Uterine fibroids are benign, non-cancerous growths which affect women in their 30s and 40s during their childbearing years. For most women they have no symptoms or signs of the disorder and it is often found incidentally during a physical examination. However, some women do experience symptoms such as heavy bleeding, longer than normal periods, bleeding between periods, urine retention, or backache and a heavy feeling in the pelvis.
Fibroids are classified by their location in the uterus. Their location will affect the symptoms they cause and will also determine the treatment protocols which are recommended. Fibroids which are inside the cavity of the uterus are called intra-cavitary myomas and will usually cause bleeding between periods with severe cramping. Fortunately these particular types of fibroids can be easily removed with a hysteroscopic resection done through the cervix without the need for incision.
Submucosal myomas are uterine fibroids which are partially in the uterine cavity and partially growing into the wall or muscle of the uterus. These can also cause heavy menstrual periods as well as bleeding between periods. Only some of these can be removed by hysteroscopic resection and others require procedures which eliminate the fertility of the woman
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Intramural myomas are uterine fibroids which grow in the wall of the uterus and can range in size from microscopic to larger than a grapefruit. Most of these do not cause problems unless it is their size when they grow quite large. There are a number of alternatives for treatment but they often do not require treatment at all. A subserous myoma is a uterine fibroid which grows on the outside wall of the uterus. These and pedunculated myomas, those which grow from a stalk, usually do not require treatment but can cause pain if they become twisted. The pedunculated myoma is the easiest type of fibroids to be removed by laparoscopy.
Submucosal fibroids is the least common of the serious types of tumors. Submucosal fibroids can increase the size of the uterus cavity and can block the Fallopian tubes causing complications with fertility. While some don’t produce symptoms others can be severely symptomatic. If they go untreated with prolonged or excessive bleeding women often experience fatigue and anemia.
It is very important that you contact your primary care physician or gynecologist if you are suffering or experiencing any of the symptoms associated with a submucosal fibroid tumor. Your physician should be involved in following the growth of the tumor and helping you to determine the correct treatment protocol you would like to use in the future.
In a recent study published in Australia, which compared the pregnancy rates following IVF treatment for women known to have fibroid tumors at the time of treatment, researchers found there was no difference in the rates when the fibroids were pedunculated or subserosal but if they were intramural or submucosal the pregnancy rates were up to 50% less than for those women who had no uterine fibroids.
In order to maintain fertility and general overall health, it is important for women who are experiencing heavy menstrual bleeding or bleeding between periods to be evaluated by her gynecologist who is experienced in treating women with uterine fibroids. Once a woman becomes anemic due to the chronic blood loss it is very difficult for her to regain normal hemoglobin and hematocrit numbers without consistent treatment and persistent care.
Resources:
American Journal of Roentgenology: Submucosal Fibroids Becoming Endocavitary Folling Uterine Artery Embolization
http://www.ncbi.nlm.nih.gov/pubmed/18430835
Centers for Disease Control and Prevention: Basic Information about uterine Cancer
http://www.cdc.gov/cancer/uterine/basic_info/index.htm
Fertility Centers of New England: Surgical Scoring System for Submucosal Fibroids
http://www.fertilitycenter.com/fertility_cares_blog/surgical-scoring-system-for-submucosal-fibroids/
Cedars-Sinai: Fibroids
http://www.cedars-sinai.edu/Patients/Health-Conditions/Fibroids-Uterine.aspx
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