Should I Use an IUD or Oral Birth Control with Fibroids?

Uterine fibroids are non-cancerous tumors. Many women will be affected by fibroids in their life.  Fibroids can develop in several different places in or on the uterus. Depending on where they develop, they will be classified  as subserosal, intramural, or submucosal.

While no one knows exactly why these tumors develop, most doctors agree that their growth can be affected by the presence of estrogen. This may be why many women’s fibroids grow and develop during pregnancy. Because of the connection between estrogen and fibroid development, you may be wondering how  birth control will impact your fibroids. Here’s what you need to know about birth control and fibroids. 

How Will Oral Birth Control Affect my Fibroid Symptoms?

  1. Your Periods Will Probably get Lighter

A common side effect of fibroids is long, heavy periods; using birth control pills may help manage this symptom. Birth control typically gives women lighter, shorter periods because the estrogen in the medications can help improve blood clotting and reduce your menstrual flow.

     2. You May Have Fewer Cramps

Pelvic pain and cramps are another typical fibroid side effect—and these cramps can be quite severe for women dealing with these tumors. Many women on birth control pills experience cramping relief because the medications can decrease a woman’s prostaglandin count (prostaglandins make the uterus contract, leading to cramps.)

     3. Your Fibroids Could Get Bigger

While taking birth control may help you manage certain side effects of fibroids, there’s a caveat: fibroids are very responsive to estrogen, which means that taking birth control can actually make your tumors grow larger. For this reason, you’ll need to discuss your options with your doctors carefully. A larger fibroid tumor may cause you to experience a worsening of symptoms, canceling out the temporary relief delivered by the estrogen in your birth control pills.

    4. Birth Control Can Help Prevent Fibroids

If you already have uterine fibroids, taking birth control could make your tumors increase in size. But if you haven’t yet been diagnosed, certain birth controls (especially those with lower doses of estrogen) may reduce your fibroid risk!

Can I Implant an IUD with Fibroids?

If oral contraceptives aren’t your best choice, you may be interested in an IUD (intrauterine device). This is a small device which gets implanted into your uterus to prevent pregnancy. IUDs come in two forms: hormonal and non-hormonal, and the type you choose will make a difference in your fibroid experience. Let’s explore the differences between the two types of IUDs. 

Hormonal vs. Non-Hormonal IUD

Hormonal IUDs prevent pregnancy by release synthetic hormones to thins your uterine lining, thicken your cervical mucus. They also partially prevent you from ovulating. In contrast, non-hormonal IUDs release copper into your uterus. And that coppers creates an inflammatory reaction within your uterus, which results in an environment in which sperm can’t survive. 

Now that you understand how IUDs work, let’s explore if they work for women with fibroids. And here’s the story: sometimes they do. But sometimes, if your fibroids have changed the shape of your uterus, you won’t be able to use and IUD. In those cases, then, you’ll want to explore alternative methods of birth control. If, however, you’re a good candidate for an IUD, you’ll need to choose between a hormonal or non-hormonal device. 

Should I get a Hormonal IUD with Fibroids? 

For many women with fibroids, using a hormonal IUD will relieve your symptoms. That’s especially true for heavy periods, since this kind of IUD gives you a thinner uterine lining. Also, since you’ll lose less blood each month with a hormonal IUD, you’re anemia risk will be lower. If you were already anemic, your symptoms should improve. 

Hormonal IUDs may also reduce painful cramping, since your uterine lining cells release the chemicals which cause this symptom. Basically, a thinner lining means less blood loss and less materials to cause cramps. Which means if you’re suffering from these fibroid symptoms, you may benefit from a hormonal IUD. Except, of course, in one instance. Keep reading to find out when you shouldn’t use a hormonal IUD.  

 

Could Hormonal IUDs Make my Fibroids Worse?

Let’s be clear: we don’t know what causes fibroids to develop or grow larger. But we do suspect that there’s a link between hormones and fibroid growth. In other words, there’s a chance that implanting a hormonal IUD could cause your fibroids to grow larger. 

If that possibility makes you nervous, we completely understand. Just know that you can still use an IUD for birth control. In this case, you’d just opt for a non-hormonal IUD. But, keep in mind, while this IUD effectively prevents pregnancy, it won’t do anything to improve your fibroid symptoms. In fact, some women using non-hormonal IUDs report heavier bleeding and cramps. Obviously, you’ll need to think carefully about your options before selecting a non-hormonal IUD. 

And, before choosing either type of IUD, keep in mind that your fibroids will increase your risk for IUD expulsion, which occurs when your device falls fully or partially out of your uterus. If you partially expel your IUD, you’ll need to consult your doctor about safe removal, and likely move on to another form of birth control once your situation is resolved. 

Choosing the right birth control when you have fibroids can be complicated, so it’s crucial to review all your options with your fibroid specialist. But please remember, while birth control may alleviate fibroid symptoms, it can’t “cure” or eliminate your actual fibroids. That will only be possible with fibroid treatment. So, feel free to reach out to Dr. Fox or Dr. Hardee to schedule a consultation on all your fibroid treatment options. And, in light of the current COVID-19 outbreak, rest assured you can choose to schedule a remote, Telemedicine fibroid consultation

Sources: fibroids.com, USA Fibroid Centers

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