Intramural Fibroid: Symptoms, Pregnancy, Treatment
There are four main types of fibroids: intramural fibroids, subserosal fibroids, submucosal fibroids, and pedunculated fibroids . It’s important to understand that most women with uterine fibroids have more than one type of fibroid, which in turn can affect symptoms and treatment options.
Intramural fibroids grow within the uterine wall. In this brief review, the fibroid specialists at ProFibroidMD explain intramural fibroid symptoms, how intramural fibroids can affect pregnancy, and what treatment options are available to women with intramural fibroids. Read on to learn more.
Intramural Fibroid Relief in Los Angeles
Dawn S, October 2021
Intramural Fibroid Anatomy
Intramural fibroids are located within the uterine wall. Some intramural fibroids can enlarge to span from the outer serosal surface, through the uterine wall, and all the way to the endometrium (the mucosal surface). These are known as transmural fibroids. In one study of 96 Italian women with fibroids, intramural fibroids were the most prevalent type of fibroid identified on transvaginal ultrasound .
According to the International Federation of Gynecology and Obstetrics (FIGO) classification system, there are two types of fibroids that are completely intramural, however submucosal and subserosal fibroid types both have intramural components as well.
- Fibroid Type 1: Submucosal, <50% intramural
- Fibroid Type 2: Submucosal, ≥50% intramural
- Fibroid Type 3: Contact with endometrium, 100% intramural
- Fibroid Type 4: Intramural
- Fibroid Type 5: Subserosal, ≥50% intramural
- Fibroid Type 6: Subserosal, <50% intramural
Intramural Fibroid Symptoms
Intramural Fibroids and Pregnancy
Intramural Fibroid Treatment
The most conservative treatment option for uterine fibroids is medical therapy. Medicine can be effective if symptoms are mild, if a woman is in perimenopause (so treatment is only needed in the short term), or if pre-operative intervention to reduce the size of the fibroids would make a surgery less technically challenging [7, 8]. Nonsteroidal anti-inflammatory drugs (NSAIDs), hormones (estroprogestins or progestogens), and oral contraceptives can help with symptomatic bleeding and fibroid pain. Gn-RH analogues and selective progesterone receptor modulators (sPRMs) like ulipristal acetate (UPA) help treat bulk symptoms such as pelvic pressure, pelvic pain, and frequent urination . Medical treatments are only used for the short-term due to the significant health risks associated with long-term use of these medicines .
Uterine Fibroid Embolization
Myolysis does impact future fertility and pregnancies. As fibroid tissue is destroyed with myolysis, scar tissue can form in the endometrium. While some women may achieve successful pregnancies, there could be potential complications. Myolysis is not always a definitive treatment. Surgical intervention may be required down the line .
Myomectomy isn’t without its shortcomings, and isn’t always ideal for women with multiple large fibroids. Failure rates range from 14.5% to 30% at 3 to 4 years’ follow-up . Between 10 and 25 percent of women will require a second fibroid surgery . Still, many women choose myomectomy in order to preserve their uterus for future pregnancies. Most women who have myomectomy are able to have children afterwards.
Hysterectomy is the most definitive treatment available for uterine fibroids, particularly for women who have no desire to conceive . It can be very effective for patients with extremely large fibroids or a large quantity of fibroids. However, after hysterectomy, once the uterus or parts of it are removed, pregnancy is no longer possible.
Intramural Fibroid Removal
Surgical vs. Non-Surgical Fibroid Treatments: Which Is Best?
When it comes to fibroid treatment, we believe that less is more. A less invasive procedure means less trauma, less risk, and shorter recovery time. Learn more about why we opt for UFE, the least invasive treatment for uterine fibroids.
Uterine Artery Embolization
Fibroid Specialist in Los Angeles
Learn more about Los Angeles Fibroid Specialist Dr. Michael Lalezarian.
 Stewart, E. A. (2001). Uterine fibroids. The Lancet, 357(9252), 293–298.
 Guo XC, Segars JH. The impact and management of fibroids for fertility: an evidence-based approach. Obstet Gynecol Clin North Am. 2012 Dec;39(4):521-33. doi: 10.1016/j.ogc.2012.09.005. PMID: 23182558; PMCID: PMC3608270.
 Simms-Stewart D, Fletcher H. Counselling patients with uterine fibroids: a review of the management and complications. Obstet Gynecol Int. 2012;2012:539365. doi: 10.1155/2012/539365. Epub 2012 Jan 9. PMID: 22272207; PMCID: PMC3261489.
 Lippman, Sheri & Warner, Marcella & Samuels, Steven & Olive, David & Vercellini, Paolo & Eskenazi, Brenda. (2004). Uterine fibroids and gynecologic pain symptoms in a population-based study. Fertility and sterility. 80. 1488-94. 10.1016/S0015-0282(03)02207-6.
 Ouyang DW, Economy KE, Norwitz ER. Obstetric complications of fibroids. Obstet Gynecol Clin North Am. 2006; 33:153–69. [PubMed: 16504813]
 Exacoustòs C, Rosati P. Ultrasound Diagnosis of Uterine Myomas and Complications in Pregnancy. Obstet Gynecol. 1993; 82:97–101. [PubMed: 8515934]
 Mas A, Tarazona M, Dasí Carrasco J, Estaca G, Cristóbal I, Monleón J. Updated approaches for management of uterine fibroids. Int J Womens Health. 2017 Sep 5;9:607-617. doi: 10.2147/IJWH.S138982. PMID: 28919823; PMCID: PMC5592915.
 Khan AT, Shehmar M, Gupta JK. Uterine fibroids: current perspectives. Int J Womens Health. 2014 Jan 29;6:95-114. doi: 10.2147/IJWH.S51083. PMID: 24511243; PMCID: PMC3914832.
 Vilos GA, Allaire C, Laberge PY, Leyland N; SPECIAL CONTRIBUTORS. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015 Feb;37(2):157-178. doi: 10.1016/S1701-2163(15)30338-8. PMID: 25767949.
 Stewart, E.A., Laughlin-Tommaso, S.K. Patient education: Uterine fibroids (Beyond the Basics). UpToDate. Accessed February 2021.
 Singh SS, Belland L. Contemporary management of uterine fibroids: focus on emerging medical treatments. Curr Med Res Opin. 2015;31(1):1-12.
 Davis MR, Soliman AM, Castelli-haley J, Snabes MC, Surrey ES. Reintervention Rates After Myomectomy, Endometrial Ablation, and Uterine Artery Embolization for Patients with Uterine Fibroids. J Womens Health (Larchmt). 2018;27(10):1204-1214.
 Munro MG. Endometrial ablation: where have we been? Where are we going?. Clin Obstet Gynecol. 2006;49(4):736-66.
 van der Kooij S.M., Hehenkamp W. Uterine fibroids (leiomyomas): Treatment with uterine artery. UpToDate. Accessed February 2021.
Schedule Your Visit
instant messaging widget.
contact form below.
for general inquiries.