Uterine fibroids are non-cancerous growths that develop in or on the muscular walls of the uterus. Many women develop fibroids at some point in their lives, but often have no symptoms and require no treatment. For those with troublesome symptoms, there are a variety of treatment options available, including natural and medical approaches.
What are fibroids?
Fibroids are tumors made up of muscle cells and other tissues that grow in and around the wall of the uterus. While the exact cause is unclear, fibroids seem to be influenced by estrogen and progesterone levels. This explains why they tend to appear during the reproductive years and shrink after menopause.
There are several types of fibroids:
- Intramural – within the muscular uterine wall
- Submucosal – just under the lining of the uterine cavity
- Subserosal – projecting out from the uterus into the pelvis
- Pedunculated – connected to the uterus by a long stalk
Fibroids can range greatly in size – from microscopic to several inches across. Some women develop just one while others have multiple fibroids of varying sizes and locations in the uterus.
What causes fibroids?
The exact cause is unknown but fibroids seem to be influenced by:
- Estrogen – fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells
- Genetics – having a family history increases risk
- Extra uterine tissue in the wall during development
- Abnormal growth factors
Other possible factors include obesity, eating habits, stress, and environmental toxins. Research continues to try to pinpoint causes and risk factors.
Common symptoms
Many women with fibroids have no symptoms at all. In those who do experience problems, symptoms may include:
- Heavy, prolonged menstrual periods
- Pelvic pain and pressure
- Frequent urination
- Low back pain
- Pain during intercourse
- Reproductive issues, such as infertility, multiple miscarriages, or early labor
Symptoms depend on the number, size, and location of the fibroids. Submucosal fibroids that crowd the interior of the uterus are most likely to cause heavy menstrual bleeding and reproductive problems.
When to see a doctor
Schedule an appointment with your doctor if you experience any persistent gynecologic symptoms or have any concerns about fibroids. Your doctor can determine if fibroids are the cause of your symptoms after performing a pelvic exam and imaging tests such as an ultrasound.
Can you pass fibroids naturally?
It is possible for small fibroids to be expelled from the uterus naturally in some cases. This occurrence is often referred to as passing fibroids. The medical term for this process is fibroid expulsion or spontaneous fibroid expulsion.
How does fibroid expulsion work?
Fibroids that develop within the uterine cavity (submucosal) or just under the surface of the uterine lining (intramural) can sometimes detach and be passed out through the cervix and vagina. This occurs rarely as most fibroids are embedded too deeply in the uterine muscle to be shed.
When a fibroid does manage to make its way out, it is often after the uterus has contracted powerfully, such as during menstruation or labor. The strong contractions essentially squeeze the growth until it separates from the uterine wall. The fibroid then moves downwards through the cervix, guided by gravity and continuing muscular contractions.
What to expect
For most women the process of passing a fibroid occurs without major symptoms or complications. It may feel similar to passing a large blood clot during menstruation. Women typically report:
- Feeling pressure, fullness, or cramps in the pelvis/lower abdomen
- Intense cramping right before passing tissue
- Seeing large tissue fragments in the toilet after urinating
- Moderate bleeding that resolves quickly
Severe pain, excessive bleeding, or fever can be signs of a complication such as tissue becoming stuck in the cervix. Seek emergency care right away if these occur.
Does size matter?
Yes, fibroid size plays a role in whether it can be passed naturally. Expulsion becomes less likely as the growth increases in size:
- Less than 2 cm – high chance of expulsion
- 2 – 5 cm – moderate chance
- Over 5 cm – unlikely to be passed
Giant fibroids over 10 cm are essentially impossible to pass without medical help. However, even medium or large growths can sometimes detach if conditions are right.
Can passing fibroids reduce symptoms?
Passing a fibroid leads to nearly immediate symptom relief for most women. Common improvements include:
- Reduced menstrual bleeding and cramping
- Less pelvic pain and pressure
- Increased fertility and fewer miscarriages
If bothersome symptoms return later, it could mean remaining fibroids are still present and potentially growing. Follow up with your doctor for reevaluation.
Natural ways to pass fibroids
While fibroid expulsion usually happens spontaneously, there are some natural ways women can potentially help facilitate passing fibroids and find symptom relief:
1. Apply heat
Heat in the form of hot packs, baths, or compresses may encourage relaxation of the cervix and promote downward movement. Try lying over a hot water bottle or towel-wrapped heating pad placed on the lower abdomen for 15-20 minutes at a time.
2. Massage
Gentle massage of the lower abdomen may help stimulate contractions to push fibroids downward. Using a few drops of relaxing essential oils can enhance the massage. Avoid massaging if you have severe pain or think the tissue is prone to twisting.
3. Support uterine health
Some supplements and herbs thought to help strengthen uterine muscle tone and encourage circulation include red raspberry leaf, motherwort, and Dong quai. Speak to a knowledgeable practitioner before use.
4. Stay hydrated
Drinking plenty of fluids may make passing tissue easier by softening the cervix and preventing any tissue from sticking. Herbal teas and electrolyte-rich drinks can prevent dehydration from heavy bleeding.
5. Improve bowel regularity
Avoiding constipation can minimize pelvic pressure and cramping. Eat high fiber foods, exercise, drink fluids, and consider a natural laxative if needed. Proper bowel function may help with expulsion.
6. Orgasm
Orgasms produce strong uterine contractions that may help loosen and propel fibroids downwards. While not proven, achieving orgasm through intercourse or masturbation could facilitate expulsion.
When to seek medical treatment
While passing small fibroids naturally may provide relief for some women, medical treatment is often still needed for larger growths or ongoing symptoms. See your doctor promptly if you experience:
- No improvement in symptoms from a passed fibroid
- Fibroids over 5 cm in size
- Persistent heavy bleeding or anemia
- Severe pain or fever
- Fibroids during pregnancy
- Reproductive problems thought to be caused by fibroids
Treating larger fibroids requires procedures like uterine artery embolization or myomectomy surgery. Your doctor can help determine the best options based on your health profile and symptoms.
Can fibroids come back after passing them?
Yes, new fibroids can sometimes grow after passing one naturally. This occurs if the original fibroid growth was due to underlying conditions that have not changed, such as:
- Genetic predisposition
- Hormonal imbalances
- Diet and lifestyle factors
- Other medical conditions
After passing a fibroid, new monitoring or preventive approaches may be beneficial. Your doctor can advise you on possible next steps to help minimize recurrence.
Follow-up care
To monitor for potential regrowth, your doctor will likely recommend:
- Periodic pelvic exams
- Imaging tests such as ultrasounds
- Tracking symptoms like menstrual changes
Prompt follow-up care can catch any new fibroids early when they are smallest and easiest to treat.
Prevention strategies
Some women opt for lifestyle changes after passing fibroids naturally to try to prevent recurrence. Areas to focus on include:
- Diet – Eating more fruits, vegetables, and whole grains can help maintain normal estrogen levels.
- Exercise – Regular activity helps reduce excess estrogens and maintain a healthy weight.
- Stress management – Finding healthy ways to cope with stress can minimize factors that may encourage fibroids.
- Supplements – Some women try supplements thought to support hormone balance, such as vitex, green tea extract, and turmeric.
Ask your healthcare provider for personalized diet, exercise, and lifestyle tips to lower your chances of growing new fibroids.
When to consider fibroid removal procedures
If fibroids continue causing significant symptoms after attempting natural expulsion and preventive strategies, surgical procedures may be an appropriate option. Common fibroid removal procedures include:
Myomectomy
In this surgery fibroids are surgically cut out while leaving the uterus in place. It preserves the ability to get pregnant in the future.
Hysterectomy
Surgical removal of the entire uterus provides a permanent solution. Hysterectomy ends the ability to get pregnant.
Endometrial ablation
This procedure destroys the uterine lining to control heavy bleeding. Pregnancy is unlikely afterward.
Uterine artery embolization
Blocking the uterine artery cuts off blood flow causing fibroids to shrink. Pregnancy can be more high-risk afterward.
Discuss all options thoroughly with your gynecologist to decide on appropriate next steps for your situation.
The bottom line
Passing small fibroids naturally only happens occasionally, but can provide prompt relief when it does occur. While encouraging expulsion gently is an option, medical management is still needed for most symptomatic fibroids. Work with your gynecologist to determine the best personalized treatment plan.
