Fibroid degeneration refers to the process where uterine fibroids –abnormal and benign growths on the muscular walls of the uterus, change in size such as shrinking, calcification, or necrosis (death of body tissues). This article navigates the complexities of fibroid degeneration, its causes, symptoms, treatment options, and how it can impact your fertility and lead to pregnancy complications. Let’s start with understanding what fibroid degeneration is!
What is Fibroid Degeneration?
Fibroids are made up of living tissue, so they take up oxygen and nutrients while they grow. They receive it from the blood vessels supplying blood to and within the uterus. This occurs particularly when a fibroid grows excessively large and lacks adequate nutrients to sustain its growth. As a result, the cells within this abnormal tissue start to die off, a process known as fibroid degeneration. This condition can be painful, and uncomfortable and may lead to complications if untreated.
What are the Types of Fibroid Degeneration?
The different types of fibroid degeneration are as follows:
- Hyaline Degeneration of Fibroid: This is a common type, which involves the replacement of fibroid tissues with hyaline tissue, reducing blood supply. While usually asymptomatic, it can lead to cell death and cystic degeneration.
- Cystic Degeneration of Fibroid: It is less common, and typically occurs post-menopause and after hyaline degeneration. Reduced blood supply and dying cells create cystic areas within the fibroids.
- Myxoid Degeneration of Fibroid: Similar to cystic degeneration, this type includes gelatinous material within the cystic masses of the fibroid.
- Red Degeneration of Fibroid: Often occurring during or after pregnancy, this type results from hemorrhagic infarcts (dead tissues) of uterine fibroids. Pain during pregnancy is a hallmark symptom of this type of fibroid degeneration.
Fibroids rely on oxygenated blood to survive. However, when they grow too large, they can outgrow their blood supply, causing parts of the fibroid to shrink and degenerate. This cycle of growth and shrinkage of the degenerating fibroid can lead to recurring symptoms, including:
Common Symptoms of Fibroid Degeneration
- Acute Stabbing Pain: The most common symptom, characterised by sharp, localised pain in the abdomen or pelvic area. It is caused by chemical release from dying fibroid cells, often accompanied by swelling.
- Chronic Pain: Lasting pelvic discomfort that may persist even after the acute phase resolves.
- Bleeding: Sudden changes in bleeding patterns, such as heavier periods or abnormal bleeding between cycles. In rare cases, degeneration may cause haemorrhaging.
- Fever: A low-grade fever (100.4–102.2°F) can occur due to the inflammatory response triggered by fibroid breakdown. This is more common during pregnancy.
Other Possible Symptoms
- Enlarged abdomen: Swelling or bloating, making the abdomen appear distended.
- Pain during intercourse: Discomfort or pain during sex.
- Fatigue: Constant tiredness due to chronic pain or heavy bleeding.
What are the Causes of Fibroid Degeneration?
When left untreated, fibroids can grow larger and demand more nutrients than are available from the blood supply, resulting in insufficient support from the surrounding blood vessels. This leads to fibroid degeneration, where fibroid cells start to die, often causing abdominal pain, swelling, and discomfort along with other symptoms. Some other causes may include:
- Pregnancy
- Hormonal imbalance
- Rapid growth of fibroids
Where a fibroid is located can affect the symptoms you experience:
- Pedunculated fibroids hang by a stalk and are more likely to twist and cut off their blood supply, causing severe pain and longer-lasting symptoms.
- Subserosal fibroids grow outside the uterine walls and can press on surrounding organs.
- Submucosal fibroids bulge into the uterine cavity and can cause heavy bleeding.
How is Fibroid Degeneration Diagnosed?
During diagnosis, an expert asks about your symptoms and conducts a physical examination. Based on the examination, they recommended further diagnostics such as:
- Ultrasound
- MRI
- Hysteroscopy (if necessary)
What are the Treatment Options for Fibroid Degeneration?
After a thorough diagnosis, the doctor will determine the best-suited fibroid degeneration treatment method. Fibroid degeneration treatment options may include non-surgical and surgical techniques:
Non-surgical fibroid degeneration treatment:
- Medications: Hormonal supplements and medication to manage symptoms such as heavy bleeding and to relieve the pain.
- Uterine Artery Embolization (UAE): Minimally invasive procedure to shrink fibroids by blocking their blood supply. This removes the fibroid and prevents it from regrowing.
- MRI-guided focused ultrasound surgery (MRgFUS): Non-invasive treatment using ultrasound waves to destroy fibroid tissue.
- Remedies: Using a heating pad or hot water bottle on your lower abdomen can help relieve the pain.
Surgical Fibroid Degeneration Treatment:
- Myomectomy: This procedure removes uterine fibroids and preserves the uterus for potential pregnancy.
- Hysteroscopy: It is a minimally invasive procedure to examine and treat issues within the uterus, often used for removing the degenerated fibroid. In rare cases, it aids in removing the uterus when the condition is worse and there are no plans for pregnancy in future.
Red Degeneration Symptoms
Red degeneration of fibroids is particularly common during pregnancy. It causes severe abdominal pain and sometimes bleeding. If you have these symptoms, it’s important to see a doctor right away.
Red Degeneration Treatment
Treatment for red degeneration focuses on managing pain and treating the underlying cause. In some cases, medical intervention may be needed to prevent complications, especially during pregnancy. Procedures like uterine fibroid embolisation (UFE) can also help by cutting off the blood supply to the fibroid, allowing it to shrink.
Conclusion
Fibroid degeneration can lead to heavy bleeding or severe pain in the abdomen. If left untreated, this condition can affect overall fertility health and at times result in infertility. If you are diagnosed with fibroids and concerned about having a child, call us today to speak to our consultant. Or, to book an appointment with our fertility specialist, fill in the required details in the given form and our medical coordinator will call you shortly.
Frequently Asked Questions
How long does the pain last from shrinking fibroid degeneration?
The pain can last between a few days to a couple of weeks. It will usually subside when the degeneration pauses (when the fibroid can survive again). However, it will begin again if the fibroid again grows and starts to degenerate.
How long does fibroid degeneration take?
The process of fibroid degeneration usually takes a few weeks.
Where does a fibroid go during degeneration?
During fibroid degeneration, the fibroid cells or tissues start to die in a process known as necrosis. Parts of the fibroid may liquefy, and parts may remain as solid matter. In some cases, the tissue is slowly reabsorbed by the body. In many cases, it remains there and decomposes.
If the fibroid is attached to a stem (pedunculated fibroid), it may twist around and prevent blood from flowing to the stalk. This can lead to severe pain and may require surgery to remove the fibroid.
What is red degeneration of a fibroid?
Red degeneration of a fibroid is a kind of fibroid degeneration that can occur with pregnancy. It usually occurs during or after pregnancy. It can lead to severe pain and bleeding. However, the symptoms usually resolve within some days.
