Uterine fibroids are still benign tumors as long as they are called “tumors”, but they can also “degenerate” for a variety of reasons. The term “sex change” is a somewhat sensational term for the difference between men and women, usually referring to male to female, or vice versa. So, what is the “sex change” of fibroids? The so-called degeneration of uterine fibroids, in most cases, is just a degenerative change of uterine fibroids due to chronic or acute ischemia, only a very small number of degeneration is malignant. Degeneration of uterine fibroids mostly occurs when the growth of fibroids is accelerated and blood flow is relatively insufficient, such as during pregnancy, after childbirth and after menopause. Usually, the texture of fibroids becomes softer after degeneration, but there are also cases where the texture becomes harder. The main types of degeneration are as follows: 1. vitreous degeneration or hyaline degeneration: mainly due to the lack of blood supply to the fibroids, the fibroids become edematous, liquefied and finally replaced by glass-like material. When examined by a gynecologist, the texture of the fibroids will be found to be softened. 2. Cystic degeneration: Most of them occur after vitreous degeneration. The glass-like material liquefies and forms a cystic cavity, making the originally hard fibroids as soft as a deflated ball, which can be easily misdiagnosed as ovarian cysts. 3. Fatty degeneration and calcification: fat cells increase within the myocytes in uterine fibroids, and fatty degeneration occurs. Further development makes the fibroids calcify, and the texture is much more win than normal fibroids, hard as a stone. If you do an abdominal X-ray, sometimes you can even see a high-density calcification shadow that cannot pass through the X-ray. 4, red degeneration: Most of them occur during pregnancy, but they can also occur after delivery, mostly due to acute ischemia of fibroids, such as embolism of the blood vessels supplying fibroids, or ischemia of twisted fibroids with tissues. Necrosis and hemorrhage can occur in ischemic myoma tissue. Hemorrhage, hemolysis, and hemoglobin infiltration into the fibroid tissue cause the tissue to turn red. Patients with red myoma degeneration often have severe abdominal pain, which can induce miscarriage and preterm delivery. This is why it is generally recommended to remove fibroids before pregnancy for larger fibroids (more than 4 cm in diameter). (5) Malignant transformation of fibroids: The chance of malignant transformation of fibroids varies from report to report, but it is generally believed to be no more than 0.5%, which means that one out of every 200 patients with fibroids may develop malignant transformation. This probability may not seem high for the malignancy of fibroids, but if you are buying a lottery ticket to catch the jackpot, the probability is temptingly high. People have a tendency to avoid harm and take chances, and with the same probability, it is usually considered much more likely to win a lottery ticket than to have a traffic accident or develop a disease. The 0.5% rate of myxoma malignancy is just an average. Generally speaking, those myomas that grow suddenly in a short period of time and do not shrink or even grow after menopause are the most alarming cases. In contrast, fibroids that grow slowly or even change little with long-term observation are relatively much less likely to become malignant. The type of malignant degeneration of uterine fibroids is sarcomatous degeneration. After malignant degeneration, the uterus becomes softer and grows faster, often accompanied by irregular vaginal bleeding or excessive menstruation. As you can see, with so many kinds of degeneration, the most worrying is the malignant degeneration, which fortunately does not occur at a high rate. Except for red degeneration, other types of fibroid degeneration have no obvious symptoms. A pelvic examination and ultrasound can assist the doctor in diagnosing the presence of degeneration. The exact type of degeneration can only be determined by pathological examination after surgical removal.