Understanding Fibroid Pain During Pregnancy: Causes, Symptoms, and Relief Options

Experiencing pain during pregnancy can be disconcerting especially when it’s tied to Uterine fibroids (commonly called fibroids). Although fibroids are noncancerous growths in the uterus and many women with them go on to have healthy pregnancies, when they do cause symptoms  particularly pain it’s important to know why this happens, how it may evolve during pregnancy, and what you can do about it.

What are fibroids and why do they matter in pregnancy?

Fibroids, medically known as leiomyomas, are benign tumours of the uterine muscle. They vary widely in size (from pea-sized to large masses) and location (within the uterine wall, on its surface or projecting into the uterine cavity).

During pregnancy, your body undergoes major hormonal and structural changes increasing blood flow to the uterus, enlarging the womb, and shifting organ positions. These changes can affect fibroids in various ways, potentially triggering pain and other symptoms. And while many pregnancies with fibroids are fairly uneventful, the presence of fibroids can increase the chance of discomfort, pain or complications depending on their size, number and location. 

Why does fibroid pain happen in pregnancy?

There are several mechanisms for Fibroid pain during pregnancy:

• Rapid growth or degeneration: Some fibroids may grow or change quickly due to increased hormones and the greater blood flow of pregnancy, which can cause stretching or irritation of surrounding tissues.

• “Red degeneration”: A fibroid may outgrow its blood supply and undergo degeneration (also called red degeneration) this can be quite painful and often feels like a sharp, localized pain or cramp.

• Pressure/space issues: As the uterus expands during pregnancy, a fibroid may press on or distort adjacent organs (bladder, bowel, nerves) causing pressure, ache in the back/pelvis or leg-pain.

• Location-specific forces: A fibroid near the lower uterus or cervix can interfere with the birth canal or hamper uterine contractions, potentially complicating late pregnancy and labour.

Pain & Fibroids Through the Trimesters

First Trimester

In early pregnancy, fibroids may start to grow under the influence of rising hormone levels (especially oestrogen). One study showed that a large proportion of fibroids increased in size during the first and second trimesters.

Pain symptoms may include:

• Cramping or sharp pain in the low abdomen or pelvis (often from fibroid growth or degeneration)

• Bleeding or spotting (if fibroid location disturbs implantation or is near the uterine lining)

• Some women may worry about miscarriage; while fibroids can modestly increase the risk (especially if very large or intracavity), many pregnancies progress normally.

Second & Third Trimesters

As your uterus grows, the effects of a fibroid may become more pronounced or sometimes dissipate as the uterus expands and moves them away from critical locations. But some key issues to watch for:

• Pain and discomfort: A fibroid under stress from the expanding uterus may cause persistent ache, especially one located near the uterine wall, bladder or in the lower uterine segment.

• Malpresentation: The baby’s position might be affected if a fibroid occupies space in the uterus, increasing chances of breech or side-lying positions.

• Restricted fetal growth or placental issues: Large fibroids might impair normal placental attachment or restrict space/blood flow increasing the risk of intrauterine growth restriction (IUGR) or placental abruptions.

• Preterm labour & higher C-section rate: Due to interference with uterine mechanics, some women with significant fibroids have a modestly higher chance of preterm labour or needing cesarean delivery.

What you can do: Management & coping?

While you can’t always prevent fibroid pain during pregnancy, there are ways to monitor and mitigate the impact:

• Frequent monitoring: Work closely with your obstetrician so that the size, number and location of fibroids are tracked via ultrasound and your baby’s growth is followed.

• Pain relief & self-care: Simple measures (rest, hydration, using a warm compress on the lower abdomen/back) can help. Any medications should be under the guidance of your doctor many pain-relievers are safe but must be chosen carefully in pregnancy.

• Avoid heavy strain: Minimise sudden movements, heavy lifting or excessive bending this reduces risk of fibroid twisting/degeneration (which is painful).

• Delivery planning: If fibroids are large, low-lying or near the cervix, your care team may discuss early planning for delivery method (vaginal vs cesarean) and preparedness for possible heavier bleeding postpartum.

• After pregnancy: Many fibroids shrink once the uterus returns to its non-pregnant size. Postpartum review helps to assess whether the fibroids remain problematic and whether future treatment is needed.

Final thoughts

To summarise: if you are pregnant and have fibroids, experiencing pain does not automatically mean a serious complication. Many women with fibroids go on to have healthy pregnancies and deliveries. The key lies in understanding your unique situation the size, number, and location of fibroids and maintaining regular contact with your obstetrician. Recognizing symptoms early, such as pain, bleeding, or changes in the baby’s movement, is essential for timely care and peace of mind.

If you experience sudden, severe pain, heavy bleeding, leaking fluid, or reduced baby movements, contact your healthcare provider immediately. With expert guidance from USA Fibroid Centers, personalized care, and mindful monitoring, you can navigate pregnancy confidently focusing on your baby’s growth and your overall well-being.