Ask Dr. John Lipman: “Do I Need to Be Worried, I Was Told I Have Calcified Fibroids?”

What Is a Calcified Uterine Fibroid?

A calcified uterine fibroid is a fibroid that contains calcium deposits that normally happens during degeneration. Degeneration starts when a fibroid loses part of its blood flow, which can lead to calcification.

Calcium may affect only part of a fibroid or much of it and this difference matters because a fibroid with some calcium may still have living tissue and active blood flow and a more calcified fibroid may have less active tissue. Imaging helps the doctor see exactly what is happening with your fibroids.

The MSD Manual lists calcific degeneration as one way a fibroid can change after it outgrows its blood supply.

Is a Calcified Fibroid Dangerous?

Most are not dangerous because of the presence of calcium. Fibroids are almost always benign growths, and calcification does not mean that a fibroid has become cancerous, but this does not mean every finding should be ignored. Medical review is important when there is:

• New or worsening pelvic pain.
• Heavy or irregular bleeding.
• Bleeding after menopause.
• Increasing pelvic pressure or abdominal enlargement.
• Urinary frequency, constipation, or other pressure symptoms.
• Uncertainty about whether the mass is a fibroid.
• A pelvic mass that appears to be growing after menopause.

ACOG’s patient guide says that fibroids without symptoms often need no treatment, but pain, bleeding, fast growth, or an unclear diagnosis can change that plan.

What Is Fibroid Degeneration and Calcification?

Blood vessels around a fibroid carry oxygen and nutrients. A fibroid may grow faster than those vessels can support it. When this happens, part of the tissue gets too little blood and starts to break down. This process is called degeneration.

Fast degeneration may cause sudden pelvic pain. Slow degeneration may cause few or no symptoms. Calcium can collect in the tissue over time.

Fibroids often shrink after menopause as hormone levels fall, but each fibroid can act in a different way. ATLii’s guide to fibroid degeneration explains this process in more detail.

Do Calcified Fibroids Cause Symptoms?

Some calcified fibroids cause no symptoms. A scan for another issue may find them by chance. Others cause the same symptoms as other fibroids. Their size or location may still affect the uterus and nearby organs.

Possible symptoms include:

• Heavy or prolonged periods.
• Bleeding between periods.
• Pelvic pain or pressure.
• Pain in the abdomen or lower back.
• Frequent urination or trouble emptying the bladder.
• Constipation or rectal pressure.
• An enlarged abdomen.
• Fatigue or weakness linked to blood-loss anemia.

These symptoms can also have other causes, so your doctor may need to rule them out. ATLii’s uterine fibroid symptoms guide covers the common warning signs.

How Are Calcified Fibroids Diagnosed?

Calcium may show on an X-ray or CT scan. Ultrasound is often the first test used to check for uterine fibroids, but an MRI gives a more detailed view and can show the number, size, location, and blood flow of the fibroids.

The American College of Radiology’s patient guide lists pelvic ultrasound as the most common test used first when fibroids are suspected. An MRI with and without contrast is normally used when the doctor needs more detail and can help when planning treatment.

An MRI is useful because calcified fibroids are not all alike and contrast may help show if a fibroid is still getting blood. ATLii’s guide to pelvic MRI for fibroids includes more examples.

Do Calcified Fibroids Need Treatment?

Not always. A calcified fibroid may need only follow-up if it causes no symptoms and the diagnosis is clear. Treatment is more likely when symptoms affect your daily life. It may also be needed when the scan needs a closer review.

The treatment plan may depend on:

• The amount of bleeding, pain, or pressure.
• The size, number, and location of the fibroids.
• What ultrasound or MRI shows.
• Whether the patient is near or past menopause.
• Pregnancy and fertility goals.
• The desire to keep the uterus.
• Past treatments and other health concerns.

Can UFE Treat a Calcified Fibroid?

Yes. Uterine fibroid embolization is also called UFE or UAE. It blocks the arteries that feed the fibroids, which cuts their blood flow and causes them to shrink.

ACOG explains that UFE helps many patients who have symptoms and want to keep their uterus.

Dr. Lipman can review your MRI to see how much blood flow remains to the problem fibroids and determine if these fibroids are causing your symptoms. He can discuss your treatment options with you and let you know if UFE would be right for you. The symptoms you are experiencing matter more than whether the fibroid is calcified.

Learn how UFE works or request an appointment for your personal consultation.

When Is It Time to Talk With a Fibroid Specialist?

A fibroid found by chance may not need urgent attention if you are not having any symptoms. A visit with a fibroid specialist can help you better understand what is going on when your scan is unclear or your symptoms are getting worse. It is also useful when you want to compare treatment choices.

A specialist can help answer these questions:

• Is the mass clearly a calcified fibroid?
• Is it likely to explain the symptoms?
• Does it still have a blood supply?
• Is follow-up a reasonable choice?
• Is UFE an option, or would another treatment fit better?

If you are experiencing severe pain, very heavy bleeding, fainting, trouble breathing, or symptoms during pregnancy, you should talk to your doctor right away and not wait for a routine office visit.

A calcified fibroid does not automatically mean you need surgery, but it should not be ignored if you are having chronic symptoms. Request a consultation with Atlanta Fibroid Center for a review of your imaging and to learn about all your treatment options.

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