Uterine fibroids, non-cancerous growths in the uterus, can cause leg pain. Their size and location can influence whether leg pain occurs. Understanding how fibroids lead to leg pain and other associated signs can guide individuals in seeking appropriate care. This article explains the connection between fibroids and leg pain, details associated symptoms, advises on when to consult a healthcare provider, and outlines management strategies.
How Fibroids Lead to Leg Discomfort
Fibroids can cause leg pain through direct pressure and indirect effects on the body. Large fibroids, particularly those growing on the outside of the uterus (subserosal fibroids), can expand and press on nearby nerves. This pressure can affect the sciatic nerve, which runs from the lower back down each leg, resulting in pain that radiates down the legs.
Fibroids may also compress blood vessels in the pelvic region, such as the iliac veins, which can hinder blood flow to the legs. This reduced circulation can lead to swelling in the soft tissues of the legs, and cause muscle pain and cramps. Pain might also be referred, meaning pain originating in the pelvic area is perceived in the legs.
Indirect effects of fibroids, such as heavy menstrual bleeding, can also contribute to leg pain. Excessive blood loss can lead to anemia, a condition characterized by a shortage of red blood cells. Anemia can manifest as fatigue, weakness, and leg cramps due to reduced oxygen delivery to muscles.
Other Signs to Notice
Leg pain linked to fibroids often presents alongside other symptoms. One frequently reported sign is heavy or prolonged menstrual bleeding, lasting seven days or more. This excessive bleeding can be accompanied by severe cramping and may lead to anemia.
Many women with fibroids also experience a feeling of pressure or fullness in the pelvic area or lower abdomen. This can be particularly noticeable when lying down, bending, or exercising. Other symptoms include frequent urination or difficulty emptying the bladder, as fibroids may press on the bladder. If fibroids are located near the colon, they can obstruct normal bowel movements, leading to constipation. Pain during sexual intercourse may also occur, especially if fibroids are near the cervix.
When to Consult a Healthcare Provider
It is advisable to consult a healthcare provider if you experience persistent leg pain, especially with other symptoms suggestive of fibroids. Seek medical attention if leg pain worsens, or if you notice new symptoms like sudden, severe pelvic pain or significant swelling in your legs. These signs could indicate a fibroid outgrowing its blood supply, or a pedunculated fibroid twisting on its stalk, which can cause acute pain.
Prompt evaluation is also recommended for severe vaginal bleeding with signs of anemia, such as lightheadedness, extreme fatigue, or weakness. While fibroids are not life-threatening, their symptoms can significantly impact quality of life. A healthcare provider can assess your symptoms, conduct necessary examinations, and determine if fibroids are the cause of your leg pain.
Managing Fibroid-Related Leg Pain
Diagnosing fibroids typically begins with a pelvic examination, where a healthcare provider may feel for a firm, irregular mass. Imaging tests, such as an ultrasound, confirm the presence, size, and location of fibroids. A transvaginal ultrasound, where a probe is inserted into the vagina, provides detailed images of the uterus. Magnetic resonance imaging (MRI) may also be used to delineate fibroid location or differentiate them from other conditions.
Treatment for fibroid-related leg pain focuses on addressing the fibroids. Medical management options include gonadotropin-releasing hormone (GnRH) agonists, which can reduce fibroid size and alleviate heavy bleeding by creating a temporary menopause-like state. Other medications like tranexamic acid can help manage heavy menstrual bleeding, although they do not reduce fibroid volume. Hormonal therapies, such as low-dose birth control pills, also help control symptoms.
Minimally invasive procedures offer alternatives to traditional surgery. Uterine artery embolization (UAE) involves blocking blood vessels that supply fibroids, causing them to shrink. Myomectomy, the surgical removal of fibroids, can be performed through hysteroscopy for smaller fibroids inside the uterus, or laparoscopically for larger ones, preserving the uterus for women who wish to become pregnant. For a definitive solution, a hysterectomy, the surgical removal of the uterus, is an option for women who do not desire future pregnancies and seek complete symptom resolution.