What Is an Intramural Fibroid?

Intramural fibroids are the most common type of uterine fibroids. A uterine fibroid is a non-cancerous growth that happens in or around the uterus.

Intramural fibroids grow within the walls of the uterus. Many people with intramural fibroids have no symptoms, but others experience painful periods and reproductive challenges. 

Read on to learn more about intramural fibroids, including types, causes, diagnosis, and treatment.

Woman in pain.

Grace Cary / Getty Images

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.

Intramural Fibroid Symptoms

Verywell / Jessica Olah

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.

Black women are more likely than other women to experience uterine fibroids, although doctors aren't sure why. Black women are also more likely to be offered invasive surgical treatments, so be sure to talk to your healthcare provider about less invasive options.

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. 

If you want to be able to have children in the future, talk to your healthcare provider about treatments that preserve fertility.

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.

Frequently Asked Questions

  • What is considered a large intramural fibroid?

    Intramural fibroids can be very large. A large fibroid is one that is 10 centimeters or more in diameter. However, even smaller fibroids that are about 4 centimeters in diameter can cause complications, like blocking the fallopian tubes or interfering with delivery. The size of the fibroid is not necessarily tied to the severity of symptoms.

  • How long should you wait to get pregnant after an intramural fibroid myomectomy?

    After a myomectomy, you should wait three to six months to get pregnant, in order to allow your uterus time to heal. Talk to your healthcare provider about the specifics of your situation.

  • What is a calcified intramural fibroid?

    A calcified fibroid is one that has died or degenerated. This usually happens after menopause when hormonal changes cause fibroids to lose blood flow, causing the cells in the fibroid to die, then calcify.

  • How do you shrink fibroids naturally with herbs?

    Although there aren’t herbs proven to shrink fibroids, certain lifestyle adjustments may help. Reducing stress, maintaining a healthy weight, and limiting red meat and soy can help keep fibroids at bay.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. USA Fibroid Centers. What are intramural fibroids?

  2. Johns Hopkins Medicine. Uterine fibroids: Q&A with an expert.

  3. De la Cruz, Maria et al. Uterine fibroids: diagnosis and treatment. American Family Physician.

  4. MedlinePlus. Uterine fibroids. U.S. National Library of Medicine.

  5. Office of Women's Health. Uterine fibroids.

  6. National Institutes of Health. How are uterine fibroids diagnosed?

  7. USA Fibroid Centers. What is considered a large fibroid?

By Kelly Burch
Kelly Burch is has written about health topics for more than a decade. Her writing has appeared in The Washington Post, The Chicago Tribune, and more.