What Is an Intramural Fibroid?

Intramural fibroids are the most common kind of uterine fibroid. These non-cancerous growths grow in the muscular wall of the uterus (womb). They are typically found during a routine pelvic exam and often diagnosed between ages 30 and 40, though they can develop at any age.

For the most part, intramural fibroids are usually harmless and do not always cause symptoms. Sometimes, they can be problematic and cause heavy periods, spotting between periods, lower back pain, and painful intercourse. Intramural fibroids can sometimes cause reproductive challenges. 

This article discusses intramural fibroids types and possible symptoms. It also explains what causes intramural fibroids and how to treat them.

Types of Intramural Fibroids

All intramural fibroids grow in the walls of the uterus, between the fibers of this muscle. Intramural fibroids are classified based on where in particular they grow:

• Anterior intramural fibroids grow on the front wall of the uterus 
• Posterior intramural fibroids grow on the back wall of the uterus
• Fundal intramural fibroids grow on the top part of the uterus

Where a fibroid appears can determine the impact it has on your health, and inform treatment options. For example, a large intramural fibroid at the bottom of the uterus could impact vaginal childbirth.

Intramural Fibroid Symptoms

Many people with intramural fibroids and other types of uterine fibroids have no symptoms. About 80% of women have fibroids by the time they are 50. However, only 20% to 50% of those have symptoms that require treatments.

The symptoms of intramural fibroids include:

• Heavy periods, possibly leading to anemia
• Spotting between periods
• Feeling full or heavy in the abdomen
• Pain during sex
• Lower back pain

 Intramural fibroids can also cause reproductive problems, especially if they are large. Some intramural fibroids can block the fallopian tubes, making it very difficult to get pregnant. Very large fibroids can make it difficult for a fertilized egg to implant in the uterus.

Causes

Doctor's aren't yet sure what causes intramural fibroids. There seems to be a genetic component, but it's not well understood. The growth of fibroids seems to be linked to the hormones estrogen and progesterone, and fibroids often shrink after menopause when the levels of these hormones drop.

Diagnosis

Oftentimes, intramural fibroids are detected during a routine gynecological exam or an ultrasound that is done for other reasons. 

If you have symptoms, like heavy periods, your healthcare provider might perform a physical examination of your uterus. To do this, they’ll press on your abdomen while inserting two fingers into your vagina. Sometimes, providers can feel fibroids during this process.

 If they can’t feel any fibroids, they may order additional screenings, including an ultrasound, MRI, or CT. The images produced during these procedures will help determine the location and size of fibroids.

Treatment

Many people who have uterine fibroids do not need treatment. Fibroids are non-cancerous, and if they’re not causing symptoms there’s no need to treat them. However, if they’re causing you pain, heavy periods, or infertility you should talk to your healthcare provider about treatment for fibroids. 

Non-Surgical Treatments

Some treatments focus on controlling the symptoms of fibroids. This can include going on hormonal birth control to alleviate heavy or painful periods.

 People who are still having symptoms might be steered toward non-surgical procedures, including:

• Uterine fibroid embolization (UFE), is a procedure that blocks blood flow to the fibroid, causing it to shrink or disappear. 
• Magnetic resonance-guided focused ultrasound, also known as myolysis, is a procedure that uses focused ultrasound rays to destroy fibroids. 

 Surgical options

Intramural fibroids can be difficult to treat with non-surgical options. Because of that, surgery is the best option for some patients. The most common procedure is a myomectomy. This surgery, which can be done laparoscopically or with a full incision, removes fibroids while keeping the uterus intact. It’s meant to be an alternative to a hysterectomy, which removes the uterus. A hysterectomy is another treatment for fibroids. 

Prognosis

People with uterine fibroids have a good prognosis. Overall, intramural fibroids are not dangerous, but they can cause unpleasant symptoms like heavy periods and trouble getting or staying pregnant. Talk with your healthcare provider about which of the many available treatment options is best for you. 

Summary

Intramural fibroids are non-cancerous growths within the walls of the uterus. These fibroids are often harmless but can cause symptoms including heavy periods or trouble conceiving. If you don’t have symptoms, intramural fibroids don’t require treatment, just monitoring. However, if you have symptoms there are treatments available, ranging from birth control to lighten your periods to the surgical removal of the fibroids. 

 A Word From Verywell

Learning that you have fibroids might be jarring if you haven’t had symptoms. If you have been dealing with symptoms like heavy bleeding, having a diagnosis might feel like a relief. It’s important to remember that fibroids aren’t usually dangerous. There are many treatment options available, so you should have an open conversation with your healthcare provider about the least invasive treatment that will be effective for your specific circumstances.