Pelvic Pain and Fibroids: Diagnosis and Treatment Options

Dr. Shamim Patel

June 15, 2023

Pelvic Pain and Fibroids: Diagnosis and Treatment Options - Dr. Shamim Patel


Pelvic pain can be a distressing condition that affects many women, and one common cause is the presence of fibroids. Fibroids are noncancerous growths that develop in or around the uterus, leading to a variety of symptoms, including pelvic pain. In this article, we will explore the diagnosis of pelvic pain caused by fibroids and discuss the available treatment options.

Understanding Fibroids and Their Relationship with Pelvic Pain

Fibroids, also known as uterine leiomyomas, are benign tumours that originate from the smooth muscle tissue of the uterus. They can range in size from as small as a seed to as large as a grapefruit. While many women with fibroids may not experience any symptoms, pelvic pain is a common complaint for those whose fibroids cause complications.

The presence of fibroids can lead to pelvic pain due to various reasons. The size and location of the fibroids can put pressure on surrounding organs, leading to discomfort. They can also cause heavy menstrual bleeding, leading to cramping and pain. In some cases, fibroids can cause pain during sexual intercourse or bowel movements, further impacting a woman’s quality of life.

Diagnosing Pelvic Pain caused by Fibroids

When a woman presents with pelvic pain, it is essential to identify the underlying cause. The diagnosis of fibroids usually involves a combination of medical history, physical examination, and imaging tests. The initial step is to discuss the patient’s symptoms, including the location, severity, and duration of the pain.

During a physical examination, the healthcare provider may perform a pelvic exam to assess the size and shape of the uterus. In some cases, additional diagnostic tools may be necessary. Ultrasound is commonly used to visualize the uterus and detect the presence of fibroids. Magnetic resonance imaging (MRI) may be recommended for a more detailed assessment, particularly if the fibroids are larger or located in unusual positions.

Treatment Options for Pelvic Pain Caused by Fibroids

The treatment of pelvic pain caused by fibroids depends on several factors, including the severity of symptoms, the size and location of the fibroids, the woman’s desire for future fertility, and her overall health. The following are some commonly used treatment options:

Watchful Waiting: If the fibroids are small and not causing significant symptoms, a “watchful waiting” approach may be adopted. Regular monitoring of the fibroids through ultrasound or MRI is recommended to ensure they are not growing or causing complications.

Medications: Certain medications, such as nonsteroidal anti-inflammatory drugs (NSAIDs), can help manage the pain associated with fibroids. Hormonal medications, such as oral contraceptives or gonadotropin-releasing hormone (GnRH) agonists, may be prescribed to shrink the fibroids or reduce symptoms.

Minimally Invasive Procedures: For women experiencing bothersome symptoms, minimally invasive procedures may be recommended. These procedures include:

a. Uterine artery embolization: This procedure involves blocking the blood supply to the fibroids, causing them to shrink and relieve symptoms.

b. Myomectomy: A surgical procedure that involves removing the fibroids while preserving the uterus. Myomectomy is an option for women who wish to preserve their fertility.

c. Hysteroscopic resection: This procedure is performed through the vagina and cervix, using a hysteroscope to remove fibroids that are inside the uterine cavity.

Surgery: In cases where the fibroids are large, causing severe symptoms, or if future fertility is not a concern, a hysterectomy may be recommended. Hysterectomy is the surgical removal of the uterus and is a definitive treatment for fibroids.


Pelvic pain caused by fibroids can significantly impact a woman’s quality of life. It is important for women experiencing pelvic pain to seek medical evaluation to determine the underlying cause. With an accurate diagnosis, appropriate treatment options can be explored. From watchful waiting to minimally invasive procedures and surgery, there are various approaches to managing fibroids and alleviating pelvic pain. Consulting with a healthcare provider can help guide women in making informed decisions about their treatment options, taking into consideration their individual circumstances and preferences.