Uterine fibroids are dense, noncancerous tumors made of smooth muscle and fibrous connective tissue that can grow in or on the uterus. They don’t contain fluids themselves, but they can lead to fluid-expelling symptoms such as heavy menstrual bleeding, bleeding between periods, the passing of large blood clots, and pink or watery vaginal discharge. In rare cases, fibroid tissue can also be expelled through the vagina.

Fibroid tissue may pass after a minimally-invasive procedure to treat fibroids, such as uterine fibroid embolization (UFE) or MRI-guided focused ultrasound (MRgFUS). Both procedures kill fibroid tissue, the former by depriving fibroids of their blood supply, and the latter by bombarding the fibroids with high-intensity ultrasonic waves of heat. As a result, the fibroid tumors shrink, but the remaining tissue is not removed.

In some patients, the tissue eventually pulls away (sloughs) from the uterine wall on its own and is discharged through the vagina. One study found that this is most likely to happen during the first year following UFE, usually within the first couple of months, though another study reported occurences more than three years after the procedure.

Approximately 5% of people who undergo UFE experience this fibroid sloughing, and it’s more common with submucosal fibroids, which protrude into the uterine cavity, and pedunculated fibroids. Fibroid tissue expulsion may be accompanied by sudden, severe cramps and malodorous vaginal discharge. The process is typically complete within 36-48 hours.

If symptoms persist, and the fibroid fragment (or whole fibroid, in some cases) does not pass, you may need to have your doctor perform a procedure to remove it. Symptoms to watch for include:

• Heavy bleeding
• Sudden bleeding after your initial post-UFE bleeding has stopped
• Persistent pain
• Fever

Some pain and vaginal bleeding (red, pink, or brownish) is normal immediately after UFE, and is not a cause for concern. There is a chance of infection, however, so the aforementioned symptoms, particularly if they are severe and accompanied by an unpleasant smell and vaginal discharge, would suggest a call to your doctor.

While self-care and comfort techniques are highly recommended, fibroid discharge does not necessarily require medical treatment. If the discharge is concurrent with or the result of an infection, then your doctor will likely prescribe antibiotics.

On rare occasions, dead fibroid tissue does not completely detach from the wall of the uterus, and hangs down toward the cervix without entering the vagina. Your doctor can perform a procedure called dilation and curettage (D&C) which involves scraping the inner lining of the uterus to resolve this.

A D&C or other procedures, such as operative transvaginal myomectomy and hysteroscopic fibroid resection, can also help resolve complications like excessive bleeding, and either partial or high volume of tissue expulsion.

Speak with your doctor about any symptoms of concern and ask about all available treatment options, to determine what’s best for you and your situation.