What Is an Exophytic Fibroid?

Uterine fibroids, also known as myomas or leiomyomas, are muscular tumors that grow in the wall of the uterus. They are typically not cancerous, but can lead to other problems like heavy bleeding and pain or cramping when they develop in the uterine wall.

There are several types of fibroids, and one of them is exophytic fibroids. These fibroids are particularly large and grow out of the uterus into the abdominal cavity. "Exophytic" describes a growth that extends beyond the surface of the organ where it originated.

Types of Exophytic Fibroids

Intramural fibroids are the only type of uterine fibroid that stay within the uterus. These tumors embed themselves in the muscular wall of the uterus. Other types of fibroids are exophytic, or ones that extend beyond the surface of the uterus:

• Submucosal fibroids: These fibroids grow in the open space of the uterus. They begin in the wall, but extend out into the uterine cavity.
• Subserosal fibroids: Subserosal fibroids grow on the outside of the uterus, extending from the outer wall into the areas surrounding the uterus.
• Pedunculated fibroids: These fibroids also grow from the outer surface of the uterus, but they are connected to its wall by a stem or trunk, with the fibroid developing at the end.

Exophytic Fibroid Symptoms

Symptoms of fibroids are generally the same regardless of where they grow in the uterus. In many cases, fibroids are tiny—microscopic, even—and develop with no symptoms at all. However, as they become larger and extend beyond the uterus wall, they may cause symptoms like:

• Heavy or extensive bleeding during your period
• Bleeding between periods
• Bloating
• Cramping
• A full feeling in the lower stomach
• Enlargement or distension of the abdomen
• The need to urinate more often
• Urinary retention, or being unable to fully empty your bladder
• Vaginal discharge
• Pain during sex
• Pain in the lower back
• Constipation
• Infertility
• Pregnancy complications
  

Causes

No one is sure of the exact cause of fibroids, but a number of things can increase your likelihood of developing them. They are thought to be caused by hormones in the body or genes.

Fibroids are most common during the reproductive years, with one in five women having these growths during their childbearing years. Half of all women have fibroids by age 50.

Risk factors for fibroid growth include:

• Family history of fibroids
• Hormonal changes
• Obesity
• Early- or late-onset menopause
• Never having children

Diagnosis

Since fibroids develop with no symptoms in many cases, they are usually discovered during a routine pelvic exam. Fibroids can be felt by your healthcare provider during these exams, even if you haven't experienced any pain.

If your healthcare provider needs more information about your fibroids, they may order additional testing, including:

• Ultrasound: This uses sound waves to create a picture of the uterus and the structures within it.
• Hysteroscopy: A thin tool called a hysteroscope is inserted into the uterus through the vagina. A small camera at the end of the hysteroscope captures images from inside the uterus, which are then displayed on a screen for your healthcare provider to view.
• Hysterosalpingography: This is a type of X-ray imaging used to examine changes in the size or shape of the uterus and fallopian tubes.
• Sonohysterography: This test fills the uterus with a special fluid before an ultrasound exam. The fluid helps define the uterine lining during the ultrasound.
• Laparoscopy: A thin device with a camera at the end is inserted through a small incision near your belly button. This instrument is used to visualize fibroids growing on the outside of the uterus.

Treatment

How your fibroids are treated depends on a number of factors. If your fibroids are not causing any symptoms, you don't need treatment. Your doctor may base your treatment plan on how you answer the following questions:

• Are your fibroids causing symptoms?
• Are you trying to become pregnant?
• How large are your fibroids and where are they located?
• What complications are your fibroids causing?
  

If your symptoms are severe or causing other complications, you may be treated with medications like:

• Hormonal birth control to help control heavy bleeding
• Gonadotropin-releasing hormone (GnRH) agonists to stop ovulation and shrink fibroids
• Progestin–releasing intrauterine devices (IUD) to releases a low dose of the hormone progestin into the uterus each day and shrink fibroids

Surgery or other invasive procedures may also be required, such as:

• Myomectomy: This is the surgical removal of fibroids from the uterus. Fibroids may develop again in the future, but this procedure is recommended if you still plan to become pregnant.
• Hysterectomy: This involves the complete removal of the uterus and possibly the ovaries. This is the recommended treatment in recurring fibroids or when other treatments haven't helped. However, you will no longer be able to become pregnant after a hysterectomy.
• Endometrial ablation: The lining of the uterus is removed or destroyed with lasers or electrical currents to prevent the growth of fibroids.
• Myolysis: A needle is inserted into the fibroids, which are destroyed by freezing them or with electric currents.
• Uterine fibroid embolization (UFE): A thin tube is inserted into the blood vessels that feed your fibroid, and particles that block the blood supply are injected. Not all fibroids can be treated with this technique.
  

Prognosis

Not everyone who has fibroids needs treatment. Your treatment plan will depend on what symptoms your fibroids are causing, what your future fertility plans are, and how close you may be to menopause.

In rare cases, untreated fibroids can cause complications like:

• Severe or heavy bleeding
• Twisting or torsion of the fibroid
• Anemia as a result of the heavy bleeding
• Urinary tract infections
• Fertility problems

While the word "tumor" may bring up concerns about cancer, this is a rare complication of fibroids. Fewer than 1 in 1,000 fibroids will develop into cancer.

Coping

While fibroids may not always be severe enough to require treatment with medications or surgery, they can still cause discomfort. Your doctor may recommend treating your pain and cramping with over-the-counter medications like Tylenol (acetaminophen) or Advil (ibuprofen).

If you have heavy periods due to fibroids, your doctor may also recommend iron supplements to help prevent anemia.

Summary

Fibroids are tumors that can grow from the inner or outer lining of the uterus. Exophytic fibroids are fibroids that extend from the surface of the uterus. Not all fibroids require treatment. Instead, you and your doctor will decide how to manage them together based on the symptoms they are causing and your future fertility plans. Fibroids rarely develop into cancer.

A Word From Verywell

Fibroids are a common type of growth that are most prevalent in women during their childbearing years. No one knows what causes fibroids, but they are affected by hormonal ups and downs. Often fibroids are so small that they cause no symptoms and don't require treatment. However, in some cases, they can cause painful cramping or heavy periods.

If you have a family or personal history of fibroids, you and your doctor will develop a treatment plan based on how uncomfortable they are making you and whether you still plan to become pregnant. Most treatments for fibroids are minimally invasive.