What Are Submucosal Leiomyomas?

Submucosal leiomyomas are non-cancerous tumors occurring at the wall of the uterus. It’s common in women of childbearing age. Most women with fibroids might not experience any visible symptoms. For some women, the symptoms of submucosal fibroids could become so severe that they interfere with their ability to perform their routine tasks.

Depending on their location, doctors have categorized fibroids as:

• Submucosal 
• Intramural 
• Subserosal 

What are submucosal fibroids?

Fibroids that occur in the submucosal layer, which is the inner surface of the uterus, are known as submucosal fibroids. These fibroids often begin as intramural fibroids and gradually start growing towards the cavity of the endometrium. Sometimes, submucosal fibroids might be connected to the uterus through a long stalk. These fibroid tumors are referred to as pedunculated submucosal fibroids. While intramural and subserosal fibroids affect more than 70 percent of women, submucosal fibroids are very rare.

Symptoms of Submucosal Fibroids

Many women don’t easily realize that they are suffering from uterine fibroids. Nevertheless, in some patients, the presence of submucosal fibroids is partly symptomatic, especially those with multiple subendometrial fibroids. Common symptoms include:

• Back pain
• Heavy bleeding between monthly periods
• Severe abdominal cramps
• Postmenopausal bleeding
• Prolonged menstrual periods
• Pelvic pain
• Extremely large submucosal fibroids that can result in lower abdominal discomforts

Submucosal Fibroids and Infertility

Submucosal fibroids can cause infertility in women who are at the childbearing age. There are numerous ways through which submucosal fibroids can trigger infertility. For example, they can cause blockage of the fallopian tube; hence, preventing the sperm from meeting with the egg. Enlarged submucosal fibroids might cause the uterine cavity to swell. An inflamed cavity elevates the distance that the sperms have to travel.

Submucosal fibroids might have a significant influence in the ability of the uterus to contract, and this in turn, prevents normal sperm migration and ova transportation. Large submucosal growths can completely distort the uterine cavity, disrupt the endometrial structure, and cut down blood supply. They can also cause thinning, atrophy, ulceration, inflammation, and hyperplasia. Actually, the whole anatomy of the uterus is disoriented, and even though the sperm is capable of fertilizing the ovum, the possibility of implantations is drastically reduced.

During pregnancy, the presence of submucosal fibroids can cause serious complications. During the pregnancy period, these fibroid tumors can grow bigger in size, thereby reducing the space available for the fetus to grow. This leads to fetal congenital deformities or miscarriages. In addition, submucosal fibroids can trigger postpartum hemorrhage, cesarean sections, obstructed labor, and stalled labor.

Treatments for Submucosal Fibroids

There is no precise medication that can permanently remove submucosal fibroids. The available treatments are aimed at alleviating the symptoms. Surgical therapies are still considered the best treatment options for submucosal fibroids. Submucosal resection and hysteroscopy have also been confirmed to work effectively in curing symptomatic submucous fibroids. Laparoscopic procedures, as well as myolysis are useful for alleviating pedunculated submucosal fibroids.

Hysteroscopy is another form of treatment. However, doctors suggest it only when the fibroids can’t be managed by other methods and the patient isn’t longer interested in childbearing. For most cases, uterine fibroids are harmless, don’t cause any symptoms, and disappear with menopause. Nevertheless, some fibroids are painful, trigger bleeding, and cause pregnancy complications.

If you have fibroid-related problems, you should seek medical attention since several treatment options are available.