Let's face it — figuring out the best way to manage uterine fibroids isn't exactly a walk in the park.
Depending on how severe your fibroids symptoms are, it may take some trial and error to find the right treatment. In some cases, people turn to birth control to help manage symptoms.
Before we dive into whether that could be a good option for you, it's helpful first to have a basic understanding of fibroids, if you don't already.
What are fibroids?
Fibroids are tumors that grow in your uterus and are most commonly non-cancerous. They can range from microscopic to the size of a grapefruit. On the bigger end, fibroids may even weigh several pounds and fill your uterus. Some people may have small fibroids they don't even notice¹.
Symptoms of fibroids² may include:
- Heavy bleeding between or during your period
- Feeling "full" in your belly/lower abdomen
- Lower back pain
- Frequent urination
- Pain during sex
- Infertility or multiple miscarriages
- Early onset labor during pregnancy
Who is most likely to get fibroids?
Many people in the United States develop fibroids at some point in their life. According to the Office on Women's Health, between 20%-80% of women develop fibroids³ by the time they're 50.
Several studies have shown that Black women are more likely to have severe symptoms that interfere with physical activities and work4. Black women are also 2.4 times more likely to get a hysterectomy⁴ as a treatment.
Does birth control help with fibroids?
So, to the main question at hand: does birth control actually help with fibroids symptoms? In short, it's complicated.
One study found that GnRH hormones can help fibroids stop growing or shrink⁵, even if it doesn't help fibroids completely disappear. Hormone therapy will only work as long as you use it, so your fibroids may grow back again once you stop⁶.
Birth Control Pills
Birth control pills may help alleviate your symptoms if your symptoms are primarily heavy periods⁶.Your options between the two different types of birth control pills include the combination pill and the mini pill. The combination pill has a combination of estrogen and progestin hormones. The mini pill only has progestin⁶.
Both the combination pill and the mini pill have been shown to slow down or stop heavy periods. However, this benefit would stop as soon as you stop taking the pills.
Hormonal IUDs, such as Skyla, Liletta, and Mirena all use the hormone progestin⁶. While they can't reduce the size of your fibroids, they can help lower the amount of blood you lose during your period6, which could address the fibroids symptom of heavy bleeding.
The small amounts of progestin released from hormonal IUDs prevents the lining from building up in your uterus. These hormones also help prevent anemia due to blood loss from uterine fibroids. Keep in mind that hormonal IUDs only work as a treatment if your fibroids aren't too big, because large fibroids can change the shape of your uterus and make it impossible to insert an IUD⁶.
The Morning After Pill
In the past, some doctors prescribed the morning after pill (also known as Ulipristal acetate) at lower doses to treat fibroids. The effect of this pill blocked the hormone progesterone, which in turn prevented fibroid growth⁶.
However, in 2018, the FDA did not approve the drug⁷ as multiple usages caused severe liver damage in some patients. As of the time of publication, it's still not on the market in either the United States or the European Union as a safe treatment for fibroids. In other words — for the time being, it’s not a good idea to use as continual treatment.
GnRH analogues are delivered either as either a daily nasal spray or monthly/quarterly injections. Doctors usually give this to patients to shrink fibroids before a procedure. It's also not safe to use GnRH analogues for more than six months because it can increase the likelihood of losing your bone mass.
Using this may reduce the pain you have around heavy bleeding and period cramps. About half of the people who take it notice an improvement in their symptoms⁶.
Beyond hormonal treatments and over-the-counter products for pain management like ibuprofen and acetaminophen¹, some people consider surgery for more serious fibroids symptoms.
Different types of surgeries for fibroids include⁸:
- Myomectomy⁹ – A myomectomy keeps your uterus intact and only removes the fibroids. As a patient, you would go through general anesthesia and the type of surgery is determined by the size and location of the fibroids. A doctor would remove your fibroids through your vagina, small cuts in your abdomen, or a cut across your abdomen.
- Myolysis³ – Myolysis is a procedure that inserts a needle into the fibroids and freezes them. This destroys the fibroids, and may be a better option for people who want the option of becoming pregnant in the future.
- Hysterectomy⁹ – A hysterectomy removes all or part of your uterus. This is a bigger decision to make, depending on whether you would like to be pregnant in the future. People who opt for a hysterectomy usually have really large and painful fibroids. After the surgery, you will no longer have your period, which often prevents fibroids symptoms from returning.
- Endometrial ablation – This procedure removes the lining of your uterus⁹, and is a minimally invasive procedure that has a faster recovery time than for a hysterectomy. Endometrial ablation may be an option for people who are not interested in becoming pregnant in the future.
- Uterine Fibroid Embolization (UFE)³ – UFE injects particles into blood vessels that block the blood supply to the fibroid. While fibroids usually don't grow back after this procedure, there is a risk of early menopause.
Reading about all the options on how to manage fibroids might feel a little scary or overwhelming, but the good news is you have a lot of options.
Finding the right solution will depend on how severe your symptoms are and how you react to certain treatments. This may take a trial of process and error, but that’s completely normal.
While birth control helps with fibroids symptoms for some people, it's not a one-size-fits-all solution for everyone. The best thing you can do is talk to your doctor and see which solutions will work best for you and your body.
adyn pairs people with the best birth control for their body. You can learn more about us here.