Intramural Fibroids: Symptoms, Causes, Treatment, and What to Know

Where Do Intramural Fibroids Grow in the Uterus?

Intramural fibroids develop within the myometrium, the thick muscular middle layer of the uterine wall. The uterus also has an inner lining called the endometrium and an outer covering called the serosa.

Their exact location within the uterine wall can be described as:

• Anterior: toward the front wall of the uterus.
• Posterior: toward the back wall.
• Fundal: in the upper part, or fundus, of the uterus.
• Lateral: toward the left or right side of the uterus.

As intramural fibroids grow, they may expand within the uterine wall and can sometimes extend toward the uterine cavity or outer surface. Larger or strategically located fibroids may change the uterus’s shape and cause heavy menstrual bleeding, pelvic pressure, pain, or urinary and bowel symptoms.

What Causes Intramural Fibroids?

The exact cause of uterine fibroids is not fully understood. Researchers believe that several biological factors may contribute to their development and growth.

Hormones

Reproductive hormones, including estrogen and progesterone, appear to influence fibroid growth. Fibroids commonly develop during the reproductive years and often shrink after menopause when hormone levels decline.

Genetic Changes

Changes in genes within uterine muscle cells may also play a role. Having a family history of fibroids is another factor associated with a higher likelihood of developing them.

Other Biological Factors

Researchers are also studying growth-related substances and other cellular processes that may contribute to fibroid development.

It is important to distinguish risk factors from proven causes. Having a particular risk factor does not mean it directly caused a fibroid.

Fibroids are common, especially during reproductive years. However, researchers are still working to understand why some people develop larger or more symptomatic fibroids than others.

What Are the Symptoms of Intramural Fibroids?

The symptoms can vary widely. Some people have no symptoms, while others experience problems that affect their periods, pelvic comfort, or daily activities.

Possible symptoms include:

• Heavy menstrual bleeding.
• Longer or more frequent menstrual periods.
• Painful periods.
• Pelvic pain or pressure.
• Lower back pain.
• Abdominal fullness or enlargement.
• Frequent urination.
• Difficulty urinating.
• Constipation or difficult bowel movements.
• Pain during sex.
• Fatigue or weakness related to anemia.
• Fertility problems in some cases.

Symptoms can depend on the fibroid’s size, number, and location. A larger fibroid may sometimes press on nearby organs and contribute to urinary or bowel symptoms.

Heavy menstrual bleeding is particularly important because repeated blood loss can lead to anemia. Anemia may cause symptoms such as tiredness, weakness, dizziness, or shortness of breath.

At the same time, having a fibroid does not automatically mean that every symptom is caused by the fibroid. Other gynecological or medical conditions can cause similar symptoms.

Do Intramural Fibroids Cause Heavy Bleeding?

Yes, they can contribute to heavy menstrual bleeding, but not everyone with an intramural fibroid will have abnormal bleeding.

Fibroids can be associated with heavier or longer menstrual periods. The effect can vary depending on the fibroid’s size, number, and location.

Heavy bleeding can affect everyday life and may contribute to anemia when blood loss is significant or persistent. Signs of anemia can include:

• Fatigue.
• Weakness.
• Dizziness.
• Headaches.
• Shortness of breath.

However, fibroids are not the only possible cause of heavy menstrual bleeding. Hormonal changes, pregnancy-related conditions, bleeding disorders, medications, and other gynecological conditions can also cause abnormal bleeding.

If your periods have become unusually heavy, last longer than expected, or interfere with normal activities, talk with a healthcare professional.

Is Intramural Fibroids Dangerous? Understanding the Risk

Intramural fibroids are usually not dangerous because they are benign, non-cancerous growths. However, some can cause significant symptoms or complications.

The potential impact depends on factors such as size, number, location, symptoms, and how the growths affect the uterus

Having an intramural fibroid does not mean you have cancer. Typical uterine fibroids are benign and are not considered precancerous.

How Are Intramural Fibroids Diagnosed?

A healthcare professional may suspect fibroids based on your symptoms and pelvic examination. Imaging tests can then help confirm whether fibroids are present and determine their size, number, and location.

1. Pelvic Examination

During a pelvic examination, a healthcare professional may detect changes in the size or shape of the uterus that suggest fibroids. However, an examination alone cannot confirm the diagnosis.

2. Ultrasound

Ultrasound is commonly used to identify fibroids and evaluate their size, number, and location. A transabdominal ultrasound examines the uterus through the abdomen, while a transvaginal ultrasound uses a probe placed inside the vagina to produce detailed images of the uterus.

3. MRI

MRI provides detailed images of the uterus and can help map the size, number, and exact location of fibroids. MRI is not necessary for everyone and may be recommended when more detailed imaging is needed.

4. Blood Tests

Blood tests do not diagnose fibroids. However, if heavy menstrual bleeding is present, they may help check for anemia or evaluate other possible causes of abnormal bleeding.

5. Hysteroscopy or Other Tests

Hysteroscopy uses a small camera to examine the inside of the uterine cavity. It is mainly useful for evaluating submucosal fibroids, which project into the cavity, rather than typical intramural fibroids.

The tests used depend on your symptoms, examination findings, and the information your healthcare professional needs to evaluate the uterus and fibroids.

What Is the Treatment for Intramural Fibroids?

There is no single treatment for intramural fibroids that is appropriate for everyone.

Treatment decisions may consider:

• Symptoms.
• Fibroid size.
• Fibroid location.
• Number of fibroids.
• Age.
• Overall health.
• Anemia.
• Fertility goals.
• Future pregnancy plans.
• How much symptoms affect daily life.

When treatment is needed, the choice depends on factors including the person’s wishes and the size and location of the fibroids.

Watchful Waiting

If a fibroid causes no symptoms or only mild symptoms, monitoring may be appropriate.

A healthcare professional may recommend follow-up visits and, when appropriate, imaging to monitor changes.

Medications

Some medications can help manage fibroid-related symptoms, particularly heavy menstrual bleeding or painful periods.

Medication does not necessarily remove a fibroid. Some medications may shrink fibroids temporarily, while others primarily manage symptoms.

Minimally Invasive Procedures

Some people may be candidates for procedures designed to reduce fibroid size or symptoms.

One example is uterine artery embolization (UFE), which reduces blood flow to fibroids and can cause them to shrink. Other procedures, such as focused ultrasound or certain ablation techniques, may be appropriate for selected patients.

These procedures are not suitable for everyone. The choice depends on fibroid characteristics, medical circumstances, available expertise, and reproductive goals.

Myomectomy

A myomectomy removes fibroids while leaving the uterus in place. It may be considered when symptoms are significant or when preserving the uterus is important.

After a myomectomy, pregnancy may still be possible. However, the effect on fertility and pregnancy depends on the individual and the procedure performed.

Hysterectomy

Hysterectomy removes the uterus. It is a definitive treatment for uterine fibroids because fibroids cannot grow in a uterus that has been removed.

However, a person can no longer carry a pregnancy after a hysterectomy. It is therefore an important decision that should take into account symptoms, other treatment options, health considerations, and reproductive goals.

Do Intramural Fibroids Need to Be Removed? 

Not always. Intramural fibroids do not necessarily need treatment, especially when they are small and cause no significant symptoms.

The presence of a fibroid alone does not determine whether treatment is needed. A healthcare professional will consider the fibroid’s size, number, location, symptoms, and impact on the uterus, along with your individual needs, before recommending monitoring, medication, a procedure, or surgery.

Intramural Fibroids and Fertility

Having an intramural fibroid does not automatically mean that you will have difficulty becoming pregnant.

Fibroids can be associated with infertility, but other causes are more common and should be explored before a fibroid is considered the cause.

For someone trying to conceive, a healthcare professional may evaluate whether the fibroid changes the shape of the uterine cavity or could otherwise affect reproductive health.

Treatment decisions should also consider future pregnancy plans. A procedure that is appropriate for one person may not be the best option for someone who wants to preserve fertility.

If you have been diagnosed with a uterine fibroid and are planning a pregnancy, discuss your reproductive goals with your gynecologist before deciding whether treatment is necessary.

Living With Intramural Fibroids: Monitoring and Lifestyle

For women managing a fibroid that isn’t yet causing major symptoms, ongoing monitoring is the most important habit to build.

• Annual or biannual ultrasounds to track growth.
• Tracking your cycle — pad/tampon changes, clot size, and cycle length.
• Iron-rich nutrition if periods are heavier than usual, since chronic blood loss can deplete iron stores.
• Weight and hormone awareness, since higher estrogen exposure is linked to fibroid growth.

None of these steps shrink a fibroid on their own, but together they help you and your doctor catch meaningful changes early.

Can Clinical Research Help Advance Fibroid Treatment?

Yes. Clinical research studies help researchers evaluate potential treatments and improve understanding of diseases and health conditions.

In uterine fibroid research, studies may evaluate medications, procedures, devices, or other treatment approaches. Depending on the study, researchers may examine outcomes such as bleeding, symptoms, fibroid size, safety, or quality of life.

How Zillan Clinical Research Supports Women’s Health Research

Zillan Clinical Research conducts research in women’s health, including studies related to conditions such as uterine fibroids. Our women’s health clinical trials evaluate investigational approaches while collecting information about their safety and potential effectiveness.

If you or someone you know is living with uterine fibroids and is interested in research, uterine fibroid clinical trials may be an option to explore. Eligibility and availability vary by study, so speak with the research team to learn whether a particular study may be appropriate for you.

Conclusion

An intramural fibroid diagnosis can feel concerning, but these growths are usually benign and manageable. Some cause no symptoms, while others may contribute to heavy bleeding, pelvic pressure, pain, or fertility concerns. The right approach depends on the size, number, location, symptoms, and impact on your quality of life. With appropriate evaluation and monitoring, many people with intramural fibroids can manage the condition effectively.

If you are living with uterine fibroids and interested in exploring clinical research opportunities, Zillan Clinical Research may have studies that could be relevant to you. Eligibility varies by study, so speak with the research team to learn more about available clinical trials.

Frequently Asked Questions

1: How serious are intramural fibroids?

Intramural fibroids are usually benign and are not cancerous. Their clinical significance depends on factors such as size, number, location, symptoms, and whether they cause problems such as heavy bleeding, anemia, pain, pressure, or fertility concerns. Some people have no symptoms at all.

2: What are the worst types of fibroids?

There is no single type of fibroid that is always the “worst.” Different locations can cause different problems. Submucosal fibroids can be associated with heavy bleeding, while larger intramural or subserosal fibroids may cause pressure, pain, or changes in the size or shape of the uterus. The effect depends on the individual fibroid rather than its type alone.

3: How do you treat intramural fibroids?

Treatment depends on symptoms, fibroid size and location, overall health, and reproductive goals. Options may include monitoring, medication, minimally invasive procedures, myomectomy, or hysterectomy. Not every fibroid requires treatment.

4: Do intramural fibroids need to be removed?

Not always. They may not require removal if they cause no significant symptoms. Treatment depends on their size, location, symptoms, and impact on fertility or quality of life.

5: Can intramural fibroids shrink on their own?

Fibroids often shrink after menopause as reproductive hormone levels decline. Some medical treatments can also reduce fibroid size, although the effect depends on the treatment and individual circumstances.

6: Can intramural fibroids cause heavy bleeding?

Yes. Intramural fibroids can contribute to heavy or prolonged menstrual bleeding. However, heavy bleeding can have many causes, so persistent or unusually heavy periods should be evaluated by a healthcare professional.

7: Can you get pregnant with intramural fibroids?

Yes, pregnancy can be possible with intramural fibroids. However, fibroids can be associated with infertility in some people, and other causes of infertility are more common. The effect of a fibroid depends partly on its size and location.