Uterine fibroids (leiomyomas or myomas) are common non-cancerous growths developing from the muscle tissue of the uterus. They affect many women, often causing symptoms such as heavy bleeding or pelvic pressure. While most fibroids are managed through medication or surgical removal, a rare occurrence involves the body naturally expelling the fibroid tissue through the vagina. This physiological event, where the uterus attempts to shed the foreign mass, can be unexpected. Understanding the physical sensation and appearance of the tissue is important.
The Process of Fibroid Expulsion
Fibroid expulsion typically occurs with specific types of fibroids: submucosal fibroids (projecting into the uterine cavity) or pedunculated fibroids (attached by a thin stalk). The process begins when the fibroid undergoes degeneration, known as necrosis, resulting from a loss of blood supply. This causes the tissue to die and detach from the uterine wall, making it a foreign body.
The uterus recognizes this necrotic tissue and initiates strong, rhythmic contractions to push it out, similar to expelling a menstrual clot. These contractions aim to dilate the cervix and move the fibroid through the vaginal canal. Expulsion can happen spontaneously or as an infrequent outcome following treatments like Uterine Fibroid Embolization (UFE), which deliberately cuts off the blood supply. The duration can vary, sometimes occurring over days as the tissue slowly separates and is pushed outward.
Physical Description of Passed Fibroid Tissue
Expelled fibroid tissue is distinct from the typical blood clots seen during heavy menstruation. Unlike soft, jelly-like blood clots, fibroid tissue is generally solid, dense, and firm, often described as having a rubbery or fibrous texture. This difference is due to the fibroid’s composition of smooth muscle and connective tissue.
The color of the passed tissue is variable, often appearing pale, ranging from grayish-white to pinkish-brown, or sometimes a darker purple or reddish-brown hue. The color variation results from necrosis and the amount of blood trapped within the degenerating tissue. The shape is typically irregular or nodular, sometimes resembling raw meat due to its solid, fleshy nature. Expelled fibroids may pass whole or in several fragments, depending on their original size and how the degeneration occurred.
Symptoms Accompanying Expulsion
The physical experience during fibroid expulsion is characterized by intense pelvic pain and cramping. This sensation is frequently described as labor-like, as the uterus contracts forcefully to push the mass through the narrow cervical opening. This pain is far more severe than standard menstrual cramping and may be accompanied by a feeling of pressure or fullness in the pelvic area.
Heavy vaginal bleeding is another common symptom, sometimes resembling a hemorrhage as the fibroid detaches from the uterine lining. The bleeding may be sudden and profuse, often mixed with the degenerating tissue fragments. Once the mass successfully passes through the cervix and out of the vagina, patients often report an immediate reduction in the severe cramping and pressure. Secondary symptoms such as nausea, dizziness from blood loss, or a low-grade fever may also occur due to the inflammatory response caused by the tissue necrosis.
Necessary Medical Follow-up
Anyone who suspects they have passed fibroid tissue must contact a healthcare provider immediately for medical evaluation. While expulsion may resolve the immediate issue, medical confirmation is necessary to ensure there are no complications, such as infection or incomplete expulsion. The provider will often advise the patient to collect and preserve the expelled tissue for pathological examination.
To preserve the tissue, place it in a clean, sealed container or plastic bag and refrigerate it until transport to the clinic or hospital. Pathology testing is the definitive way to confirm the tissue’s identity and rule out other serious conditions. Individuals should watch for emergency signs, including soaking through more than one sanitary pad per hour for several hours, severe dizziness, or a persistent fever, as these may indicate excessive blood loss or infection requiring immediate emergency care. Subsequent diagnostic imaging, such as an ultrasound, will confirm that the entire fibroid was expelled and check for any remaining fragments within the uterine cavity.