Submucosal Fibroids: The Rarest Uterine Fibroid Explained
Submucosal Fibroids are the ones that grow just under the uterine lining (endometrium).
They are the rarest of all Uterine Fibroids, which are overgrowth of smooth muscles that are non-cancerous.
Despite no cancer risk, they can cause several problems like heavy menses and infertility.
So, to find relief, you must first be well aware of its causes and consequences.
Read this article to learn all about Submucosal Fibroids and how their treatment is navigated.
Types of Submucosal Fibroids
Submucosal Fibroids are divided into 3 subtypes:
- Type 0: These are Pedunculated Submucosal Fibroids (attached by a narrow stem to the uterus) without intramural extension
- Type I: These are sessile (broad-based) with intramural extension less than 50 percent
- Type II: These are sessile with intramural extension of more than 50 percent
Intramural extension of Submucosal Fibroids means the extent to which the Fibroid embeds in the muscular wall of the uterus. Submucosal Fibroids with no intramural extension are entirely in the endometrial cavity.
Submucosal Fibroids symptoms
Submucosal Fibroids can cause more severe symptoms than others.
These may include:
- Painful periods or Dysmenorrhea
- Heavy bleeding
- Prolonged menstrual bleeding
- Anemia
- Infertility
Some other symptoms generally related to Fibroids are:
- Low back pain
- Constipation or feeling pressure on your rectum
- Inability to pee
- Increased abdominal distention (enlargement)
- Bleeding between your periods
- Bloating
- Chronic vaginal discharge
- Frequent urination
Submucosal Fibroids causes
The exact cause of any type of Fibroid is unknown.
However, some of the possible ones can be:
- Genetics: Changes to the genes of the uterine muscles, i.e., abnormal genes, can be one of the causes of Fibroids
- Insulin growth factor: It is one of the factors that helps the body maintain tissues, which can boost Fibroid growth
- Extracellular matrix (ECM): ECM makes cells stick together, which can result in Fibroids
- High hormone levels: The hormones Estrogen and Progesterone thicken the lining of the uterus and help the Fibroids grow
Submucosal Fibroids risk factors
Some factors can also increase the risk of having Fibroids.
Age
Getting periods at an early age can increase the risk of developing Fibroids.
Moreover, it is more likely to affect women aged between 30 to 50.
After menopause, the risk decreases as Fibroids shrink.
Obesity
Weight can also impact the likelihood of having Fibroids.
Obese women are more prone to developing Fibroids.
Factors like Body Mass Index (BMI), body fat percentage, or waist circumference are also crucial in determining the risk.
No pregnancy
Women having no children have higher chances of having Fibroids.
Those with children have lesser risk in comparison.
Diet
Diet is crucial as improper food intake increases the risk of developing Fibroids.
This includes less fruit and green vegetable consumption and deficiency of Vitamin D.
Moreover, the intake of soy milk can also boost the chances of having Fibroids.
Other factors
Some other factors like family history of Fibroids and ethnicity can also contribute.
Black women are more likely to develop Fibroids.
This may be due to racial discrimination that deprives them of medical care.
Submucosal Fibroids diagnosis
The type of Fibroid depends on the location and how it is attached.
They can be diagnosed through various simple methods.
Ultrasound Scan
An ultrasound probe is moved outside of the abdomen to check for Fibroids.
Another ultrasound scan option is transvaginal ultrasound, also called Sonohysterogram.
This method requires the insertion of an ultrasound probe into the vagina to determine the condition of Fibroids.
Magnetic Resonance Imaging (MRI)
Another available option for early and accurate diagnosis is MRI.
This method helps determine detailed placement information, number, size, and condition of Fibroids as well.
Hysteroscopy
This is an advanced test for Fibroids.
It helps to determine submucosal Fibroids and polyps in the body.
Submucosal Fibroids treatment
Fibroids need no treatment if you do not have any symptoms.
If symptoms arise, a doctor may opt for the following options:
Hormonal birth control
To reduce symptoms like painful or heavy periods, a doctor may prescribe hormonal birth control.
It can be an IUD, birth control pills, or injected Progestogen.
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Gonadotropin-releasing hormone analogs (GnRH)
They are used to shrink Fibroids by reducing Estrogen production.
Additionally, they can offer relief from frequent constipation and urination.
Anti-inflammatory medicines
Non-steroidal anti-inflammatory drugs (NSAIDs) can ease menstrual symptoms like pain and bleeding.
Some examples include Ibuprofen and Mefenamic acid.
Hysterectomy
It involves the removal of the uterus.
This surgical option is used in case of big Fibroids or excessive bleeding.
Myomectomy
This method is used to remove Fibroids from the walls of the womb.
It can be carried out through small incisions or open surgery, depending on the Fibroids.
Uterine Artery Embolization (UAE)
It is an alternative to surgical methods for large Fibroids.
A medical professional interprets the problem through X-rays and scans.
The blood vessels are blocked to cut off the supply from Fibroids to shrink them.
Endometrial ablation
This procedure removes only the lining of the uterus.
It can be carried through laser energy or a heated wire loop.
Ulipristal acetate
It is an additional treatment for Fibroids.
This medicine is prescribed for occasional use in case of severe to moderate symptoms.
Submucosal Fibroids and pregnancy
Submucosal Fibroids and fertility are related.
These types of Fibroids are most likely to cause pregnancy and fertility problems in the future.
Moreover, Fibroids can also cause other complications like:
- Increased risk of C-section
- Baby entering the birth canal upside down
- Preterm birth
- Miscarriage
- The placenta covers the cervix
- Excessive bleeding after childbirth
All this can be worrying if you have Fibroids, but do not lose hope.
Manu patients with Fibroids can have a safe and healthy pregnancy.
You must discuss with your doctor about the risks involved and available options to embrace motherhood.
Submucosal Fibroids complications
All types of Fibroids can cause complications such as:
- Severe pain or heavy bleeding that needs surgery
- Anemia from blood loss
- Infertility
- Twisting of Fibroids
- Urinary Tract Infections
Conclusion
Submucosal Fibroids are the rarest Uterine Fibroids, which can cause pregnancy issues, heavy periods, and pain.
Other possible symptoms are bloating, constipation, problems with urination, and chronic vaginal discharge.
To diagnose these Fibroids, a doctor may use an ultrasound, MRI, or Hysteroscopy.
Depending upon the symptoms and severity of Fibroids, a doctor can prescribe hormonal birth control, anti-inflammatory drugs, or surgery.
Frequently Asked Questions
What are Submucosal Fibroids?
Submucosal Fibroids are the rarest of all Uterine Fibroids, which are overgrowth of smooth muscles that are non-cancerous. They grow just under the uterine lining (endometrium).
Why do Submucosal Fibroids cause heavy bleeding?
The exact cause of heavy bleeding due to Submucosal Fibroids remains unclear. However, the excessive deposit of tissue can deform the uterus and exert pelvic pressure. So it can cause heavy menstrual bleeding.
When should Submucosal Fibroids be removed?
Any Fibroid should be removed when it starts causing severe symptoms, which may include heavy menstrual bleeding, pain, and discomfort. Submucosal Fibroids that enter the uterine cavity are usually removed through surgical methods like Hysteroscopy.
Can Submucosal Fibroid be treated without surgery?
It is possible to treat Submucosal Fibroids without surgery. Depending on the symptoms and severity, certain options can be used. It includes hormonal birth control, anti-inflammatory drugs, and Ulipristal acetate. For the right option, always consult a doctor.
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