There are three major types of uterine fibroids. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus.
Intramural fibroids are located predominantly within the width of the uterine muscle or myometrium.
They tend to behave like subserous fibroids, but depending on their size and position, can cause all the usual symptoms associated with fibroids:
- Heavy bleeding or extended periods
- Bleeding between menstrual cycle
- Pressure syomtoms
- Infertility and miscarriages
Submucous fibroids grow towards the internal layer or mucosa of the uterus and protrude into the uterine cavity.
They tend to be symptomatic at smaller sizes, the main symptom being heavy and irregular bleeding.
Submucous fibroids are also more likely to impact fertility, both by making it difficult to fall pregnant and by causing miscarriages.
Submucous fibroids can be removed through a hysteroscopy, a very non-invasive method and consideration for removal should be done early, as soon as they are diagnosed.
Subserosal Fibroids are located near the outer layer or serosa of the uterus.
Because they grow more towards the outside of the uterus, small subserosal fibroids are less likely to cause significant symptoms.
Small asymptomatic subserosal fibroids usually do not require any treatment and can be just monitored with regular ultrasounds. Larger fibroids can become symptomatic.
Typical Symptoms of Subserosal Fibroids:
- Heavy menstrual bleeding, caused by the larger size of the uterus.
- Pressure symptoms over nearby organs, most commonly the bladder (increased urinary frequency) and rectum (difficult motions/constipation).
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