Sex is meant for pleasure, but at times, it may be painful due to an infection or an underlying medical condition like uterine fibroids. These are non-cancerous growths that develop in the muscular wall of the uterus. They are composed of smooth muscle cells and fibrous connective tissue. Many women with fibroids experience no symptoms, but sometimes they may notice signs like feeling pain during sex. This is not the only way fibroids can affect sex life of women. Fibroids may also have an impact on their sex drive.

Can lack of sex cause fibroids?

There is no scientific evidence to suggest that a lack of sexual activity causes fibroids. Fibroids develop due to a variety of factors, primarily related to genetics, and hormones, says obstetrician and gynaecologist Dr Kanupriya Jain. Here are some possible causes:

• Estrogen and progesterone, two hormones that stimulate the development of the uterine lining during each menstrual cycle, appear to promote the growth of fibroids.
• Many fibroids contain genetic alterations that differ from those in normal uterine muscle cells, so these genetic changes may lead to fibroids.
• Extracellular Matrix makes cells stick together and can store growth factors, causing biological changes in cells.

Painful sex and fibroids

Almost 3 out of 4 women experience pain during sex at some time during their lives, according to the American College of Obstetricians and Gynecologists. For some, the pain is a temporary problem, but for others, it is a long-term issue. In that case, it may be a sign of a problem, such as fibroids. Most women are not aware they have fibroids because of no symptoms, but if they do, they may experience abdominal pain, or feel discomfort during sex, as per the UK’s National Health Service.

Fibroids located near the cervix or in other sensitive areas can cause pain during deep penetration, says Dr Jain. Also, if the fibroids are large, they can press against pelvic organs, causing discomfort or pain during sex.

How do fibroids can affect sex life?

Fibroids can cause pain during sex. It can impact a woman’s sex life in more ways:

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1. Low sex drive

Heavy bleeding can make sexual activity less appealing or more challenging, leading to a decrease in sexual frequency. Constant worry about bleeding can affect sex drive and reduce enjoyment.

2. Pelvic pain and pressure

Persistent pelvic pain and a feeling of pressure can reduce overall comfort and sexual desire. So, chronic pain can lead to a decrease in intimate moments, and affect relationship satisfaction, says the expert.

3. Urinary and bowel symptoms

Fibroids pressing on the bladder can cause frequent urination, which can be inconvenient during intimate moments. Fibroids can also press on the bowel, leading to constipation and bloating, which can cause discomfort and reduce sexual interest.

4. Emotional and psychological effects

Dealing with fibroid symptoms can lead to stress and anxiety, impacting mental health and sexual desire. The physical changes and discomfort associated with fibroids can affect body image and self-esteem, influencing sexual confidence, says the expert.

5. Fatigue and low energy

Heavy or painful periods is another sign of fibroids. Heavy menstrual bleeding can lead to anemia, causing fatigue and low energy levels. This in turn can reduce interest in sexual activity.

6. Reduced lubrication

Hormonal treatments for uterine fibroids can sometimes affect lubrication down there. When lubrication gets reduced, it can cause vaginal dryness and discomfort while having sex, says Dr Jain.

What are the ways to treat fibroids to improve sex life?

Treating fibroids to improve sex life involves a combination of medical, surgical, and lifestyle approaches. Here are some ways –

1. Medications

Medications like Gonadotropin-releasing hormone (GnRH) agonists, birth control pills, and progestins can help reduce fibroid size and control heavy bleeding. Reducing symptoms can lead to improved comfort during sex, says the expert. Non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help manage pain associated with fibroids, making sexual activity more comfortable.

2. Uterine Artery Embolization (UAE)

UAE involves injecting small particles into the arteries supplying the uterus to block blood flow to fibroids, causing them to shrink. This can reduce symptoms like heavy bleeding and pelvic pain, enhancing sexual comfort and activity levels. During a 2017 study published in the CardioVascular and Interventional Radiology journal, it was found that Uterine Fibroid Embolization, sometimes called uterine artery embolization, can improve sexual function and quality of life.

3. Myomectomy

Surgical removal of fibroids while preserving the uterus, can be done via hysteroscopy, laparoscopy, or laparotomy, says Dr Jain. By removing fibroids, myomectomy can alleviate symptoms like pain and heavy bleeding, improving sexual function and comfort.

4. Hysterectomy

It is a complete removal of the uterus, which can be performed through the abdomen, vagina, or laparoscopy. It provides a permanent solution to fibroid symptoms, leading to improved quality of life and sexual health. However, it eliminates fertility.

5. Diet and exercise

Consuming a balanced diet full of colourful fruits, vegetables, and whole grains, and lean proteins can help manage symptoms and improve overall health. Reducing red meat and increasing green leafy vegetables may lower the risk of fibroid growth, says the expert. Engaging in regular physical activity can help manage weight and reduce symptoms, contributing to better sexual health.

6. Stress management

Practices such as meditation, mindfulness, and yoga can help manage stress and improve overall well-being. This can positively affect sexual desire and performance.

7. Therapy and support groups

Reaching out to therapists for counseling and joining support groups can help women cope with the emotional and psychological impacts of fibroids. This can help in improving overall quality of life and sexual health.

Fibroids may lead to painful sex, so treating them effectively can significantly improve sexual health and overall quality of life. There are medical treatments, and lifestyle adjustments that you will have to make to help alleviate symptoms such as pain, heavy bleeding, and pelvic pressure.