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Uterine fibroids: Living with fibroids

Created: ; Last Update: November 16, 2017; Next update: 2020.

If fibroids cause symptoms, they can affect your quality of life. When deciding about treatment, being able to deal with the symptoms in everyday life is one important factor for many women.

Even though these benign (non-cancerous) growths aren’t always noticeable, if they cause severe symptoms they can really affect your everyday activities. A lot of women say their fibroids are painful and can put them out of action for days at a time.

The treatment for fibroids will depend on the woman’s symptoms, as well as on her personal situation and age: For some women the biggest problem is their heavy periods, cramps and exhaustion. Others are more worried that they might not be able to have children. Because the symptoms tend to get better during menopause and then generally disappear completely, women in their mid-40s and women in their early 20s will often consider different treatments.

But they all want to know how they can cope with the symptoms on their own. Many women find their own way to keep the impact on their everyday life to a minimum.

When is it a good idea to seek medical advice?

Sometimes women who have symptoms such as heavy periods, cramps and period pains think that they are just a normal part of life for women. Other people may think so too. It can be difficult to decide when these problems are no longer normal and justify going to see a doctor. Although menstrual periods are a part of every woman's life, severe menstrual problems aren’t normal. Women don’t have to simply put up with them – they can usually be treated effectively. So getting medical advice is a good idea, and often helpful.

Fibroids that don’t cause any symptoms are often discovered during routine gynecological check-ups. Many women go directly to their gynecologist to find out why they are in pain and because they are worried that they may have a serious illness. They often aren’t aware that fibroids aren’t malignant (cancerous). So it’s very important to know that fibroids aren’t cancerous and also can’t turn into cancer.

How do fibroid symptoms affect everyday activities and quality of life?

Severe period pains and other symptoms like urinary incontinence or exhaustion can affect your personal and working life, reducing your overall quality of life. Regularly not being able to go to work because of these problems often makes women feel guilty for letting their colleagues or boss down, or they might end up under pressure at work. They may often have to cancel arrangements with their partner, family or friends too.

Heavy periods can be very taxing, make you feel tired and affect your concentration and general performance. But it’s not only the physical effects of losing a lot of blood that can be a problem. Women may feel embarrassed or sometimes even frightened by heavy periods. Some have the unpleasant feeling that the blood is literally flowing out of them. They may then avoid leaving the house and cancel appointments.

Severe symptoms can make you feel down, irritable and grumpy. That can then have an effect on relationships, especially as the symptoms often reduce sexual desire. If your partner feels rejected or isn’t very understanding, it can easily lead to arguments. Sex can be painful for some women, so they may not want to have sex as often or perhaps try to avoid it completely. Being caring and talking openly is then important for both partners.

Women who have large or a particularly high number of fibroids might feel differently about their bodies, and many generally feel less attractive. Some feel as though they have something “alien” and uncontrollable inside them. Putting on weight for no apparent reason or looking pregnant can be particularly unpleasant.

What can you expect from treatment?

Treatment can sometimes make symptoms go away for good. But not every treatment has the desired result, some only help for a while, and they all have their disadvantages. Weighing the risks and benefits isn’t always easy, but there’s no need to rush into a decision: You can take your time to work out which symptoms are the worst for you, and then look into which treatment offers the best chances of relieving them.

Unsuccessful treatment can be disheartening, especially if it also causes unpleasant side effects. For some women it turns into a roller-coaster of emotions, between hope and disappointment. Others worry that the fibroids might come back after an operation, or that an operation will cause other problems. In addition to advice from doctors, the experiences and recommendations of friends and relatives often also play a role when trying to decide on a treatment. It can become tricky if those people are worried and – with the best of intentions – pressure you into choosing a particular treatment.

The choice of treatment will very much depend on whether you would like to have (more) children. Some of the treatment options aren’t suitable for women who want to become pregnant. Many have a contraceptive effect, reduce fertility or increase the risk of a miscarriage. Hysterectomy (surgical removal of the womb) isn’t an option if you still wish to have children.

Doctors sometimes simply assume that women who are over 40 no longer want children. And some doctors still hold the once widespread opinion that the womb is an unnecessary organ for women who don’t want to have children. But it can be an important part of a woman's body and how she feels about herself as a woman. Hysterectomies can also sometimes cause problems such as a weak bladder. But many women who have this operation feel relieved and very happy to no longer have their period and the fibroid symptoms.

Nowadays a lot of doctors deal with the issue sensitively and provide detailed information about the treatment options for women who want to have children, including the possible associated risks.

Finding your own way to cope

There are several other things you can do to better deal with the symptoms of fibroids in everyday life. Many women find it helpful to feel that they can manage their symptoms themselves. They try to find out how to keep the effects to a minimum in daily life. One option is to keep a close eye on your symptoms, for example by writing them down in a diary. If you can see when the different symptoms occur, it’s easier to develop a strategy to cope with them. That can be very helpful if you have heavy periods, for instance.

Women often also try out various self-help strategies, such as a healthier diet and more physical exercise. Others do yoga or try relaxation techniques. Home remedies such as applying heat to soothe cramps and pain are often used, as well as herbal products, acupuncture and other complementary therapies. However, there is little good-quality research on these approaches, so it’s difficult to say whether they help in the treatment of fibroids.

But that doesn’t mean it isn’t worth trying to find out for yourself what helps you. That may involve talking to other women with the same problems, for instance on the internet, with friends and family, or in self-help groups. This can also be helpful in preparing to talk to doctors, or in finding a doctor who takes your needs and wishes into account.

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© IQWiG (Institute for Quality and Efficiency in Health Care)
Bookshelf ID: NBK279534

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