What Is Fibroid Degeneration?

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Uterine fibroids are mostly noncancerous tumors that can grow in and on your uterus (womb). They require oxygenated blood to survive and grow. When a fibroid becomes too large, it may become impossible to provide enough blood and nutrients to support the growth of the fibroid. When this occurs, the cells of the fibroid begin to degenerate and die.

Fibroid degeneration can cause fever and acute pain that may require pain medication or surgical intervention. Learn more about fibroid degeneration, including symptoms to look out for, causes, and treatment.

Black woman lying on couch holding lower abdomen in pain

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Fibroid Degeneration Symptoms

Uterine fibroids are growths made of smooth muscle cells and fibrous tissue. These growths develop in or around the uterus (womb) and can appear alone or in groups. They range in size, from as small as a grain of rice to as big as a melon. In some cases, fibroids can grow into the womb itself or outward from the womb on stalks.

You may not be aware you have fibroids—many people with a uterus have no symptoms. The main signs of fibroids include:

For some people with a uterus, a degenerating fibroid is what first draws attention to their fibroids. Common symptoms of fibroid degeneration include:

  • Acute abdominal pain lasting a few days to a few weeks
  • Swelling of the abdomen
  • Fever

Pedunculated Fibroids

Fibroids can grow on a stalk extending out from the uterine wall (pedunculated fibroids). In these cases, the stalk can become twisted, cutting off the blood supply to the fibroid. If this occurs, not only is the pain intense, but it lasts longer than a normal degeneration. In severe cases, surgery may be required to remove the fibroid.

Causes

There are several risk factors that can play a role in your chances of developing fibroids. These can include:

  • A family history of fibroids
  • Not having children
  • Early-onset of menstruation (getting your period at a young age)
  • Late age for menopause

Fibroids are living tissue that needs blood and oxygen to survive. Fibroid degeneration happens when a fibroid grows quickly, and the blood vessels feeding the fibroid may not be able to grow fast enough to supply the new tissue with enough blood and oxygen.

Fibroids are considered estrogen dependent because no prepuberty cases have been described in medical literature and the growths tend to regress after menopause.

The increase in estrogen that occurs during pregnancy can increase the chances of fibroid growth and subsequent degeneration.

Fibroid Degeneration in Pregnancy

The majority of fibroids do not change their size during pregnancy, but one-third may grow in the first trimester of pregnancy. Fibroid enlargement may be influenced by increased estrogen levels during pregnancy.

Large fibroids may undergo degeneration when rapid fibroid growth results in the tissue outgrowing its blood supply, or the growing uterus may cause distortion and kinking of the blood vessels, disrupting the blood supply to the fibroid.

One type of fibroid degeneration, called red degeneration. It occurs in 8% of fibroid growths complicating pregnancy, although the prevalence is about 3% of all uterine fibroids.

Red degeneration is so-called because on examination the degenerating fibroid has a red color. The most common symptom of red degeneration in pregnancy is pain.

Is Fibroid Degeneration a Good Thing?

Though fibroid degeneration does decrease the size of fibroids, this is only temporary—a degenerated fibroid is likely to expand and degenerate again. Though many people with fibroids don’t experience symptoms on a daily basis, when fibroid degeneration starts, it can be uncomfortable and disruptive.

Diagnosis

The first signs of fibroids may be detected during a routine pelvic exam. A number of tests may show more information about fibroids:

  • Ultrasound uses sound waves to create a picture of the uterus and other pelvic organs.
  • Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves.
  • Hysteroscopy uses a slender device (the hysteroscope) to see the inside of the uterus. It is inserted through the vagina and cervix (opening of the uterus). This lets your healthcare professional see fibroids inside the uterine cavity.
  • Laparoscopy uses a slender device (the laparoscope) to help your healthcare professional see the inside of the abdomen. It is inserted through a small cut just below or through the navel. Fibroids on the outside of the uterus can be seen with the laparoscope.

Differential Diagnosis

When fibroids degenerate, they may mimic the symptoms of other medical conditions. If you are unaware that you have fibroids and have lower abdominal pain and fever, your doctor may rule out other causes for your symptoms, including:

Uterine Leiomyosarcoma

A single uterine fibroid that undergoes rapid growth may raise a concern about uterine leiomyosarcoma, which is a rare (less than one in 1,000) cancerous fibroid tumor. Symptoms of this rare tumor include:

  • Pain
  • Unintentional weight loss
  • Nausea and vomiting
  • A lump under the skin

Treatment

If fibroid degeneration is causing pain and discomfort, your doctor may suggest using a heating pad on your abdomen, and pain medication should provide relief for a few days or weeks until the pain subsides.

In order to treat fibroids, your doctor will discuss with you the following options:

Frequently Asked Questions

How long does the pain last from shrinking fibroid degeneration?

Severe pain associated with fibroid degeneration can last anywhere from several days up to four weeks.

How long does fibroid degeneration take?

Unfortunately, there’s no simple answer to how long fibroid degeneration can take. Degeneration is linked to the growth of fibroids, which can be tricky to predict as everyone's fibroids grow at different rates.

We do know that fibroids can grow in the first trimester of pregnancy, and that degeneration is seen most often in pregnant people with large fibroids (greater than 5 centimeters) during the second and third trimesters of pregnancy.

Where does a fibroid go during degeneration?

If a large fibroid goes through the process of degeneration, it can shrink back to a much smaller size as it loses oxygenated blood. As long as it has a supply of blood and nutrients, it will not disappear, but it may be smaller.

What is red degeneration of a fibroid?

Red degeneration is a type of degeneration that occurs most commonly during pregnancy, where as many as 30% of fibroids present will increase in size. It can cause pain and bleeding, which must be investigated by your healthcare provider.

A Word From Verywell

Uterine fibroid degeneration can cause significant discomfort, but thankfully there is treatment available. If you have fibroids and discover you are pregnant, talk to your healthcare provider about what signs to look out for if you are worried about degeneration.

Severe abdominal pain and fever can be a sign of many illnesses, but if you know you have fibroids and you start experiencing sharp lower abdominal pains, speak to your primary care physician.

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9 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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