Uterine fibroids are common, non-cancerous growths that develop within the uterus. While many fibroids may not cause noticeable symptoms, their location can significantly influence their impact on a person’s health. This article discusses submucosal fibroids, including their characteristics, common symptoms, diagnosis, and treatment options.
What Are Submucosal Fibroids?
Submucosal fibroids are benign growths that form just beneath the inner lining of the uterus, known as the endometrium. These growths can protrude into the uterine cavity, either partially or entirely. They can occur as single growths or in clusters.
Their location, directly impacting the uterine lining, distinguishes them from other fibroid types. Intramural fibroids, for instance, grow within the muscular wall of the uterus, while subserosal fibroids develop on the outer surface. This internal positioning means even small submucosal fibroids can significantly affect the uterine cavity, leading to various symptoms.
Recognizing the Symptoms
Submucosal fibroids cause menstrual irregularities and discomfort. The most common symptom is heavy menstrual bleeding, medically termed menorrhagia, which can be prolonged and occur between periods. This excessive blood loss can lead to fatigue, dizziness, and anemia, a condition where the body lacks sufficient healthy red blood cells.
Individuals may also experience the passage of frequent or large blood clots during menstruation. Pelvic pain or pressure can also arise as the fibroids grow and exert force on the uterine walls or surrounding organs.
How Submucosal Fibroids Are Diagnosed
Diagnosis begins with a routine pelvic examination, where a healthcare provider may detect irregularities in the uterus. Following this, imaging techniques are often used to confirm the presence, size, and exact location of the fibroids. A transvaginal ultrasound, which involves inserting a small probe into the vagina, is a common initial imaging test that provides detailed images of the uterus.
Saline-infusion sonography, also known as sonohysterography, involves introducing sterile saline into the uterus to expand the cavity, allowing for clearer visualization of submucosal fibroids and the uterine lining. Another effective diagnostic tool is hysteroscopy, where a thin, lighted telescope with a camera is inserted through the cervix into the uterus. This procedure allows direct visualization of the uterine cavity and the fibroids within it, helping to assess their impact.
Treatment Approaches
Treatment for submucosal fibroids varies based on symptom severity, fibroid size and location, and an individual’s reproductive goals. For managing symptoms like pain, non-steroidal anti-inflammatory drugs (NSAIDs) can be used. Hormonal therapies, such as gonadotropin-releasing hormone (GnRH) agonists, may be prescribed to temporarily shrink fibroids and reduce bleeding by lowering estrogen levels.
When medical management is not sufficient, surgical interventions are often considered. Hysteroscopic myomectomy is a common procedure for submucosal fibroids, as it is minimally invasive. During this outpatient procedure, a hysteroscope is inserted through the vagina and cervix, allowing the surgeon to remove the fibroids from within the uterine cavity without external incisions. This approach is effective for improving heavy bleeding and can enhance fertility outcomes. In cases where other treatments are not suitable or effective, a hysterectomy, which involves the complete removal of the uterus, may be considered as a definitive solution.