Fibroids, also known as uterine leiomyomas, are growths that develop in the uterus and are non-cancerous. Statistics show that almost 80% of women develop fibroids during their lifetime, but they may not know they have them because they do not experience any symptoms. Other women with fibroids experience a host of unpleasant symptoms that impede their ability to carry out their normal routine and diminish their quality of life.
Some of the most common symptoms of fibroids are heavy menstrual bleeding, pelvic pain and pressure, abdominal enlargement, frequent urination, pain during sex, lower back pain that can also travel down the leg, and more.
These symptoms are typically worse during the menstrual cycle; however, some of these symptoms may also present themselves during a process called fibroid degeneration and necrosis.
Today we are going to talk about necrotic uterine fibroids, what causes this condition to occur, and the best treatment to eliminate degeneration and the painful necrotic fibroid symptoms.
The exact reasons fibroids grow are still unknown, but research has shown us certain conditions that make fibroid growth more likely, including:
- An imbalance in hormones, with an excess of estrogen relative to progesterone, may promote fibroid growth;
- Studies have shown that women with a family history of fibroids are more likely to develop them themselves;
- Uterine fibroids are more prevalent in certain ethnic groups, such as African-American women. They tend to develop fibroids at a younger age and have larger and more numerous fibroids compared to women of other ethnic backgrounds;
- Evidence shows that obesity is associated with an increased risk of uterine fibroids. Excess body weight, particularly excess fat tissue, can lead to higher levels of estrogen production and create an environment conducive to fibroid growth;
- Other factors that have been linked to an increased risk of uterine fibroids include early onset of menstruation, never having given birth, vitamin D deficiency, certain environmental exposures, and lifestyle factors such as a high-fat diet, consumption of foods or use of products that contain ingredients that mimic natural estrogen receptors, excessive alcohol consumption, etc.
What Is A Necrotic Fibroid?
The terms fibroid degeneration and fibroid necrosis are often misunderstood or used interchangeably because they are closely related, but they mean two different things. Fibroid degeneration is the action or process of a fibroid breaking down or dying, and necrosis is the condition of the fibroid resulting from the action of degeneration.
A necrotic fibroid is one that is in the process of shrinking and dying as a result of one or more factors. Let’s look a bit closer at degeneration and necrosis to provide more clarity.
What Is Fibroid Degeneration?
Most fibroids do not degenerate on their own, at least not usually prior to menopause. However, degeneration does occur sometimes and can affect women in different ways. The degeneration of fibroids is a natural process where fibroids undergo changes that cause them to shrink or deteriorate over time. Some of the conditions that can trigger fibroid degeneration and create necrotic uterine fibroids include:
- Inadequate Blood Supply
- Fibroids rely on a network of blood vessels that stem from the uterine artery to provide them with what they need to stay alive. Sometimes fibroids grow larger than their blood supply can support, and when this happens, the cells of the fibroid start to die in a process called degeneration. When a fibroid is going through the stages of dying, it is called a necrotic fibroid.
Degeneration of fibroids can be a chronic condition that runs in cycles and causes unpleasant symptoms. The cycle of fibroid degeneration looks something like this:
The fibroid grows large enough to outgrow its blood supply and begins to shrink and die. While it is shrinking and blood-deprived, it creates painful symptoms that may last a few hours, days, or more than a week. During degeneration, as the fibroid becomes smaller, the blood supply becomes sufficient once again, and it starts to regrow. Eventually, the blood supply will no longer be sufficient to support the fibroid, and degeneration will start all over again. The only way to stop this cycle is to eliminate the fibroids.
- Hormonal Changes
- Hormones, particularly estrogen, play a crucial role in the growth and development of fibroids. Excess estrogen levels can impact fibroid growth, triggering degeneration as they outgrow their blood supply. Being aware of sources of excess estrogen and taking measures to avoid them can help mitigate degeneration and the necrosis of fibroids, but to stop the growth of fibroids forever, they must be eliminated.
What Are The Most Common Necrotic Fibroid Symptoms?
When degeneration causes necrosis of fibroids, women may encounter the following symptoms:
- Severe Abdominal Pain: The most common symptom of fibroid necrosis is sudden, intense abdominal pain. The pain usually feels like a sharp stabbing pain and may be localized to the area of the affected fibroid;
- Fever: In some cases, necrosis can lead to an inflammatory response that causes a fever;
- Vaginal Discharge: Necrotic fibroids may cause vaginal discharge that is foul-smelling or may contain blood.
How Are Necrotic Uterine Fibroids Diagnosed?
Sometimes, degeneration and necrotic uterine fibroids can be mistaken for other medical conditions because they produce symptoms that are similar to those of other common issues such as endometrial polyps, pelvic inflammatory disease, ruptured ovarian cysts, adenomyosis, appendicitis, etc.
Necrotic fibroids are often diagnosed during a visit to the emergency room when a woman finds herself with sudden and severe abdominal pain. Typically, a look at your medical history, a physical exam, and an imaging test such as an MRI will help assess the size and location of the fibroid(s) and also identify the source and pattern of the blood flow that they are utilizing.
What Are The Treatment Options For Necrotic Fibroids?
Treatment recommendations for degeneration and necrotic fibroids may depend on the frequency of occurrence, severity of symptoms, and the individual’s unique circumstances.
Conservative management may involve anti-inflammatory pain medication and close monitoring to ensure the symptoms resolve on their own. In more severe cases, where symptoms are debilitating, there is a risk of infection or a cycle pattern of degeneration has been identified, surgical intervention may be recommended by an OB-Gyn. Surgical options such as myomectomy or hysterectomy involve removing the fibroids one at a time or removing the entire uterus. Both surgical options come with elevated risks, the possibility of complications, and long-term side effects.
The Best Treatment To Eliminate The Possibility Of Necrotic Fibroids
Uterine fibroid embolization (UFE), also known as uterine artery embolization, is a minimally invasive procedure used to treat uterine fibroids. It involves blocking the blood vessels that supply the fibroids, thereby depriving them of the necessary blood flow and causing them to shrink.
During the procedure, tiny particles are injected into the blood vessels to block the blood flow to the fibroids. UFE offers an alternative to surgical interventions such as hysterectomy or myomectomy and is associated with shorter recovery times and significantly fewer complications.
It is performed by an interventional radiologist who has been specially trained in the UFE procedure. Once completed, it provides effective and permanent relief from the cycle of degeneration and fibroid-related symptoms such as heavy menstrual bleeding, pelvic pain, and more.
Where To Find Help To Stop The Symptoms Of Fibroids
The Atlanta Fibroid Center is a state-of-the-art medical facility dedicated to providing comprehensive care for women suffering from uterine fibroids. Founded by Dr. John Lipman, a world-renowned specialist in UFE, The Atlanta Fibroid Center has helped countless women find relief from fibroid symptoms and improve their quality of life.
If you have been diagnosed with uterine fibroids or are seeking relief from heavy menstrual bleeding, pelvic pain, or other fibroid-related symptoms, you can trust the expertise of John Lipman, MD and Mitchell Ermentrout, MD at the Atlanta Fibroid Center who will provide compassionate, individualized care and help you make an informed decision about your health. Make an appointment today and start living your best life, free from fibroids.