Uterine fibroids are common, non-cancerous growths that develop within the uterus. Many wonder if they might be passing these growths during their period. This article clarifies the nature of fibroids and the types of tissue that can be expelled during menstruation.
Understanding Uterine Fibroids
Uterine fibroids, also known as leiomyomas, are non-cancerous growths of muscle and fibrous tissue that form in or on the uterine wall. They vary significantly in size, from microscopic to larger than a grapefruit, and can occur as a single nodule or in clusters.
Fibroids are categorized by location: intramural (within the muscular wall), submucosal (under the inner lining), and subserosal (on the outer surface). Pedunculated fibroids, a less common type, attach to the uterus by a stalk. Their growth is linked to hormones like estrogen and progesterone, and they tend to shrink after menopause.
The Likelihood of Passing a Fibroid
Directly expelling an entire uterine fibroid through the vaginal canal during menstruation is rare. Fibroids are typically embedded within the uterine wall or firmly attached, making natural detachment uncommon. However, certain types, particularly pedunculated submucosal fibroids, might detach if their stalk twists, cutting off blood supply and leading to expulsion.
This process, known as fibroid degeneration, occurs when a fibroid outgrows its blood supply, leading to cell death. While the fibroid tissue may shrink or break down, it is far more common to pass blood clots or other uterine tissue than a whole fibroid. Such an event is often associated with heavy bleeding and intense cramping.
What You Might Be Passing
During heavy periods, individuals with fibroids often pass various types of material. Large blood clots are common, especially during heavy flow, when the body’s natural anticoagulants cannot keep menstrual blood entirely liquid. These clots can appear bright red or burgundy, often resembling mashed-up fruit or liver-like tissue, and vary in size.
Another possibility is passing necrotic or degenerated fibroid tissue. As discussed, when a fibroid degenerates, its tissue can break down and be expelled. This tissue might appear fleshy or resemble “dead tree pulp.” Additionally, fibroids can cause the uterine lining to thicken, and pieces of this lining may be shed during menstruation, contributing to heavy flow.
When to Seek Medical Attention
Consult a healthcare professional if you experience unusual menstrual symptoms or are concerned about what you might be passing. Symptoms warranting medical attention include extremely heavy bleeding, defined as soaking through sanitary products every one to two hours for several consecutive hours, or periods lasting longer than seven days. Passing large blood clots, particularly those larger than a quarter, also indicates a need for evaluation.
Other concerning symptoms include severe, unmanageable pelvic pain, bleeding or spotting between periods, or signs of anemia like persistent fatigue, weakness, shortness of breath, dizziness, or pale skin. A healthcare provider can conduct a physical examination, often including a pelvic exam, and may order imaging tests like an ultrasound to assess the uterus and identify fibroids. Blood tests may also be performed to check for anemia or other conditions.