Uterine fibroids are non-cancerous growths that develop within the uterus. These growths are common, affecting up to 80% of women by age 50, though many do not experience symptoms. A common concern for individuals with fibroids is unexpected bleeding during or after sexual intercourse, and fibroids can cause this.
Why Fibroids Can Cause Bleeding During Intercourse
Fibroids can lead to bleeding during or after intercourse due to several factors. One reason relates to fibroid location; those near the uterine lining (submucosal) or on the cervix (cervical) are particularly susceptible. When irritated or subjected to pressure during intercourse, delicate blood vessels within or around them can rupture, causing bleeding.
Fibroids can also make the uterine lining more fragile and irregular. This makes it vulnerable to bleeding upon contact or pressure, even from minor friction. Larger fibroids require a significant blood supply. Disruption to this blood flow or direct stimulation during intercourse can lead to bleeding as tissues become more sensitive and prone to damage.
Other Common Fibroid Symptoms
Beyond bleeding during intercourse, fibroids can cause other symptoms, varying by size, number, and location. Many women experience heavy menstrual bleeding (menorrhagia), often with prolonged periods lasting seven days or more. This blood loss can lead to anemia, causing fatigue and weakness.
Fibroids can also cause pelvic pain or pressure in the lower abdomen due to their size. Depending on their location, fibroids may press on surrounding organs, causing frequent urination (bladder pressure) or constipation (rectum impact). Some individuals also report lower back or leg pain, which can occur when larger fibroids compress nerves and blood vessels.
When to Seek Medical Advice and Diagnosis
If you experience bleeding during or after intercourse, or any other concerning fibroid symptoms, consult a healthcare provider. While fibroids are typically benign, similar symptoms can indicate other conditions requiring medical attention. Diagnosis is important to rule out more serious issues and determine the cause of your symptoms.
Diagnosis usually begins with a pelvic exam, where a provider may feel for an enlarged or irregularly shaped uterus. This is often followed by imaging tests like ultrasound, which uses sound waves to create images of the uterus and ovaries, confirming fibroid presence, size, and location. An MRI scan may offer a more detailed view, or a hysteroscopy can examine the inside of the uterus with a small camera.
Management and Treatment Options
Addressing fibroids, especially those causing symptoms like bleeding during intercourse, involves various tailored approaches. For mild cases, “watchful waiting” may be recommended, monitoring symptoms without immediate intervention. For symptomatic fibroids, medical treatments can manage symptoms.
Medical Treatments
Hormonal therapies, such as birth control pills, can control heavy bleeding by reducing the uterine lining.
Gonadotropin-releasing hormone (GnRH) agonists can temporarily shrink fibroids and stop menstrual flow by creating a low-estrogen state.
Non-Surgical Procedures
Uterine Fibroid Embolization (UFE) involves blocking the blood supply to fibroids, causing them to shrink.
Focused ultrasound surgery uses high-frequency sound waves to destroy fibroid tissue without incisions.
Surgical Interventions
Myomectomy removes only the fibroids while preserving the uterus.
Hysterectomy, the complete removal of the uterus, is typically reserved for severe cases or when childbearing is no longer desired.