Ask Dr. John Lipman: Can Fibroids Burst?

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“I have fibroids but not any symptoms. My girlfriend said she read about fibroids bursting and told me to see a doctor for this and have them removed. Is that correct?”

Uterine fibroids are very common; particularly in adult African American women (~80%). Some women with fibroids do not have symptoms and do not need any treatment for them.

Fibroids are benign, noncancerous tumors. They can cause heavy periods, pelvic pain/pressure which can radiate in to the back or legs, increased urinary frequency, painful sex just to name some of the more common symptoms.

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If there are no symptoms, you don’t have to have anything done for the fibroids, but we still encourage people to make healthy eating choices, regular exercise, and try to be as close to their ideal body weight as possible.

Can Uterine Fibroids Burst?

Fibroids grow with estrogen and estrogen is stored in body fat. Avoiding exogenous hormones, hormone-rich foods, shedding excess body fat, exercise, increase outdoor activities, and supplementing with vitamin D as needed are some of the best ways to keep the fibroids from causing symptoms in the future. It’s also helpful for your overall cardiovascular health.

Fibroids have a rather simple blood supply with vessels at the perimeter of each fibroid. Nutrients brought in to the fibroid from these vessels have to rely on simple diffusion out of the vessel in to the surrounding fibroid.

However, as the fibroid grows, the center of the fibroid gets increasingly farther away from the perimeter and is vulnerable to ischemia (lack of blood flow) and if it continues, leads to the death of fibroid cells. This is called degeneration and can cause very sudden and severe pain; often localized to the specific fibroid that is dying.

The pain will typically continue until enough of the fibroid dies that the remainder can be adequately nourished by the available blood supply. However, with more growth of the fibroid, more degeneration can occur with a return of the pain. This will often prompt a woman to seek urgent or emergent care.

⇒ Related: Uterine Fibroid Embolization (UFE) as Nonsurgical Fibroid Treatment Option

If the pain from degeneration is not as severe, it can last for days and even a couple of weeks, but still should be evaluated by a physician.

If the fibroid happens to be located on the right side of the uterus, this can initially mimic signs of appendicitis.

In unusual circumstances, a fibroid that is on a stalk connected to the outer surface of the uterus (i.e. pedunculated subserosal fibroid) can twist and abruptly interrupt the blood supply to the fibroid causing extreme pain; which is typically even more intense than a degenerating fibroid. On extremely rare occasions, fibroids can rupture and cause intra-abdominal bleeding and is an emergency that is handled surgically.

For more information on fibroids make an appointment online or call the Atlanta Fibroid Center at 770-953-2600.

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