Uterine fibroids, also known as leiomyomas, are common, non-cancerous growths that develop within the muscular wall of the uterus. They consist of smooth muscle cells and connective tissue, ranging in size from microscopic seedlings to bulky masses. Fibroids are the most common non-cancerous tumor in women, affecting a significant portion of women by age 50. While many fibroids remain stable or shrink without intervention, some women experience intense symptoms, leading to questions about whether these growths can naturally leave the body.
What Uterine Fibroids Are
Uterine fibroids are dense masses composed of smooth muscle and fibrous connective tissue that grow in or on the wall of the uterus. They are classified based on their location, with three main types: intramural, subserosal, and submucosal fibroids. Intramural fibroids are embedded within the muscular wall, while subserosal fibroids bulge from the outer surface of the uterus.
Submucosal fibroids project into the uterine cavity itself. The presence of fibroids can lead to symptoms such as heavy or prolonged menstrual bleeding, which may cause anemia. Other common symptoms involve pelvic pressure, frequent urination due to bladder compression, and sometimes pain during intercourse.
When Fibroids Can Be Expelled Naturally
It is possible for fibroids, or fragments of them, to be expelled from the body through the vagina, though this phenomenon is rare. This natural expulsion, often called “fibroid delivery,” typically involves fibroids positioned to interact directly with the uterine cavity and the cervix. The submucosal fibroid is the most common type involved, as it grows beneath the inner lining and protrudes into the space where menstrual flow exits.
Another type prone to expulsion is the pedunculated fibroid, which is attached to the uterine wall by a slender stalk. If this fibroid grows toward the inside of the uterus, the stalk can twist or uterine contractions may push the mass toward the cervical opening. Complete expulsion is medically confirmed but occurs in less than 5% of symptomatic cases.
The Process of Necrosis and Sloughing
The expulsion process is often preceded by necrosis, which is the death of the fibroid tissue. Necrosis occurs when the fibroid outgrows its blood supply or when the stalk of a pedunculated fibroid twists, cutting off oxygen and nutrients. This loss of blood flow causes the fibroid’s internal structure to degenerate, leading to cell death.
Once the tissue is necrotic, the body attempts to shed the material through a process known as sloughing. Uterine contractions, similar to those during labor or a heavy period, push the dead mass through the cervix and out of the vaginal canal. This results in the passage of tissue fragments or, rarely, the entire fibroid, which may resemble a fleshy mass or large clots.
The sloughing process can be accompanied by intense, labor-like cramping and significant vaginal bleeding. The release of chemicals from the dying cells during degeneration causes the sharp, severe pain associated with this event. The expelled tissue may also cause a foul-smelling discharge if it remains in the body before being passed.
Immediate Medical Guidance
If a person believes they have passed fibroid tissue, immediate medical evaluation is necessary to prevent complications. It is important to collect the passed tissue, if possible, for pathological analysis to confirm it is benign fibroid tissue and to rule out other conditions. The primary risks following a natural expulsion include hemorrhage (excessive blood loss) and infection due to necrotic or retained tissue.
A physician will perform an examination to ensure the fibroid has been completely expelled and no fragments remain attached to the uterine wall. Retained tissue can cause infection or continued bleeding, sometimes requiring a small procedure to remove remaining pieces. Seeking prompt medical attention ensures the proper management of pain, bleeding, and the prevention of serious issues like sepsis.