Fibroids can cause pain during sexual intercourse and are unfortunate realities for many women. Understanding the potential impacts of all types of fibroids on your sex life can help you navigate them in your relationships, and empower you to achieve improved sexual health, increased confidence, and more enjoyable intimate encounters with your partners.

Two aspects of fibroids that can cause painful sex are their size and location. Fibroids that grow near the cervix are vulnerable to impact and pressure during intercourse. Additionally, larger fibroids can create a constant pressure—both in the uterus and against surrounding organs—that increases during sex.

Other ways fibroids can impact sexual health and enjoyment can include:

• Vaginal dryness. The hormone imbalances underlying fibroid growth can cause vaginal dryness, and the friction of vaginal penetration can lead to the irritation and tearing of those delicate tissues.
• Irregular periods – One of the unfortunate realities of fibroids is that they can cause abnormally long periods, often up to 10 days, as well as heavy bleeding. Excessive blood flow can make intercourse or any type of vaginal contact awkward and unpleasant.
• Fatigue and loss of energy – In some cases, heavy bleeding can be so severe that it leads to anemia, occasionally requiring blood transfusions. Anemia, along with the nausea and headaches that can also accompany fibroids, can cause dizziness, weakness, and fatigue, all of which can diminish libido.
• Frequent urination – Fibroids can press on the bladder and cause urinary frequency, urgency, and even incontinence. They can block the ureters (tubes that carry urine from the kidneys to the bladder), causing kidney problems, and make it difficult to empty your bladder completely, which can lead to urinary tract infections.
• Body image issues. Fibroids can cause uncomfortable bloating, and large fibroids can distend your abdomen, causing it to look misshapen. Large fibroids also often mimic pregnancy. This can erode a woman’s self-confidence and make her feel less sexy.
• Decreased sex drive. All of the above-mentioned issues—pain, vaginal dryness, irregular periods, fatigue, frequent urination, and negative body image—can individually or collectively diminish your desire for, and enjoyment of, sex.

While fibroids can interfere with sexual pleasure, they don’t have to put a stop to all intimacy. Here are some ways to manage painful fibroids and improve your sex life:

• • Be open and honest with your partner. Articulate your feelings, your needs, and your struggles, and let your partner know how they can help you. Try to be patient with them; find out as much as you can about your condition and share what you learn.
  • Work with your doctor. The care plan for any chronic disease should prioritize quality of life. Tell your healthcare provider that sex is important to you, and request treatment suggestions that could optimize your experience in that area.
  • Explore different options. Try different positions to find the most comfortable ones for you and your partner, given the size and location of your fibroids. If you haven’t already, you can also experiment with other means of intimacy beyond vaginal penetration.
  • Timing can be everything. Understanding the timing of your periods can help you plan for more enjoyable physical intimacy.
  • Watch what you eat. Making dietary changes, such as cutting down on red meat, fat, alcohol, and caffeine, can reduce the excess estrogen production that feeds fibroids.

Intimacy aids, like vaginal lubricants, can help if your body is having trouble lubricating naturally. Physical therapy and pelvic exercises can also help to improve mobility and stamina.

An array of pain relievers, hormonal therapies, minimally-invasive procedures, and surgeries are available to help manage your fibroid symptoms.