Fibroids and Birth Control: Your Questions Answered

If you're one of the estimated 26 million American women who have been diagnosed with uterine fibroids, you may be wondering: "Should I continue (or start) using birth control?"

Fibroids (also called leiomyoma or just "myoma") are muscular tumors that grow in the wall of the uterus (womb). Fibroids are nearly always benign (not cancerous), and they can grow as a single tumor, or in a cluster.

There's a potential dual link between birth control and fibroids. First, this article in WebMD cites birth control use as a risk factor in whether you develop fibroids in the first place. Second, once you have been diagnosed, some providers will prescribe certain types of birth control to manage your uncomfortable fibroid symptoms, such as cramping or heavy periods. Of course, the third birth-control fear is that now or in the future, either your fibroids or your birth control will make it harder for you to get pregnant.

Below, in order to give you the correct information, we address questions about fibroids and birth control.

Can you take birth control when you have fibroids?

Yes. If you have developed uterine fibroids, it's safe to take birth control. However, you should first speak with your doctor to discuss your options and determine which type of birth control is right for you. As you know, there are many types of birth control options (see below), and what your doctor prescribes for you will depend on a number of factors, such as the size and number of fibroids you have.

Many women with fibroids use birth control (for contraception) without any unwanted side effects and without a decrease in their particular medication or barrier method's contraceptive effectiveness. Some doctors prescribe drugs commonly used for birth control to help control fibroid symptoms, including heavy menstrual bleeding.

Does birth control make fibroids worse?

Generally speaking, no, birth control won't make fibroids grow. In fact, in some cases, particularly preceding surgery to remove larger (the size of a small potato to a grapefruit) fibroids, some physicians will prescribe a Gonadotropin-releasing hormone (GnRH) agonist to shrink fibroids to reduce the risk of during-surgery bleeding. But beyond pre-surgical prep, GnRH agonists do not shrink fibroids for the long term. They also have side effects.

Overall, we need further research to confirm the correlation between birth control and fibroid growth.

Also, if you have medium to large fibroids, birth control will have less impact on your painful symptoms, and these large fibroids will still press on other structures in the abdomen or pelvis and cause lower back pain or cramping--regardless of birth control use.

Overall, birth control will not impact the growth of your fibroids. However, birth control can help with fibroid symptoms. For example, low-dose birth control in the form of a pill or an IUD (intrauterine device) can temporarily lessen heavy bleeding or abdominal pain. However, birth control is a short-term fix for these symptoms, and should not be considered an ongoing form of treatment for your fibroids. Plus, if or when you stop taking birth control, your symptoms may return.

Also, depending on which option you choose, birth control methods can come with their own set of side effects, such as weight gain, moodiness, decreased libido, headaches, and cramping (IUDs). There is some risk of blood clots with hormonal birth control, but these are rare. About 0.3% to 1% of women taking the pill over a 10-year duration report blood clots

What birth control is best for fibroids?

There are many birth control options available to you, including barrier methods (such as condoms), Intrauterine Devices (IUDs), and hormonal methods, such as the pill."

What's the best option for you? It will depend on your body, your symptoms, and your preferences. According to the U.S. Office of Women's Health, many doctors will prescribe low-dose birth control pills or progesterone-like injections (e.g., Depo-Provera®) or an IUD (intrauterine device) that contains a small amount of progesterone-like medication to control fibroid-induced heavy bleeding as well as provide contraception.

Also, based on feedback we receive, the following have proven to be the most beneficial for women who have developed fibroids:

Progesterone and fibroids

Commonly known as "the pill," the progesterone-only pill is taken once a day and can ease cramping caused by fibroids. The pill suppresses ovulation, reduces the number of prostaglandins (the hormones that trigger uterine contractions), and thus reduces blood flow and cramping sensations.

Unlike implants and IUDs, if you suffer side effects, the pill can be stopped immediately.

Depo Provera and fibroids

Progesterone-like injections such as medroxyprogesterone acetate--marketed as Depo Provera--contain the hormone progestin. Progestin is a synthetic form of the body's natural hormone progesterone, and when released, it inhibits the lining of the womb that forms before menstruation. As a result, bleeding is lighter during periods.

In a study published in The Journal of Obstetrics and Gynecology, 70% of the study's participating women noticed an improvement in their bleeding patterns after they began using Depo Provera to treat their fibroids.

Nexplanon and fibroids

Nexplanon (sometimes referred to as "the implant") is a small birth control rod that gets inserted underneath the skin at the top of the arm. Like Depo Provera, it slowly releases progestin into the bloodstream and can help reduce cramping and lessen heavy periods. According to Planned Parenthood, after a year of use, o ne in three people with the implant stops getting periods altogether.

IUD and fibroids

An IUD is a small piece of plastic that is placed in the uterus and releases progestin to thicken the cervical mucus and soothe painful periods. There are three types of progestin IUDs: Liletta, Skyla, and Mirena.

Similar to Nexplanon, some women prefer an IUD to help with fibroids because they don't have to remember to take a pill; however, IUD insertion is invasive and, in the first few weeks after insertion, can cause some discomfort.

Conclusion

Birth control can be used by women who have fibroids, and in some instances, can provide temporary relief from typical fibroids symptoms such as heavy bleeding, cramps, and irregular periods for short timeframes. It's important to note though, that birth control should not be used to treat fibroids, and that there is a small risk that birth control could exacerbate the condition.

If you have more questions about birth control and fibroids, or would like to explore Uterine Fibroid Embolization (UFE) as a way to remove your fibroids, book a free care consultation with a Helped Care Coordinator.

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