Fibroid Pain During Pregnancy: What It Is, Why It Happens, and What to Expect?

Uterine fibroids are noncancerous growths that form within the muscular wall of the uterus. They are extremely common among women of reproductive age, and many women with fibroids have healthy pregnancies without complications. However, fibroids can influence how a pregnancy feels, especially when it comes to discomfort and pain. Fibroid-related pain is one of the most common concerns during pregnancy, and understanding why it occurs can help expectant mothers feel more prepared and reassured.

What Are Fibroids and How Common Are They?

Fibroids, also known as leiomyomas, vary in size from very small nodules to large masses that can distort the shape of the uterus. Many women do not experience symptoms, while others may face heavy bleeding, pelvic pressure, or pain. During pregnancy, the presence of fibroids can sometimes lead to changes in discomfort levels due to hormonal and physical changes in the uterus. These shifts may contribute to fibroid pain during pregnancy, affecting how symptoms are experienced as the uterus expands and hormone levels fluctuate.

Why Fibroid Pain Happens During Pregnancy?

"Pregnancy triggers significant hormonal changes, particularly increases in estrogen and progesterone. These hormones can stimulate fibroid growth, especially during the first and second trimesters, when the body is rapidly adapting to support the developing baby. As fibroids enlarge, they may press against nearby organs or surrounding tissues, causing pain, pressure, or a feeling of fullness in the abdomen. Some women may also experience sharp or localized pain if a fibroid outgrows its blood supply, leading to degeneration. These discomforts can vary from mild to severe, depending on the size, number, and location of the fibroids. Understanding these changes helps expectant mothers manage symptoms more confidently.

Several mechanisms explain why fibroid pain may occur during pregnancy:

• Mechanical Pressure: As fibroids grow, they can press on the bladder, bowel, nerves, or pelvic bones, causing a dull ache, sharp twinges, or pelvic heaviness.
• Fibroid Degeneration: Sometimes a fibroid grows faster than its blood supply can support. When this happens, part of the fibroid may break down in a process known as degeneration. Degeneration often causes sudden, sharp, and intense pain.
• Uterine Irritation: Fibroids may irritate the uterine wall, potentially triggering painful contractions or tightening sensations.

The type, size, and location of the fibroid influence how much pain a woman experiences. Intramural fibroids, which grow within the uterine wall, are more likely to cause discomfort compared to fibroids that grow on the outer surface.

How Fibroid Pain Changes Throughout Pregnancy?

1. First Trimester

During early pregnancy, rising levels of estrogen and progesterone can stimulate fibroid growth. As fibroids enlarge, some women may begin to notice mild cramping, pelvic pressure, or general discomfort. This is also the trimester when fibroid degeneration is most likely to occur. Degeneration happens when a fibroid outgrows its blood supply, leading to sharp, intense, or localized pain that can last from a few days to a couple of weeks. Some women may also experience low-grade fever or tenderness in the abdomen. Although these symptoms can be alarming, they are usually manageable with rest, hydration, and guidance from a healthcare provider.

2. Second Trimester

As the uterus continues to expand to accommodate the growing baby, fibroids may shift in position or continue to increase in size. This movement can lead to pelvic pressure, lower-back pain, abdominal discomfort, or feelings of heaviness. Degeneration can still occur during this trimester and may cause sudden or severe pain. For some women, the stretching uterus places less pressure on certain fibroids, resulting in reduced discomfort. For others, the added tension and structural changes may intensify pain. Symptoms may vary depending on whether fibroids are located within the uterine wall, on the outer surface, or near sensitive organs such as the bladder or bowels.

3. Third Trimester

In the final stage of pregnancy, many women experience less fibroid-related pain because the uterus rises higher into the abdomen, allowing fibroids to shift away from the pelvis. However, large or strategically positioned fibroids may still press on nearby organs, causing back pain, constipation, frequent urination, or bladder discomfort. As the body prepares for labor, uterine contractions may feel stronger or more uncomfortable for women with fibroids. Monitoring symptoms and maintaining communication with a healthcare provider ensures comfort and safety throughout the remainder of pregnancy.

Symptoms That May Accompany Fibroid Pain

Fibroid-related pain can vary widely in intensity, from a mild ache to severe cramping. Additional symptoms may include:

• Pelvic pressure or heaviness
• Back pain or discomfort
• Lower abdominal cramps
• Frequent urination due to bladder pressure
• Constipation or bloating
• Sharp, localized pain during fibroid degeneration

Because many pregnancy symptoms overlap with fibroid symptoms, it is important to communicate any new or severe discomfort to a healthcare provider.

When to Seek Medical Attention?

Although fibroid pain is common during pregnancy, certain symptoms may indicate a more serious complication. Pregnant women with fibroids should contact their healthcare provider if they experience:

• Sudden or severe abdominal pain
• Persistent pain that does not improve with rest
• Heavy vaginal bleeding or passage of clots
• Fever or chills accompanying pain
• Signs of preterm labor, such as regular painful contractions
• Difficulty urinating or severe pelvic pressure

These symptoms may signal complications such as fibroid degeneration, placental issues, or preterm labor, all of which require medical evaluation.

Managing Fibroid Pain During Pregnancy

Treatment for fibroids is generally avoided during pregnancy due to potential risks, so managing symptoms focuses on comfort and supportive care. Common approaches include:

• Rest: Lying on the side with knees bent can reduce pressure on the uterus.
• Heat Therapy: Warm compresses or heating pads applied to the lower abdomen can ease cramping or muscle tension.
• Hydration: Drinking plenty of water can help reduce uterine irritability.
• Gentle Activity: Light movement or stretching may relieve pelvic pressure for some women.
• Safe Pain Relief: Acetaminophen is often recommended for pain during pregnancy, but women should consult their healthcare provider before taking any medication.

Final Thoughts

Fibroid pain during pregnancy is a common experience, especially when fibroids grow or undergo degeneration. While many women with fibroids deliver healthy babies without complications, understanding why pain occurs, how symptoms change throughout pregnancy, and when to seek help can make the journey more comfortable. Staying in close communication with a healthcare provider and monitoring symptoms ensures the best possible outcome for both mother and baby. USA Fibroid Centers provides guidance and comprehensive care to help expectant mothers manage fibroid-related discomfort safely and effectively.