By: Jean Johnson for Fibroids1
The National Women’s Health Information Center lists pain during sex as one of the seven main symptoms of uterine fibroids. Yet, when women talk about their experiences with fibroids, pain associated with sexual intercourse is something they tend to avoid bringing up.
It’s not surprising. Women with fibroids are already suffering from a variety of complaints associated with the anatomical region below the belt. More, they are the type of complaints few like to discuss over the backyard fence or while sipping on a latté with a friend.
Bloating – that generalized gassy feeling of fullness in the lower abdomen can be one rather unpleasant result of fibroids. Then there is urinary frequency complete with a frustrating inability to empty the bladder fully. And, of course, constipation is never far away – that can come from fibroids growing in positions that allow them to press on the colon.
| Learn to recognize fibroids symptoms. The National Women’s Health Information Center lists the following symptoms for fibroids: |
Heavy bleeding or painful periods
Bleeding between periods
Feeling of fullness in the pelvic area (lower abdomen)
Pain during sex
Lower back pain
Reproductive problems including: Infertility, having more than one miscarriage or having early onset of labor during pregnancy
All in all, the roster of fibroid symptoms is not a line-up that one might discuss readily. What if, for example, it was the heart instead of the uterus that was in question? Indeed, with these symptoms, a woman wouldn’t particularly want to add ‘pain with sexual intercourse’ to the list if she can avoid it.
“I admit that this was the case for me,” said Irene MacNulty of Portland, Ore. “I guess I’m just like everyone else and sensitive about talking about sex even when everything is normal. But especially when it’s so painful as it was – and I did the ‘not tonight, honey’ thing more than I wish I had to – I’m sure not going to be telling that all to my friends. Frankly, I didn’t even make it widely known that I had fibroids at all since everything was so embarrassing. Even when I did discuss things with my doctor, she had to pry the pain with sex part out of me. But then I guess they’re used to that.
“Now that I’ve had a UFE [uterine fibroid embolization] and everything’s behind me, I can laugh about it to some degree,” MacNulty added. “In part that’s because my sex life is back to normal. But back then when I had the fibroids, it was tough. It really was.
“I can’t think of anything that makes a woman feel so ambivalent about being female than fibroids. The heavy bleeding – so bad you can’t even go out sometimes – the horrible feeling in your belly. And on top of all that, not even being able to enjoy sex. It was quite a nightmare for me, and I don’t think I’m that much different than other cases…”
Location is Everything – Cervical Fibroids Especially to Blame for Painful Sexual Relations
When benign fibroid tumors grow in the vicinity of the cervix at the end of the vaginal tract, they can make penetrative sex highly uncomfortable for women.
Not all fibroids grow in this area, of course, and there are three other types of tumors besides cervical fibroids. Submucousal fibroids develop on the inner surface of the uterus just underneath the uterine lining. Subserousal fibroids grow on the outer layer of the uterus wall. Fibroids that can sometimes grow on stalks on the outer wall or into the cavity of the uterus are called pedunculated. Finally the most common type of fibroid, intramural, grows directly in the wall of the uterus.
The cervical fibroids in question, though, can either press on the cervix or actually hang through the cervical opening, making it exceedingly difficult for women to enjoy sexual relations. To make matters worse, fibroids growing in this area can also result in bleeding during sexual activity.
Restoration of Sexual Pleasure after Uterine Fibroid Embolization Treatment
Because researchers are still evaluating ways in which treating fibroids with uterine fibroid embolization (UFE) can benefit patients, two interventional radiologists involved in this work completed preliminary polling designed to see how women fared sexually in the aftermath of the UFE procedure.
Michael Wysoki, M.D., assistant professor of radiology at the Yale University School of Medicine, was the lead on a telephone survey of women who underwent UFE. Twenty-one patients responded to the calls, and his team of researchers found that 43 percent reported increased sexual desire. The pain the women had experienced during intercourse prior to having their fibroids embolized decreased in 60 percent of the group’s participants.
Wysoki’s queries included detailed questions related to the quality of the sexual experience women were having as well. Twenty-seven percent of those who responded reported an increased frequency of orgasms after having UFE. “No patients reported a deterioration of sexual function,” Wysoki told the Yale-New Haven Hospital online newsletter, [email protected]
“Many women said they didn’t have a great desire for sex before UFE because they felt bloated and had bleeding or pain during intercourse,” Wysoki added. “As we continue to gather information, we are seeing improvement in sexual function after UFE.”
Another approach was taken by Jackeline Gomez-Jorge, M.D., assistant professor of interventional radiology at the University of Miami in Florida. Gomez-Jorge wanted to know if UFE itself caused women any sexual difficulty in the aftermath of the procedure. In other words, how did embolization as a treatment option compare to the traditional way of treating fibroids with hysterectomies when it came to a woman’s sex life.
Gomez-Jorge’s team sent a questionnaire to 115 premenopausal women who had undergone UFE. Around half responded with 80 percent of the group reporting sexual desire more than one time a week. There were 8 percent who indicated they had no interest in sex, although Gomez-Jorge did not report whether this was associated with pain or not.
“UFE does not adversely affect patient’s sex lives, and, in fact, may improve them,” Gomez-Jorge told [email protected] “In general women felt a lot better after UFE, especially after a few weeks. When you feel better, you’re more energetic and more likely to desire sex.”
As did Wysoki, Gomez-Jorge wanted to know about the quality of women’s sex lives. She found was that 64 percent indicated that they had no change in strength of orgasms, while 6 percent had stronger orgasms and another 6 percent reported no orgasms.
Gomez-Jorge was particularly interested in the 56 percent of the group that reported internal uterine contractions since unlike hysterectomies, UFE leaves the uterus intact. “Keeping the anatomy involved in sexual response intact may be an advantage,” she said. “This is particularly true for women who experience uterine contractions as part of their sexual response.”
Gomez-Jorge’s findings dovetail with what has been long-reported about hysterectomies: Some women may feel that they are no longer feminine after a hysterectomy, and this can have psychological effects on self-esteem and interest in sex.
Uterine Fibroid Embolization Refresher Course
For those that haven’t been keeping up with changes in medicine, or those who have simply forgotten what UFE is all about, Fibroids1 offers the following short course on this revolutionary technology that has done so much to improve women’s lives:
UFE is performed by experts in the circulation system called interventional radiologists. These fully-licensed medical doctors place tiny particles in the arteries that lead to the fibroid eventually cutting off the blood supply to the fibroid, causing the tumors to gradually shrink over several months’ time.
There is no major surgery with UFE in as much as the embolization particles are delivered via a tiny catheter that is inserted into a major artery in the groin and guided into place using an imaging screen.
Recovery times with UFE are dramatically faster than with hysterectomy or myomectomy, both of which require abdominal surgery. Further, since there is no large incision, risk of infection is considerably lower. In sum, this interventional radiology procedure has dramatically altered and improved the way clinicians treat fibroid patients.