Intramural uterine fibroids affect up to 70% of women by age 50, causing symptoms like heavy menstrual bleeding, pelvic pain, and frequent urination.

But it doesn’t have to be this way.

There are more effective treatment options now than ever before to manage these non-cancerous growths and improve your quality of life. From medications to minimally invasive procedures, you have the power to take control of your uterine health.

What are Intramural Uterine Fibroids?

Intramural uterine fibroids are the most common type of uterine fibroids, accounting for about 70% of all cases. These growths develop within the thick, muscular layer of the uterus called the myometrium. Although benign, intramural fibroids can significantly impact a woman’s quality of life when they grow large enough to cause symptoms.

Symptoms of Intramural Uterine Fibroids

Intramural uterine fibroid symptoms can vary depending on the size, number, and location of the growths. Some common fibroid symptoms include:

  1. Heavy or prolonged menstrual bleeding: Intramural fibroids can increase the surface area of the uterine lining, leading to excessive menstrual blood loss. This can result in anemia, fatigue, and a decreased quality of life. According to a study published in the American Journal of Obstetrics and Gynecology, women with uterine fibroids reported that heavy menstrual bleeding was the most common symptom, affecting 59% of women with fibroids.
  2. Pelvic pain or pressure: As intramural fibroids grow, they can cause a sensation of fullness or pressure in the pelvic region. This discomfort may be more noticeable during menstruation or intercourse.
  3. Frequent urination: Large intramural fibroids can press on the bladder, leading to increased urinary frequency or difficulty emptying the bladder completely.
  4. Constipation: Fibroids that press on the rectum can cause constipation or a feeling of incomplete bowel movements.
  5. Backache: Intramural fibroids can cause lower back pain, particularly if they are large or located near the back of the uterus.

It is important to note that not all women with intramural uterine fibroids experience symptoms. In fact, many fibroids are discovered incidentally during routine pelvic exams or imaging studies. However, for those who do experience symptoms, seeking prompt medical attention is crucial for proper diagnosis and management.

Benefits of Managing Intramural Uterine Fibroids

Managing intramural uterine fibroids can dramatically improve a woman’s quality of life by reducing or eliminating symptoms such as heavy menstrual bleeding, pelvic pain and pressure, frequent urination, and constipation. These symptoms can be debilitating and interfere with daily activities, work, and relationships.

Timely management of fibroids can lead to a marked reduction in symptoms and an overall improvement in well-being. Women may experience increased energy levels, better sleep, and enhanced ability to participate in activities they enjoy.

Preserved Fertility

For women who desire future pregnancies, preserving fertility is a key benefit of managing intramural uterine fibroids. While fibroids themselves do not typically impact fertility, their size and location can potentially interfere with conception and pregnancy.

Women considering fibroid treatment should discuss their fertility goals with their healthcare provider to determine the best approach for their individual situation. Factors such as age, fibroid size and location, and overall reproductive health will influence treatment recommendations.

Reduced Risk of Complications

Left untreated, intramural uterine fibroids can lead to various complications that impact overall health and well-being. Managing fibroids in a timely manner can help reduce the risk of these potential issues:

  • Anemia: a condition in which the body lacks sufficient healthy red blood cells to transport oxygen effectively. Anemia can cause fatigue, shortness of breath, and other symptoms. Treating fibroids can help normalize menstrual bleeding and prevent or resolve anemia.
  • Pelvic Floor Disorders: fibroids put pressure on the pelvic floor muscles, potentially leading to conditions such as urinary incontinence or pelvic organ prolapse. 
  • Pregnancy Complications: there is an increased risk of certain complications such as miscarriage, preterm labor, and placental abruption. 

Intramural Fibroid Treatment Options

Medications for Symptoms

Several medications can help manage the symptoms of intramural fibroids, particularly heavy menstrual bleeding and pelvic pain. Hormonal birth control, such as the pill, patch, or intrauterine device (IUD), can regulate menstrual bleeding and reduce cramping. Gonadotropin-releasing hormone (GnRH) agonists, like leuprolide acetate, can temporarily shrink fibroids by inducing a menopausal-like state. However, these medications can cause side effects such as hot flashes, mood changes, and bone density loss, and fibroids often regrow after discontinuing treatment. Tranexamic acid, a non-hormonal medication, can reduce heavy menstrual bleeding by promoting blood clotting.

Minimally Invasive Fibroid Procedures

Minimally invasive procedures offer an alternative to surgery for treating intramural fibroids. Uterine fibroid embolization (UFE) involves injecting small microsphere particles into the blood vessels supplying the fibroids, cutting off their blood supply and causing them to shrink. This outpatient procedure preserves the uterus, cervix, and ovaries and allows for rapid relief of painful symptoms without major surgery. 

In the days following the procedure, patients may experience post-embolization syndrome, which includes pain, fever, nausea, and vomiting. These symptoms usually resolve within a week with appropriate pain management and supportive care.

Invasive Surgical Options

Myomectomy, the surgical removal of fibroids while preserving the uterus, can be performed through small incisions (laparoscopic myomectomy) or through the cervix (hysteroscopic myomectomy) for fibroids protruding into the uterine cavity.

In severe cases or when fertility is not a concern, surgical removal of the uterus (hysterectomy) may be recommended. This is the only definitive treatment for intramural fibroids, as it eliminates the possibility of recurrence. Hysterectomy can be performed through open abdominal surgery, laparoscopically, or vaginally. For women who wish to preserve their uterus but have large, numerous, or deeply embedded fibroids, an abdominal myomectomy may be necessary.

Factors influencing the decision for surgery

The decision to undergo surgery for intramural fibroids depends on several factors, including:

  • Severity of symptoms
  • Size and location of fibroids
  • Failure of conservative treatments
  • Desire for future pregnancy
  • Overall health and surgical risk

Procedural risks and complications

Hysteroscopic myomectomy carries a small risk of bleeding, infection, or uterine perforation. Proper patient selection, surgical technique, and postoperative care can minimize these risks. Patients should be counseled on the potential complications and the importance of follow-up care.

Bleeding, infection, and damage to surrounding organs are potential complications of fibroid surgery. The risk of these complications depends on factors such as the size and location of the fibroids, the surgical approach, and the patient’s overall health. Experienced surgeons and proper postoperative care can help minimize these risks.

Your Next Steps for Intramural Fibroid Management

As you navigate this journey, remember to prioritize your health and seek guidance from a trusted healthcare provider. They can help you determine the best course of action based on your individual circumstances, such as the size and location of your fibroids, your symptoms, and your fertility goals.

Start managing your intramural uterine fibroids and reclaiming your health! Schedule a consultation with United Fibroid & Vascular Centers near you to discuss your candidacy for uterine fibroid embolization. 

Frequently Asked Questions

Can fibroids go away on their own?

No matter a patient’s age, only about 10 percent of fibroids will shrink on their own and not require proactive treatment, such as uterine fibroid embolization. The remaining 90% of cases will either continue to grow larger, or stay the same size.

What happens if fibroids go untreated?

If left untreated, intramural uterine fibroids can cause extreme pelvic pain, unmanageable menstrual bleeding (which can sometimes lead to anemia), urinary tract infections due to pressure on the bladder, and pregnancy and/or fertility complications.

Does insurance cover fibroid treatment?

It’s recommended to contact your specific insurance provider to check your health plan’s benefits for gynecological care and outpatient procedures.