Uterine Fibroids: Causes of Pain and Treatment Options

Uterine fibroids

Hello, doctor.
My question is that this year I was diagnosed with uterine fibroids.
Besides causing menstrual cramps, can fibroids cause pain at other times? I often feel pain in my lower abdomen, and I also experience pain in the upper left abdomen, mostly concentrated on the left side, along with pain in my lower back.
The doctor prescribed me Pain Relief 250 mg and Buscopan 10 mg for four days, but even after taking the medication, I still feel very uncomfortable and in pain.
Last year, I had a colonoscopy due to upper abdominal pain, and my condition has worsened since then.
It seems like there was inflammation in my lower abdomen that went unnoticed until it became severe enough to cause bleeding, which led to a urine test that confirmed the inflammation.
After my menstrual period, the pain continues.
I wonder if there is inflammation again, as most of the pain is in my lower abdomen, with some in the upper left abdomen and lower back.
I don't know what to do now because I've been suffering for a long time.
I'm not sure if it's inflammation in my lower abdomen, the fibroids, or an issue with my back that's causing the problem.
I'm in pain every day.
Should I consider switching hospitals? I've been to the same clinic multiple times, and it feels like I've gone in circles with similar consultations.

Zhenzi, 20~29 year old female. Ask Date: 2010/07/06

Dr. Dong Yuhong reply Obstetrics and Gynecology

Hello; based on what you've described, I understand your concerns, but your issue will require collaboration with your attending physician for a period of treatment.
Although I am not familiar with your previous medical history and treatment, your problem has been present for some time.
It would be advisable to seek consultation and treatment at a higher-level hospital.
Bringing your past medical records would be beneficial.
Thank you.

Reply Date: 2010/07/06

More Info

Uterine fibroids, also known as leiomyomas, are non-cancerous growths that develop in the uterus. They can cause a variety of symptoms, including pain, particularly during menstruation, but they can also lead to discomfort at other times. The pain you are experiencing in your lower abdomen, upper left abdomen, and lower back may indeed be related to the presence of fibroids, but it could also be due to other underlying conditions.

Fibroids can cause pain through several mechanisms. They may exert pressure on surrounding organs, leading to discomfort in the abdomen and back. Additionally, if a fibroid degenerates or undergoes changes, it can lead to acute pain. In some cases, fibroids can also cause heavy menstrual bleeding, which may lead to anemia and further exacerbate feelings of fatigue and discomfort.

Your description of persistent pain, particularly after your menstrual period, raises concerns about potential complications. For instance, if there is inflammation in the pelvic region, it could be due to conditions such as pelvic inflammatory disease (PID) or endometriosis, which can coexist with fibroids. Given your history of abdominal pain and the previous colonoscopy, it is essential to rule out any gastrointestinal issues that might be contributing to your symptoms.

The medications prescribed to you, such as Buscopan (an antispasmodic) and pain relief medications like pain relievers, are typically aimed at alleviating symptoms. However, if you find that these medications are not providing sufficient relief, it may indicate that the underlying issue requires further investigation or a different treatment approach.

It is crucial to communicate your ongoing symptoms to your healthcare provider. If you feel that your concerns are not being adequately addressed, seeking a second opinion from another healthcare professional or a specialist in gynecology may be beneficial. A thorough evaluation, including imaging studies like an ultrasound or MRI, can help assess the size and location of the fibroids and determine if they are contributing to your pain.

In terms of treatment options, if fibroids are confirmed to be the source of your discomfort, several approaches can be considered. These may include:
1. Medications: Hormonal treatments can help manage symptoms by regulating menstrual cycles and reducing bleeding. Non-steroidal anti-inflammatory drugs (NSAIDs) can also help alleviate pain.

2. Minimally Invasive Procedures: Options such as uterine artery embolization (UAE) can reduce the size of fibroids and alleviate symptoms without the need for major surgery.

3. Surgical Options: In cases where fibroids cause significant pain or other complications, surgical removal (myomectomy) or hysterectomy (removal of the uterus) may be recommended.

4. Lifestyle Modifications: Maintaining a healthy diet, regular exercise, and stress management techniques can also contribute to overall well-being and may help manage symptoms.

In conclusion, while uterine fibroids can cause pain and discomfort, it is essential to consider other potential causes of your symptoms. Persistent pain warrants further evaluation, and if you feel that your current healthcare provider is not addressing your concerns adequately, do not hesitate to seek a second opinion. Your health and comfort are paramount, and there are various treatment options available to help manage your symptoms effectively.

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