Submucosal fibroids are the rarest type of fibroids. Also called submucous fibroids, they are benign growths that develop underneath the inner uterine lining and protrude into the uterine cavity. Since these fibroids affect the endometrium, they will cause heavy bleeding and fertility-associated problems during menstruation and implantation.
If you are experiencing prolonged, heavy periods, it is time to Book a Consultation at Treatment Range Hospitals to discuss possible treatment options.
Classification Of Submucosal Fibroids
Doctors classify submucosal fibroids to determine the appropriate management and treatment plan. As per the FIGO (International Federation of Gynaecology and Obstetrics) classification system, these fibroids fall into three categories.
- FIGO type 0: Located entirely within the uterine cavity and attached by a stalk.
- FIGO type 1: Less than 50% is embedded in the uterine wall, and most of it grows into the uterine cavity.
- FIGO type 2: Around 50% remains within the uterine wall, and only a small part grows into the cavity.
If your ultrasound scan report mentions any of these types, our expert team will explain the management and treatment in detail.
Why Do They Cause Heavier Symptoms Than Other Fibroids?
Submucosal fibroids can affect the endometrium and blood vessels of the uterine lining. This would interfere with the usual shedding and repair of the uterine lining during menstruation, causing heavy bleeding.
Submucosal fibroids might further cause:
- Irregular spotting and bleeding
- Disruption in uterine contractions during menstruation
- Interference with embryo implantation
- Iron deficiency anemia
Even a small submucosal fibroid might cause considerable bleeding if it protrudes into the uterine cavity.
Book a Consultation now at Treatment Range Hospitals for further evaluation and guidance.
How Does A Submucosal Fibroid Appear On Ultrasound?
The primary imaging test for identifying submucosal fibroids is transvaginal or pelvic ultrasound. The ultrasound scan describes the following:
- Fibroid’s size, either in centimeters or millimeters
- Exact location within the uterus
- Proportion of the fibroid within the uterine muscle
- Status of the endometrial cavity
- Number of fibroids
- FIGO classification
A submucosal fibroid appears as a solid, round, and well-defined growth that alters the shape of the endometrial cavity. In case of tiny or multiple fibroids, ultrasound findings may be unclear.
Your gynecologist may also recommend further tests for precise management:
- Saline infusion: This uses sterile fluid to outline the uterine cavity
- Hysteroscopy: A thin camera is passed into the cervix to view the uterine cavity
- MRI: Useful when multiple fibroids are present or detailed surgical planning is needed.
If you are confused about the scan reports, Check with our Expert Team for a detailed ultrasound review.
Symptoms Specific To Submucosal Fibroids
Submucosal fibroids usually cause heavy menstruation and might affect fertility and pregnancy. Possible symptoms include:
- Anemia as a result of severe bleeding
- Lower back or pelvic pain
- Large blood clots
- Dizziness or fatigue
- Recurrent miscarriage
- Difficulty in conceiving
Since submucosal fibroids develop within the uterine lining, they might cause early symptoms.
If heavy menstrual bleeding is affecting your daily activities, sleep, or work, consult our doctors for a proper treatment management plan.
Submucosal Fibroid Treatment Options
A hysteroscopic myomectomy is a preferred surgical option for treating submucosal fibroids. It is an outpatient procedure where the surgeon removes the fibroids at the time of diagnosis. The other myomectomy options include:
- Open myomectomy, a procedure for removing large fibroids. They are removed through an incision in the abdomen across the bikini line.
- Minimally invasive laparoscopic myomectomy, a procedure where small incisions or one larger incision is made to remove the fibroids.
These procedures will protect the uterus and improve the possibility of pregnancy. But sometimes, fibroids can return after a myomectomy. The recurrence rate is around 15% to 30% depending on the size and severity of the fibroids.
Other treatment options include
Wait and watch: Some fibroids may not require treatment, and your doctor may recommend monitoring the condition and using over-the-counter pain medications.
Medical treatment: Your doctor will suggest medicines based on your symptoms, medical history, contraception needs, and pregnancy plans. Hormonal birth control and gonadotropin-releasing hormone agonists (GnRHa) might help reduce fibroid risk. Iron supplements will help treat and prevent anemia caused by severe bleeding.
Myolysis: This treatment involves inserting a needle via laparoscopy to pass an electric current or freeze to destroy the fibroids.
Uterine fibroid embolization (UFE): In this procedure, a thin catheter is inserted into the artery at the wrist or groin to alter the blood supply to the fibroid.
Magnetic resonance-guided focused ultrasound (MRgFUS): This procedure combines ablation techniques and magnetic resonance imaging.
Ultrasound-guided radiofrequency ablation: This minimally invasive procedure uses high-energy waves to generate heat and destroy fibroids.
Hysterectomy: This is a definitive treatment that completely removes the uterus. It is considered when other options are not workable, and future pregnancy is not planned.
Do not delay in Booking a Consultation with our experts at Treatment Range Hospitals for a treatment option based on your fibroid condition.
Submucosal Fibroids And Fertility
Submucosal fibroids will affect fertility as they alter the shape of the uterine cavity and interfere with implantation. They might also cause miscarriage in some women.
Having a submucosal fibroid does not mean pregnancy is not possible. Fertility depends on the following factors:
- Fibroid’s size and FIGO type
- The portion of the uterine cavity it occupies
- Age and ovarian reserve
- Number of fibroids
- Previous pregnancies and other gynecological problems
Removing a cavity-distorting submucosal fibroid may improve the chances of pregnancy, but the expected benefit varies and should be discussed with your fertility specialist.
If you are planning to conceive with a submucosal fibroid, our gynecology team can help you understand whether treatment before pregnancy may be appropriate.
Frequently Asked Questions
1. Why do submucosal fibroids cause heavy bleeding?
Submucosal fibroids protrude into the uterine cavity, affecting the endometrial lining. Therefore, they increase bleeding, interfere with the uterine lining post-menstruation, and alter uterine contractions. This will lead to irregular and prolonged bleeding.
2. Are submucosal fibroids dangerous?
Submucosal fibroids are usually benign. In some instances, they might lead to severe pain, bleeding, fertility problems, and pregnancy loss. Prompt management and treatment are recommended if the symptoms worsen or persist.
3. Can a submucosal fibroid shrink on its own?
Submucosal fibroids may shrink after menopause as hormone levels decline, but shrinkage is not guaranteed. A fibroid that causes heavy bleeding or fertility-related problems may require treatment before menopause rather than waiting for it to shrink.
You should seek immediate medical care for heavy bleeding, severe pelvic pain, fatigue, or symptoms of significant anemia.
Book an Appointment at Treatment Range Hospitals to check the size and position of your submucosal fibroid and discuss safe, personalized treatment options with our gynecology specialists.
