin D levels are associated with smaller ones.
-
Excess sugar: On the flip side, excess added sugar and refined carbs may worsen fibroids, possibly due to their impact on blood sugar and insulin levels. Prioritizing nutrient-dense foods and maintaining balanced vitamin D levels can be key to
-
Exercise: Exercise is an effective tool to help manage weight and alleviate some of the symptoms associated with fibroids.
-
Weight management: Obesity increases the risk of developing fibroids. Achieving a healthy weight cannot shrink existing fibroids but may slow the progression of existing fibroids and help prevent the occurrence of new fibroids.
Which Fibroids Need Surgery if You’re Trying to Get Pregnant?
Fibroids of a certain size and location may impact fertility and your quality of life. You may need surgery to eradicate them. The surgical procedure to remove uterine fibroids is called a myomectomy, which removes the fibroids while leaving the uterus intact.
Specifically, submucous fibroids require surgery to support fertility. Intramural fibroids may also require surgery if they are larger than four centimeters in diameter, either alone or in combination (if there are two or more).
Fertility Treatments Without Fibroid Removal
Some women are candidates for fertility treatment options without fibroid removal, depending on the size, shape and location of the fibroids. This section explores the available fertility treatment options, how fibroids can affect success rates, and which types of fibroids may need to be removed before starting treatment.
In Vitro Fertilization (IVF)
Submucosal fibroids can distort the uterine cavity, and so it is generally accepted that they negatively impact IVF outcomes. Removal is beneficial to fertility outcomes. In fact, one study found that myomectomy appeared to return fertility outcomes to the baseline of infertile women without fibroids.
Research on the benefit of removal of non-cavity distorting fibroids, including intramural fibroids, is mixed. A healthcare practitioner should evaluate these fibroids. Recommended treatment may depend on size and location.
Intrauterine Insemination (IUI)
Intrauterine insemination (IUI) is a procedure that involves placing sperm directly into the uterus during ovulation. IUI is often a successful fertility treatment for women with fibroids that do not affect the uterine cavity. In fact, research has found no difference in conception and live birth rates after IUI in women with non-cavity distorting fibroids and those without fibroids.
Complementary and Alternative Therapies
Several complementary and alternative treatments for uterine fibroids exist. A study of 933 premenopausal women with symptomatic fibroids who participated in the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives (SOPHIA) for an average of 4.3 years found that these therapies were commonly used. The study found that 37% of participants used herbal remedies, and 16% of participants used acupuncture. Participants reported significant symptom improvement and few side effects with these interventions.
Acupuncture
Acupuncture is a popular holistic treatment across several cultures. It supports overall health and fertility. Although research on the clinical benefits of acupuncture for fertility has yielded mixed results, the practice has several studied health benefits that may support fertility.
While there is a lack of research available on acupuncture for uterine fibroids, some research has promising initial conclusions. Some women report relief from symptoms following acupuncture therapy.
Herbal Remedies
Herbal remedies may help treat fibroids or alleviate related symptoms. However, more research is needed to determine their efficacy and effective dosage. The following herbal remedies are commonly used to support uterine fibroids.
-
Vitex (Chasteberry): may support heavy menstrual bleeding, painful periods, and overall hormone balance. Research is limited on its efficacy for supporting uterine fibroids.
-
Green tea extract: The bioflavonoid EGCG, found in green tea, may help reduce the size and number of fibroids.
-
Chinese herbs: Herbal remedies are used in traditional Chinese medicine to slow fibroid growth and treat symptoms. It is important to work with a trained Chinese medicine practitioner to determine which herbs might be right for you.
It’s important to consult your healthcare practitioner before using any herbal or prescribed medication, especially if you are undergoing other therapies for fertility or fibroid management.
Mind-Body Techniques
We know that stress can affect hormones and ovulation, which may impact fertility. However, some research suggests that there may also be a link between stress and fibroids. Further research is needed, but mind-body practices like yoga, meditation, and mindfulness can help manage stress and are a relatively simple way to support your health and fertility.
The Bottom Line
Every woman’s journey with fibroids is unique, so finding a trusted healthcare provider to support you along the way is important. The good news is that there are many different options to explore for treatment, and many women with fibroids can have healthy pregnancies.
For more fertility support, check out Needed Women’s Fertility Supplements.
