More than Physical: How Fibroids Affect Sex and Pleasure

A note on language: while mainstream medicine and media typically refer to this topic as a “women’s health issue,” we at PbK we acknowledge and affirm that gender is not defined by genitals. Anyone with a uterus, regardless of their gender identity, can have suffer from fibroids. Throughout this article on fibroids and sex, we refer to it as a reproductive health issue that affects people with uteruses or uterus-havers.

I learned about uterine fibroids (UF) earlier than most—middle school, to be exact. My mom always had them but was in the lucky subset of patients without symptoms or side effects (until she was older). Since they have a genetic component, and my periods were heavy, I was told to let my future healthcare providers know about my family history, and that was that.

If not for this early knowledge, I’d know nothing about fibroids or their impact on sex or pleasure. They weren’t discussed in either my public health program or during sex ed certification. Yet the impact of fibroids on sex is rather far-reaching. In this article, we’ll cover everything you need to know about fibroids and sex. This includes what they are, who they impact, side effects, and practical solutions.

Fibroid Basics

Fibroids are muscular growths in the wall of the uterus (womb)

Also called leiomyomas or myomas, fibroids are typically noncancerous and extremely common. The exact number of people living with UF varies widely, depending on both a study’s population and the diagnostic methods used. The Office of Women’s Health places it between 20-80% of people with uteruses.

Implicit bias and the nature of fibroids impact the ability to diagnose treat and them and their symptoms

If the wide range of fibroid side effects and symptoms confuses you, know that you aren’t alone. There are many reasons for it.

First, people with uteruses, especially if they also carry one or more other marginalized identities, struggle to receive a diagnosis. They’re also less likely to be correctly diagnoses and believed about their symptoms, especially pain. This goes for a wide variety of physical and mental health conditions (just google “diagnostic gender bias”). It’s especially true for still poorly misunderstood conditions related to the uterus and/or menstrual cycle.

There’s also the fact that fibroids themselves vary a lot. They can range in size from an apple seed to a grapefruit (or larger). Some people have a single fibroid, others have dozens.

Lastly, many people with UF have no symptoms. If diagnosed, it happens incidentally such as their healthcare provider feeling irregularities in the shape of the uterus. This means many people can be living with fibroids but not know it unless they are large and/or causing symptoms. This varies by race, as Black uterus-havers are more likely to experience UF symptoms, which may also contribute to increased rates of diagnosis in this population.

Age and race play a role in who develops UF

Fibroids are most common in uterus-havers in their 40s and 50s. Black people with uteruses have a three times higher risk for UF than their white counterparts. They also are more likely to develop them at a younger age, have bigger fibroids, have more fibroids, have more symptoms, and be hospitalized for them. (Source

The exact reasons for this remain unknown. However, some other risk factors for UF are also higher amongst Black uterus-havers. These include low Vitamin D levels, hypertension, food additive consumption, and family history. All of these are influenced by psychosocial causes such as reduced access to healthcare and lower socioeconomic status. And, all of this is connected to racialised trauma, especially from the medical field, and ongoing anti-Blackness. Together, this creates additional stress in Black bodies that leads to overall more and worse health outcomes.

Fibroid side effects are wide-ranging

Though many people with UF remain asymptomatic, when symptoms are present they can be hard to live with. 

Common symptoms and side effects of fibroids include:

  • Heavy bleeding
  • Long periods
  • Painful periods
  • Constipation
  • Anemia (from the bleeding)
  • Bloating in the lower belly
  • Frequent peeing
  • Pelvic pain
  • Painful sex
  • Lower back pain
  • Complications during pregnancy and labor
  • Infertility

Fibroids and Sex

Now that you know the basics about UF, let’s focus on how fibroids and sex intersect.

Painful sex is a common Side effect of uterine fibroids

While painful sex is only one symptom of UF, the other symptoms—as well as the stress of living with a chronic condition—can impact your sex life. That’s because sex impacts, and is impacted by, every other part of your life. Especially your health. 

Read more: 15 Sensual Self-Care Practices that Don’t Cost a Thing

The side effects of fibroids and sex go beyond pelvic pain

When talking about the sexual impacts of…well, anything, really…it helps to look at them across three levels.

  1. Direct physical: physical symptoms and/or side effects that directly impact your sexual functioning (e.g. painful sex)
  2. Indirect physical: physical symptoms that make having and/or enjoying sex harder (e.g. lower back pain, frequent peeing, long periods)
  3. Psychosocial: the mental, emotional, and energetic fallout from dealing with the above symptoms that impact how you feel about yourself, your desire levels, your energy level, how your partner interacts with you, etc. (e.g. dinging your self-esteem)

Read more: How to Talk to Your Partner About Lack of Intimacy & Other Sex Problems

addressing painful sex from fibroids Is simple but not easy

There are a variety of established approaches to managing pelvic pain from fibroids. They include:

Unraveling the non-physical Side effects of fibroids and sex can be more complex

These are the less tangible impacts. You can’t measure them in any quantifiable way. And, they often result from living with the above list of physical symptoms. Things like:

  • not feeling confident and sexy
  • feeling betrayed by your body
  • hating, disliking, and/or disconnecting from your body
  • internalizing harmful messages—from family, religion, school, society, and more—about what it means for YOU, with all your varied identities, to have fibroids/a chronic condition. These messages are very individual—a Black trans man with fibroids will have a different set of messages to unlearn and heal than a white Latinx cis woman.
  • stress over accessing empathetic and affirming care and navigating the bureaucracy of health systems
  • and many more

All of these feelings don’t magically disappear when you start to get it on (if/when they create that device, I’ll take 10 please!). You carry them with you into sexy times and they can easily hit your sexual brake. 

Furthermore, for each of these, there’s less individual control. There’s a lot you can do (more on that below), but you still have to live in a world where these systems of oppression are baked into every part of our society.

Read more: Wondering How to Have Better Sex? You Only Need These Three Things

Sexual and psychosocial side effects are commonly dismissed or ignored 

This is especially true for non-white folx and those carrying multiple marginalized identities, for whom even finding affirming mental health care to address these symptoms can be a challenge.  

Thankfully, this is changing. As mainstream medicine acknowledges the important role psychosocial factors play in overall health, it’s becoming less hard to find healthcare providers who help you thrive, not just survive, with a chronic condition like uterine fibroids.

Read more: Homophobia, Racism, Fatphobia, & Other Intimacy Barriers

If you have UF and want more intimate, exciting, and fulfilling sex, don’t focus only on the physical

Because sex is so much more than physical, finding freedom in pleasure with fibroids and sex means seeking solutions go beyond the physical.

Incorporating mindfulness; noticing, reframing, and healing harmful thoughts and internalized racism, sexism, ableism, etc; learning how to resource yourself; asking for help; communicating what you want and need; setting and upholding boundaries; taking action to boost your confidence; and more will not only help you navigate life with UF but also bring more fun and satisfaction to sex as well. 

3 thoughts on “More than Physical: How Fibroids Affect Sex and Pleasure

Leave a Reply

Your email address will not be published. Required fields are marked *

To Top