Fibroids or leiomyomas are non-cancerous growths (tumors) that form on or in the uterus. Uterine fibroids are very common and approximately 80% of women, who have a uterus, will experience fibroids by the time they are 50 years old. A woman can have only one fibroid or many and they can be small (like a pearl) or can grow as large as a pumpkin.
Some women will be asymptomatic and never know they have fibroids while others may suffer every month if their fibroids are left untreated. If fibroids grow too large they can begin to degenerate and can cause severe pain. Today we are going to address fibroid degeneration and the symptoms of dissolving fibroids.
How Are Fibroids Formed?
The medical community still does not know what causes fibroids to grow but they do understand some of the risk factors that are associated with uterine fibroids. They are also aware of certain factors that promote the growth of fibroids. Some of the factors that put women at risk for fibroids are:
- Age – fibroids are most often found in women aged 30-40s;
- Early-onset of the menstrual cycle;
- Family history;
- African American women are 2 to 3 times more likely to experience fibroids;
- Vitamin D deficiency;
- Estrogen dominance.
Fibroids are formed from the same type of muscle tissue that is found inside the uterine wall. They can be attached directly to the uterus or they can grow from a stalk-like structure called a peduncle. They are usually round or oblong, appear smooth, and are hard as a rock.
What Makes Fibroids Grow?
Small fibroids may or may not cause unpleasant symptoms but when fibroids grow large they can create many problems. Although the cause of fibroids is not fully understood, research has provided some details in relation to what causes fibroids to grow larger.
Fibroids thrive in estrogen-rich environments. Today, most women experience levels of estrogen exposure far and above what is healthy. Estrogen exposure can be due to:
- Girls beginning their periods at younger ages (elevated estrogen exposure levels);
- Women having no children or fewer children;
- Carrying extra weight as body fat promotes elevated estrogen storage levels;
- Exposure to substances that mimic estrogen and “attach” themselves to a woman’s natural estrogen receptors, damages them, and inhibits or eliminates their functionality.
Some sources of estrogen exposure include:
- Food additives;
- Parabens in personal care products and 90% of grocery items;
- Certain medication;
- Oral contraceptives;
Excessive estrogen exposure can promote fibroid growth and this is why many pregnant women will experience rapid growth of a fibroid during their first trimester of pregnancy.
What Keeps Fibroids Alive?
Fibroids are attached to the main artery in the uterus by a network of blood vessels. Without these blood vessels, the fibroid would not be able to survive.
What Is Fibroid Degeneration?
Sometimes, fibroids will grow large enough that they “outgrow” the blood vessels that are feeding them. These fibroids will then begin to shrink or degenerate as some cells die off reducing them to a smaller size that the blood vessels can support. The process of fibroids shrinking is referred to as fibroid degeneration.
Sometimes, degeneration will alleviate some of the side effects caused by fibroids but unfortunately, this is only temporary. The fibroids will begin regrowing again to a larger size and the cycle will continue to repeat. The only way to keep them from regrowing is to treat and eliminate the fibroids.
What Happens When Fibroids Start to Shrink?
Many women experience symptoms related to fibroids, especially during their periods. These symptoms include heavy and/or prolonged menstrual bleeding, (sometimes severe enough to cause anemia), abdominal pain and pressure, urinary incontinence, and back or leg pain, and they can even cause fertility issues. But the signs of fibroids breaking down or degenerating are markedly different and more intense.
Do Fibroids Hurt When Shrinking?
One of the tell-tale signs of a fibroid shrinking due to degeneration is a severe stabbing-like pain in the abdomen accompanied by swelling. This happens because, as the fibroid shrinks and its cells die, chemicals are released into the abdominal cavity. Other signs of fibroids shrinking include:
- Vaginal discharge that is watery or could look like a pinkish-tinged discharge;
- Sharp abdominal pain or localized pain near the fibroid;
- Dull achy pelvic pain;
- Elevated white blood cell count.
Do Fibroids Bleed When They Shrink?
Shrinking fibroids can cause abnormal and severe bleeding. If you experience heavy bleeding that is abnormal for you, seeking immediate medical care is recommended.
Are All Degenerating Fibroids the Same?
There are different types of degeneration that can occur in a fibroid due to the restriction of blood flow.
1. Hyaline Degeneration
The smooth muscle and tissue that normally make up the fibroid convert into hyaline tissue and become similar to the cartilage which looks glossy and smooth. Hyaline degeneration makes up approximately 64% of fibroid degeneration cases.
2. Myxoid Degeneration
Myxoid degeneration happens in about 19% of fibroid degeneration cases and sort of looks like the fibroid is melting (when observed under a microscope). The connective tissue looks like clear mucus. This type of degeneration looks similar to a rare type of cancer so pathologists should take care to ensure their diagnosis is correct.
As a fibroid is dying, some of the connective fibrous tissue is converted into calcium deposits and forms a hard mass. Around 8% of fibroid degeneration cases contain calcification.
4. Cystic Degeneration
This type of calcification accounts for about 4% of fibroid degeneration cases and normally presents after menopause. The fibrous connective tissues resemble a honeycomb pattern when they are viewed under a microscope. Cystic degenerating fibroids can look similar to ovarian cysts.
5. Red Degeneration
This is the least common type of degeneration and only occurs about 3% of the time. This is the type of fibroid breakdown that is most often associated with pregnancy but does occur in non-pregnant women. The dying fibroid turns red and is caused by internal bleeding from a ruptured blood vessel deep within the fibroid.
Two forms of red degeneration are:
- Necrobiosis Fibroid Degeneration
- A variation of red degeneration or a fibroid breaking down can occur during pregnancy. The blood vessels that are feeding the fibroid can become kinked due to the growing uterus or the uterus becoming distorted due to fibroid growth. Necrobiosis can cause acute abdominal pain and bleeding both of which would raise alarm during pregnancy.
To ensure the safety of both mother and baby, it is best to seek immediate medical attention.
- Pedunculated Fibroid Torsion
- Although rare, sometimes fibroids that are growing from a stem or stalk can twist which suddenly cuts off the blood supply to the fibroid. This form of red degeneration requires immediate medical attention.
The pain is usually sudden, severe, and lasts much longer than what is experienced during a slower degeneration process. A fibroid that is breaking down due to torsion may require surgery.
How Long Do Symptoms of Degenerating Fibroids Last?
The pain associated with a degenerating fibroid can last a few days or it can last a couple of weeks. Women often use over-the-counter anti-inflammatory pain medications or heating pads to help ease their discomfort.
The best way to stop the unpleasant symptoms and pain caused by fibroids breaking down is to eliminate the fibroids.
Stopping the YO-YO Symptoms of Degenerating Fibroids
As fibroids shrink from degeneration, their initial blood supply will once again be able to provide an adequate amount of blood. The symptoms they cause may ease up however, this cycle is only on “pause” for a small amount of time until the fibroid outgrows the blood supply once again.
This painful cycle can repeat countless times until the fibroids, which are the source of degeneration, are eliminated.
Eliminating the fibroids can be done safely and effectively through a non-surgical procedure called uterine fibroid embolization (UFE).
Uterine Fibroid Embolization (UFE) To Eliminate Fibroids
UFE is performed by an Interventional Radiologist as an outpatient procedure. UFE works by cutting off the blood supply to the fibroids causing them to shrink and die.
During the non-surgical UFE procedure, any type of fibroid that is attached to blood vessels connected to the Uterus can be reduced or eliminated. Patients are discharged to return home to recover the same day with only a Band-Aid as evidence of their procedure.
Recovery normally takes about a week and patients may experience cramping and pain for about 3 to 4 days as the fibroids begin to die off. As unpleasant as these 3 to 4 days can be, when compared to recovery after surgery or ongoing fibroid symptoms it will be very worth it.
If you have been diagnosed with fibroids or are exhibiting symptoms associated with fibroids, contact the Atlanta Fibroid Center today and set up a consultation with Dr. John Lipman or Dr. Mitchell Ermentrout. We have been helping women from all over the world become free from fibroid symptoms through expertise in performing uterine fibroid embolization for over 28 years. Contact us today!