Uterine Fibroids: How Pelvic Floor Physical Therapy Can Help Manage Your Symptoms

Overview

Uterine fibroids are noncancerous growths that develop in or around the uterine wall, creating challenges ranging from subtle discomfort to life-disrupting symptoms. While these benign tumors (also called leiomyomas or myomas) cannot be treated through physical therapy alone, pelvic floor physical therapy offers powerful tools for managing the pain, bladder issues, and daily limitations that often accompany fibroids.

Understanding uterine fibroids begins with recognizing just how common they are. Research shows that an estimated 70-80% of people with uteruses will develop fibroids by age 50, making this one of the most prevalent reproductive health conditions. The impact varies dramatically from person to person—some individuals never experience symptoms, while others face significant challenges with heavy bleeding, pelvic pain, and pressure symptoms that affect work, relationships, and quality of life.

Fibroids disproportionately affect Black individuals, who tend to develop these growths at younger ages and often experience more severe symptoms. This disparity highlights the importance of accessible, culturally sensitive pelvic health care that addresses the unique needs of diverse populations. Additionally, fibroids can affect people across all reproductive ages, from those in their twenties to individuals approaching menopause.

Pelvic floor physical therapy plays a crucial supportive role in fibroid management by addressing the muscular and functional challenges that arise from these growths. While physical therapy cannot shrink fibroids, it can significantly improve associated pelvic pain, bladder dysfunction, bowel symptoms, and movement limitations. This conservative treatment approach works alongside medical management to help patients maintain active, comfortable lives while managing their fibroid symptoms.

Symptoms

Uterine fibroid symptoms vary significantly based on the size, location, and number of growths present. Many people with small fibroids experience no symptoms at all, while others with larger or strategically located fibroids may face considerable daily challenges.

Menstrual and Reproductive Symptoms:

• Heavy menstrual bleeding (menorrhagia) that may include large clots
• Prolonged periods lasting more than seven days
• Irregular bleeding between periods
• Painful periods with severe cramping
• Fertility challenges or pregnancy complications
• Recurrent pregnancy loss in some cases

Pelvic and Abdominal Symptoms:

• Chronic pelvic pain or pressure, often described as heaviness
• Lower back pain that may radiate into the legs
• Pain during sexual intercourse (dyspareunia)
• Abdominal bloating and visible enlargement
• Feeling of fullness in the lower abdomen

Bladder and Bowel Symptoms:

• Frequent urination, particularly at night
• Urgency to urinate with little warning
• Difficulty completely emptying the bladder
• Constipation or straining with bowel movements
• Feeling of incomplete bowel evacuation
• Hemorrhoids due to increased abdominal pressure

Systemic Symptoms:

• Fatigue, often related to iron deficiency from heavy bleeding
• Shortness of breath during physical activity
• Weakness or dizziness
• Sleep disruption from frequent urination or pain

These symptoms can significantly impact daily functioning, affecting everything from professional responsibilities to intimate relationships and social activities.

Causes

While researchers haven't identified a single cause for uterine fibroids, several factors influence their development and growth. Understanding these contributing factors can help individuals make informed decisions about prevention and management strategies.

Hormonal Influences: Estrogen and progesterone, the primary female reproductive hormones, stimulate fibroid growth. This explains why fibroids typically develop during reproductive years when hormone levels are highest, and often shrink after menopause when hormone production decreases. Hormone replacement therapy and certain medications can also influence fibroid growth.

Genetic and Family History: Having a family history of fibroids significantly increases the likelihood of developing them. Specific genetic variations affect how the body processes hormones and responds to growth factors, contributing to fibroid development. Twin studies suggest that genetics account for a substantial portion of fibroid risk.

Race and Ethnicity: Black individuals face a disproportionately higher risk of developing fibroids, often at younger ages and with more severe symptoms. Research indicates this disparity likely involves a combination of genetic factors, environmental influences, and social determinants of health, including stress and access to healthcare.

Lifestyle and Environmental Factors: Several modifiable factors may influence fibroid risk:

• Diet high in red meat and low in fruits and vegetables
• Vitamin D deficiency
• Obesity, particularly excess abdominal weight
• Physical inactivity
• Chronic stress and its effects on hormone levels
• Environmental toxin exposure

Reproductive History: Early onset of menstruation (before age 12) and never having been pregnant both increase fibroid risk. Conversely, pregnancy and breastfeeding appear to have protective effects, possibly due to hormonal changes that occur during these times.

Age Factors: Fibroids most commonly develop during the reproductive years, with peak incidence occurring in the 30s and 40s. They rarely develop before puberty or after menopause, underscoring the role of reproductive hormones in their formation and growth.

How Pelvic Floor Physical Therapy Can Help

While pelvic floor physical therapy cannot eliminate uterine fibroids, it offers significant benefits for managing the complex symptoms and functional challenges these growths create. Our evidence-based approach focuses on optimizing pelvic floor function, reducing pain, and improving quality of life through targeted interventions.

Pain Management and Muscle Function: Fibroids can create chronic pelvic pain through direct pressure on surrounding structures and secondary muscle tension. Pelvic floor physical therapy addresses both the primary pain and compensatory patterns that develop over time. Manual therapy techniques help release fascial restrictions and muscle tension, while specific exercises restore normal movement patterns and reduce pain sensitivity.

Bladder and Bowel Function Optimization: Large fibroids can compress the bladder and rectum, leading to urinary frequency, urgency, and bowel dysfunction. Our specialized techniques help optimize bladder and bowel function through:

• Pelvic floor muscle coordination training
• Bladder retraining programs
• Bowel management strategies
• Positioning techniques to reduce pressure symptoms
• Education about timing and fluid management

Core Stability and Postural Support: Fibroids can significantly impact core stability and posture, leading to secondary pain in the back, hips, and pelvis. We address these issues through:

• Deep core strengthening programs
• Postural re-education and ergonomic training
• Movement pattern correction
• Breathing techniques that support pelvic floor function

Sexual Health and Intimacy: Pain during intercourse (dyspareunia) is common with fibroids, but pelvic floor physical therapy can help address the muscular and fascial components contributing to this discomfort. We provide education about positioning, pelvic floor relaxation techniques, and communication strategies to help restore intimacy and sexual satisfaction.

Comprehensive Movement and Activity Management: Our approach includes education about activity modification, exercise progression, and lifestyle strategies that minimize fibroid symptoms while maintaining an active lifestyle. We help patients understand how to move and exercise safely and comfortably despite their condition.

Treatment Methods at Mendwell Pelvic Health: Our individualized treatment approach may include:

• Comprehensive pelvic floor assessment and muscle testing
• Manual therapy including myofascial release and visceral mobilization
• Therapeutic exercise programming for core and pelvic floor coordination
• Biofeedback training for muscle re-education
• Electrical stimulation for pain management when appropriate
• Breathing and relaxation techniques
• Patient education and self-management strategies
• Collaboration with your healthcare team for comprehensive care

We recognize that each person's experience with fibroids is unique, and we tailor our treatment approach to address individual symptoms, goals, and lifestyle needs in an inclusive, supportive environment.

Frequently Asked Questions

Can pelvic floor physical therapy help reduce heavy menstrual bleeding from fibroids?

While pelvic floor physical therapy cannot directly reduce fibroid-related heavy bleeding, it can help manage associated pelvic pain and pressure symptoms. We also provide education about positioning and movement strategies that may help you feel more comfortable during heavy bleeding days. For bleeding management, coordination with your gynecologist or healthcare provider is essential.

How long does it take to see improvement in fibroid symptoms with pelvic floor physical therapy?

Most patients begin experiencing some symptom relief within 4-6 sessions, with more significant improvements typically occurring over 8-12 weeks of consistent treatment. However, the timeline varies based on fibroid size and location, symptom severity, and individual response to treatment. We'll discuss realistic expectations and create a personalized treatment timeline during your initial evaluation.

Is pelvic floor physical therapy safe if I'm considering fibroid surgery?

Yes, pelvic floor physical therapy is safe and often beneficial both before and after fibroid surgery. Pre-surgical therapy can help optimize pelvic floor function and prepare your body for recovery, while post-surgical therapy addresses scar tissue, muscle weakness, and functional restoration. We coordinate closely with surgical teams to ensure seamless care throughout your treatment journey.

What should I expect during my first pelvic floor physical therapy appointment for fibroid symptoms?

Your initial visit includes a comprehensive discussion of your symptoms, medical history, and treatment goals. We'll perform a thorough assessment of your posture, movement patterns, and pelvic floor function. Internal examination is sometimes helpful but always performed with your complete consent and comfort as our priority. We'll develop a personalized treatment plan and begin education about self-management strategies.

Can men develop fibroids, and would they benefit from pelvic floor physical therapy?

Uterine fibroids specifically affect individuals with a uterus. However, people of all genders can experience pelvic pain, bladder dysfunction, and core stability issues that respond well to pelvic floor physical therapy. We provide inclusive, affirming care for all individuals experiencing pelvic health challenges, regardless of gender identity or anatomy.

How does pelvic floor physical therapy work alongside other fibroid treatments like medication or procedures?

Pelvic floor physical therapy complements all forms of fibroid treatment, from watchful waiting to medication management to surgical interventions. We coordinate with your entire healthcare team to ensure our approach aligns with your overall treatment plan and enhances the effectiveness of other therapies you may be receiving.