Fibroid expulsion describes the process where a uterine fibroid, a non-cancerous growth within the uterus, is naturally passed out of the body through the vagina. This phenomenon can sometimes occur spontaneously or following certain medical procedures.
Understanding Fibroid Expulsion
Fibroid expulsion is more common with submucosal fibroids, which grow just beneath the inner lining of the uterus, or pedunculated fibroids, which are attached by a stalk. During expulsion, the uterus contracts, similar to labor or strong menstrual cramps, to push the fibroid through the cervix and into the vaginal canal. This can happen spontaneously due to changes in blood supply or hormonal shifts that cause the fibroid to degenerate. More frequently, it is observed after uterine fibroid embolization (UFE), a procedure that cuts off blood flow to the fibroids, causing them to shrink and sometimes detach. The expelled tissue can vary in appearance, sometimes resembling dark, clotted discharge mixed with fragments, or even appearing as a single, flesh-like mass that may be pale yellow or tan.
Recognizing Warning Signs
While fibroid expulsion often occurs without severe complications, certain signs indicate a need for immediate medical attention. Excessive bleeding is a primary concern, characterized by soaking one or more sanitary pads or tampons hourly for several consecutive hours, or passing blood clots larger than a quarter. Such significant blood loss can lead to anemia, causing symptoms like dizziness, weakness, or fainting due to reduced oxygen delivery throughout the body.
Severe pain, often described as intense cramping or labor-like contractions, can accompany fibroid expulsion as the uterus works to expel the tissue. A fever, particularly when combined with foul-smelling vaginal discharge, suggests a potential infection. If a fibroid is only partially expelled, it can create a risk of infection or continued bleeding, requiring further intervention.
Seeking Medical Care
If you suspect fibroid expulsion, especially with any concerning symptoms, contacting a healthcare provider promptly is important. For those who have undergone uterine fibroid embolization, reaching out to the interventional radiologist who performed the procedure is often the first step. They may recommend an MRI to confirm the expulsion and assess the situation.
In cases of heavy bleeding, severe pain, or signs of infection, seeking immediate medical care, such as visiting an emergency room, is advisable. Medical evaluation helps determine the extent of blood loss, rule out complications, and provide appropriate management. Interventions might include pain medication, antibiotics for infection, or procedures like hysteroscopy to remove any remaining fibroid tissue.
Differentiating Expulsion from Other Conditions
Distinguishing fibroid expulsion from other gynecological events can be challenging due to overlapping symptoms. A miscarriage, for instance, can present with similar signs such as vaginal bleeding and the passing of tissue. Due to this similarity, a medical professional’s evaluation is necessary to accurately determine the cause of symptoms and ensure appropriate care. Fibroid expulsion can also be confused with exceptionally heavy menstrual bleeding, a common symptom of fibroids themselves. While a typical period involves blood loss up to 80 milliliters over no more than eight days, fibroids can cause bleeding that is significantly heavier or lasts longer, sometimes with large clots.