Uterine fibroids are non-cancerous growths that develop in or around the uterus. While often associated with heavy bleeding or pelvic pressure, their potential connection to hip pain is less commonly recognized. Although not a primary symptom, a link can exist, particularly as fibroids grow in size and location. Understanding this relationship is important for individuals experiencing unexplained hip discomfort.
Understanding Uterine Fibroids
Uterine fibroids, also known as leiomyomas or myomas, are growths composed of muscle and fibrous tissue that form within the uterus. These benign tumors are common, affecting up to 80% of women by the age of 50. They often develop during a woman’s reproductive years, typically between ages 30 and 50, when estrogen levels are highest. Fibroids can vary significantly in size, ranging from as small as a pea to larger than a grapefruit.
Fibroids are categorized by their location within the uterus. Intramural fibroids are the most common, growing within the muscular wall. Subserosal fibroids develop on the outer surface, sometimes growing into the pelvis. Submucosal fibroids grow under the inner lining and protrude into the uterine cavity. Less common are pedunculated fibroids, attached by a stalk. Many women with fibroids experience no symptoms, often discovering them during a routine pelvic exam or ultrasound.
How Fibroids Can Lead to Hip Pain
Uterine fibroids can contribute to hip pain through several mechanisms, primarily due to their size and location. Large fibroids, especially subserosal ones located on the back of the uterus, can exert direct pressure on nearby nerves and structures. This pressure can affect the sciatic nerve, which runs from the lower back through the hips and buttocks down the legs, leading to sciatica-like pain that radiates into the hip and down the leg. Pressure on other nerves of the lumbosacral plexus, a network supplying the lower limbs and pelvic girdle, can also cause leg and lower back pain that worsens with movement.
Pain in the hip area can also manifest as referred pain. This occurs when discomfort originating in the uterus or pelvic region is perceived in the hip due to shared nerve pathways. Fibroids can also contribute to pelvic floor dysfunction, where tension or imbalance in the pelvic floor muscles can refer pain to the hips, groin, or lower back.
Recognizing Other Fibroid Symptoms
Beyond hip pain, uterine fibroids can cause a range of other symptoms that vary depending on their size, number, and location. Many women experience heavy menstrual bleeding, prolonged periods, or bleeding between cycles. This excessive bleeding can sometimes lead to anemia, causing fatigue and weakness.
Pelvic pressure or pain is a common complaint, often described as a feeling of fullness or heaviness in the lower abdomen. Fibroids can also press on adjacent organs, leading to frequent urination or difficulty emptying the bladder. Pressure on the rectum can cause constipation or painful bowel movements. Other symptoms may include lower back pain, abdominal enlargement, or discomfort during sexual intercourse.
Diagnosis and Treatment Approaches
Diagnosing uterine fibroids typically begins with a pelvic examination, where a healthcare provider may feel an enlarged or irregularly shaped uterus. Imaging tests then confirm the presence, size, and location of fibroids. An ultrasound, performed either transabdominally or transvaginally, is a standard initial diagnostic tool. Magnetic Resonance Imaging (MRI) offers more detailed images, helping to precisely map fibroids and differentiate them from other conditions. A hysteroscopy, where a small telescope is inserted into the womb, or a laparoscopy may also be used to visualize the uterus.
Treatment for uterine fibroids aims to manage symptoms, including hip pain, and varies based on fibroid size, location, and the individual’s desire for future fertility. For mild cases, watchful waiting may be an option. Medical management includes over-the-counter pain relievers like ibuprofen, hormonal birth control to manage bleeding, or GnRH agonists to temporarily shrink fibroids. Oral therapies like elagolix can also help manage heavy bleeding.
When symptoms are severe or unresponsive to medication, surgical or minimally invasive procedures may be considered. Uterine fibroid embolization (UFE) is a non-surgical procedure that blocks the blood supply to fibroids, causing them to shrink. Myomectomy involves the surgical removal of fibroids while preserving the uterus. For individuals who have completed childbearing or desire a definitive solution, a hysterectomy (removal of the uterus) is the only way to completely cure fibroids and prevent their recurrence. Other options include radiofrequency ablation, which uses heat to destroy fibroids.