What symptoms are associated with a degenerating uterine fibroid?

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Symptoms of a Degenerating Uterine Fibroid

A degenerating uterine fibroid typically presents with acute pelvic pain, nausea, fever, and leukocytosis, which is known as post-embolization syndrome when occurring after uterine artery embolization treatment. 1

Key Symptoms of Fibroid Degeneration

  • Acute pelvic pain - The most common presenting symptom, often severe and of sudden onset 1
  • Fever - Part of the flu-like syndrome associated with fibroid degeneration 1
  • Nausea - Commonly accompanies the pain and fever 1
  • Leukocytosis - Elevated white blood cell count due to inflammatory response 1

Additional Associated Symptoms

  • Vaginal expulsion - Particularly with submucosal fibroids that are breaking down 1
  • Abdominal bloating - Due to inflammation and swelling 2
  • Constipation - From pressure on surrounding structures 2
  • Menorrhagia - Heavy menstrual bleeding may worsen during degeneration 2

Severe Complications

  • Hemorrhage - In rare cases, a degenerating fibroid may rupture, causing acute intraabdominal hemorrhage requiring emergency intervention 2
  • Increasing abdominal distress - Symptoms may rapidly worsen over hours, indicating potential complications 2

Red Degeneration During Pregnancy

  • Fibroids may enlarge during pregnancy and undergo red degeneration, causing significant pain 3
  • This is a specific type of degeneration that occurs more commonly in pregnant women 3

When to Seek Immediate Medical Attention

  • Severe, unrelenting abdominal pain 2
  • Signs of hypovolemic shock (dizziness, rapid heart rate, hypotension) 2
  • Rapid increase in abdominal girth with pain 2
  • High fever with severe pelvic pain 1, 2

Diagnostic Considerations

  • Symptoms of degenerating fibroids may mimic other acute abdominal conditions 2
  • Imaging studies (ultrasound, CT scan) are typically needed to confirm the diagnosis 3, 2
  • Rapid growth of fibroids with pain should raise concern for potential sarcomatous change, though this is rare 3

Recognizing these symptoms promptly is crucial as some cases of fibroid degeneration, particularly those involving rupture, may require emergency surgical intervention to prevent serious morbidity or mortality 2.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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