This article discusses the symptoms, causes, diagnosis, and treatment of uterine fibroid degeneration.
Fibroid Degeneration Symptoms
Uterine fibroids are benign uterine growths made of smooth muscle cells and fibrous tissue, ranging in size from the size of a grain of rice to the size of a melon.
Uterine fibroids mainly develop in and around the uterus (womb), but rarely may develop in the muscular portion of the uterine wall or form stalks that form pouches or stalks outside the womb. The size and location of uterine fibroids usually determine whether or not you will develop symptoms.
You may not be aware you have fibroids—many people with a uterus have no symptoms. The main signs of fibroids include:
Longer, more frequent, or heavy menstrual periods Menstrual pain (cramps) Bleeding between periods Anemia (from blood loss) Pain in the abdomen or lower back (often dull, heavy, and aching, but may be sharp) Pain during sex Difficulty urinating or frequent urination Enlarged uterus and abdomen
For some people with a uterus, a degenerating fibroid is what first draws attention to their fibroids. Common symptoms of fibroid degeneration include:
Acute abdominal pain lasting a few days to a few weeksSwelling of the abdomenFever
Causes
The exact cause of fibroids is unknown but there are several risk factors that can play a role in your chances of developing fibroids. These can include:
A family history of fibroidsNot having childrenEarly-onset of menstruation (getting your period at a young age)Late age for menopause
Fibroids need two elements to survive, hormones and a blood supply. If a fibroid grows so quickly that it outstrips its blood supply you may experience a sharp, stabbing pain in the abdomen and swelling. Increases in estrogen during pregnancy can increase the chances of fibroid growth and subsequent degeneration.
Fibroid Degeneration in Pregnancy
Fibroid enlargement may be influenced by increased estrogen levels during pregnancy. Fibroids do not usually grow during pregnancy, but some research points to the first trimester as the most likely time that they may.
The larger the fibroid the more likely it is that fibroid degeneration will may occur. Large fibroids outgrow their blood supply. Even more, the growing uterus may distort and kink blood vessels, compromising the fibroid’s blood supply.
One type of fibroid degeneration – called red degeneration due to it’s red color appearance on examination – occurs in 8% of fibroid growths. While is makes up only 3% of all uterine fibroids it may be a troublesome cause of pregnancy complications, such as severe pain, in many women.
Diagnosis
The first signs of fibroids may be detected during a routine pelvic exam. A number of tests may show more information about fibroids:
Ultrasound uses sound waves to create a picture of the uterus and other pelvic organs. Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves. Hysteroscopy uses a slender device (the hysteroscope) to see the inside of the uterus. It is inserted through the vagina and cervix (opening of the uterus). This lets your healthcare professional see fibroids inside the uterine cavity. Laparoscopy uses a slender device (the laparoscope) to help your healthcare professional see the inside of the abdomen. It is inserted through a small cut just below or through the navel. Fibroids on the outside of the uterus can be seen with the laparoscope.
Differential Diagnosis
Fibroids degeneration is often easily confused for other medical conditions because its symptoms are nonspecific and mimic other medical common issues. Other common conditions that are confused with fibroid degeneration include:
Endometrial polyps Adenomyosis Pelvic inflammatory disease Appendicitis Ovarian cancer
Treatment
If fibroid degeneration is causing pain and discomfort, your healthcare provider may suggest home remedies such as using a heating pad on your abdomen or massaging your lower abdomen. Pain medication may provide relief for a few days or weeks until the pain subsides. Your provider may also order imaging such as a CT of the abdomen, a urine analysis, and blood tests to rule out other causes of your pain.
Pain Unintentional weight loss Nausea and vomiting A lump under the skin
There are many treatment options for fibroids so make sure you discuss all your options with your healthcare provider. The following treatments are frequently used to help manage fibroids:
Birth control pills, and other types of hormonal birth control methods Gonadotropin-releasing hormone (GnRH) agonists: These drugs stop the menstrual cycle and can shrink fibroids. Endometrial ablation: The lining of the uterus is removed or destroyed to control very heavy bleeding. Uterine fibroid embolization (UFE): A procedure that blocks the blood supply to the fibroid, causing it to shrink Myomectomy: Surgery to remove fibroids without taking out the healthy tissue of the uterus Hysterectomy: Surgery to remove the uterus. This surgery is the only definitive cure for uterine fibroids.
A Word From Verywell
Uterine fibroid degeneration can cause significant discomfort, but thankfully there is treatment available. The first step in treatment is to be aware of fibroid degeneration, especially if you are pregnant. Meeting frequently with your OBGYN is one way to ensure that you and your healthcare provider discuss the signs to look out for if you are worried about degeneration. Severe abdominal pain and fever can be a sign of many illnesses, but if you know you have fibroids and you start experiencing sharp lower abdominal pains, reach out to a healthcare provider so you can get the care you need.
We do know that fibroids can grow in the first trimester of pregnancy, and that degeneration is seen most often in pregnant people with large fibroids (greater than 5 centimeters) during the second and third trimesters of pregnancy.
