Although much concern is expressed about infertility and pregnancy complications with fibroids, the fact of the matter is avoiding pregnancy-that is, finding appropriate contraceptive methods is much more of a common problem.  

Many, if not most women with myomas at any given point in time are attempting to avoid pregnancy either because they have not reached a time at which they wish to begin or continue having children or because of a desire to space the births of their children. 

Hormonal contraception is the most popular method of avoiding pregnancy.  This group includes the standard birth control pill, which contains both an estrogen and a progestin (a hormone which is chemically different from progesterone but has progesterone-like effects).  It also includes the mini-pill, which contains only a progestin, as well as injections such as Depoprovera and finally, implants such as Norplant.  In contrast to the combination oral contraceptive these others have in common that they only contain a progestin.  These methods can be quite effective for women who have fibroids. They not only are good methods of preventing pregnancy but they can sometimes decrease the heavy periods associated with fibroids.

Today's birth control pills contain extremely low doses of estrogen and progestin and tend not to stimulate growth of the tumors contrary to what had been thought in the past.  As a consequence they contain insufficient amounts of estrogen to stimulate tumor growth and in fact contain so much progesterone that they may suppress growth. 

The intrauterine contraceptive device (IUD) is a highly effective and convenient form of pregnancy prevention.  There are three situations with fibroids where this method is not suitable.

The first is where the cavity of the uterus is greatly enlarged beyond normal.  In this situation the amount of contact that the IUD has with the lining of the uterus may not be sufficient to bring about the contraceptive effect.

The second situation is when the cavity (womb) contains one or more fibroids (submucous fibroids).  This will prevent the appropriate placement of the device and lead to a less effective method of pregnancy prevention.

The third case is in women who have heavy bleeding since most IUD's tend to increase bleeding.  An exception to the last is the IUD that contains a progestin, Mirena.  This type of IUD is a very effective treatment for heavy periods.

For most women with myomas, the vaginal diaphragm can be a very convenient method.  However, in some women, the fibroid tumors press on the vagina and distort the shape of the vagina.  This will prevent the proper placement of the diaphragm resulting in a lower level of effectiveness.  –  Francis L. Hutchins, Jr., M.D.

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Note:  The Henry J. Kaiser Family Foundation has a free guide, "It's Your (sex) life - your guide to safe & responsible sex".  1-866-rap-it-up or URL  rap-it-up.com