Uterine fibroids, also known as leiomyomas, are common, non-cancerous growths that develop from the smooth muscle tissue of the uterus. They are one of the most frequent pelvic tumors in women of reproductive age, though many women with fibroids never experience symptoms. When these growths undergo a specific natural change, they can become a calcified fibroid. This form represents a later stage in the fibroid’s life cycle.
Understanding Fibroids and Calcification
A fibroid is a dense, benign mass composed of muscular and fibrous connective tissue. The term “calcified fibroid” refers to a regular fibroid that has accumulated deposits of calcium, which causes the tissue to harden over time. This hardening process is an example of dystrophic calcification, where mineral deposits accumulate in damaged or degenerating tissue. Calcified fibroids are essentially fibroids that have reached an end-stage of their natural progression, becoming inactive due to these mineral deposits. Unlike actively growing fibroids, the calcified variant is stable and less likely to grow.
Why Calcified Fibroids Form
Calcification begins with tissue degeneration, often triggered when a fibroid outgrows its blood supply. As the fibroid increases in size, insufficient blood flow and nutrients lead to cell death, or necrosis, in the central tissue. This damaged tissue then becomes a site for the deposition of calcium phosphate and other circulating minerals. This degenerative process is associated with the natural aging of the fibroid, hormonal shifts, and reduced blood flow to the uterus. Women approaching menopause are more likely to have calcified fibroids because the drop in estrogen levels causes existing fibroids to shrink and degenerate, and medical procedures like uterine fibroid embolization (UFE) can also intentionally induce this degeneration.
Symptoms and How They Are Diagnosed
A calcified fibroid is often asymptomatic because the calcification indicates that the tissue has stabilized and is no longer undergoing active growth. However, symptoms may still be present if the initial fibroid was large or poorly positioned before calcification occurred. These persistent symptoms are related to the fibroid’s size causing pressure on neighboring structures. A woman may experience pelvic pressure, frequent urination if the fibroid presses against the bladder, or constipation if it impacts the rectum. Diagnosis is typically made incidentally during routine imaging, as the hardened calcium deposits are easily visible, often using an ultrasound, CT scan, or X-ray.
Management and Clinical Outlook
Calcification generally signals that the fibroid is benign, stable, and inactive, which leads to a favorable clinical outlook. For fibroids that are not causing any symptoms, the standard management approach is “watchful waiting” or expectant management. This involves monitoring the fibroid over time to ensure no new symptoms develop, rather than immediate intervention. Intervention is considered only if the patient experiences persistent or disruptive symptoms, such as significant pain or pressure. Treatment options range from medications to manage specific symptoms like pain, to surgical procedures such as a myomectomy or hysterectomy, which are reserved for cases where the size or location causes ongoing problems.