What Are Pedunculated Fibroids?

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Like all types of fibroids, pedunculated fibroids develop out of the muscle of the uterus. Fibroids are typically round formations of muscle fiber. In the case of pedunculated fibroids, the round nodule is attached to the uterus by a stem known as the peduncle. 

Pedunculated fibroids are any fibroids that have a peduncle, or stem. However, these fibroids are further broken down into types of fibroids based on where around the uterus they occur:

  • Submucosal fibroids grow directly under the lining of the womb. Pedunculated submucosal fibroids extend into the uterus, but originate in the lining of the womb. 
  • Subserosal fibroids grow on the outer wall of the womb.

This article focuses on the causes, symptoms, and treatment of pedunculated fibroids.

at the doctor's office

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Causes and Risk Factors

Healthcare providers aren’t sure what causes fibroids to develop, or why some fibroids develop on a peduncle. It’s believed that the sex hormones estrogen and progesterone play a role since most women don’t experience fibroids after they enter menopause. However, the exact cause of fibroids isn’t understood.

Healthcare providers do know about certain risk factors that will make it more likely that a person will experience fibroids. However, in most cases, they don’t know why these factors increase risk—just that they do. 

The risk factors for fibroids are:

  • Being Black (Black women have a two to three times increased risk of fibroids) 
  • Being overweight
  • Having a close female relative, like a mother or sister, who has fibroids
  • Never having been pregnant

On the other hand, fibroids are less common in people who have had several pregnancies, or those who have been on birth control pills. This suggests that there is a hormonal factor at play in the development of fibroids. 

Symptoms

In most cases, uterine fibroids don’t cause symptoms. However, for some people, they can become problematic. If you experience symptoms of fibroids, it’s a good idea to speak with a healthcare provider. 

Symptoms of Pedunculated Fibroids

Pedunculated fibroids can cause more severe and noticeable symptoms than fibroids that are not attached by a stem. That’s because sudden movements can cause the stalk to twist. This cuts off blood flow to the fibroid, which can cause a sudden pain or pressure. 

Other symptoms of pedunculated fibroids include:

  • More frequent painful episodes as the fibroid gets bigger and more prone to twisting
  • Cramps
  • Pressure in the lower abdomen
  • Irregular bleeding or heavy periods if the fibroid is submucosal (occurring inside the uterus)

Fibroids and Fertility

Many people are concerned about whether fibroids will affect fertility. It’s estimated that only 1% to 2% of infertility cases can be blamed on fibroids.

In particular, submucosal fibroids can affect fertility, since they can change the space within the womb and could prevent a fertilized egg from implanting. If you have a pedunculated submucosal fibroid and would like to become pregnant, you should speak with a healthcare provider about the best course of action. 

Fibroids and Cancer

Fibroids are not linked to cancer. Healthcare providers used to think they might increase the risk of cancer, but there is no evidence for this, and scientists now agree that they are not a risk factor for cancer.

Treatments

The treatment for fibroids varies, so it’s best to speak with a healthcare provider about what treatment options are best for you.

Some treatments control the symptoms of fibroids, such as heavy periods. Others—like surgery—address the fibroids themselves, reducing the size or removing them. There are two common treatments for pedunculated fibroids, which are explained below.

Uterine Artery Embolization

Uterine artery embolization (UAE) is a process that cuts off blood flow to fibroids. This is done using a catheter, and the person is usually awake for the procedure but doesn’t feel it due to local anesthesia. Once the blood flow to the fibroid has been cut off, the fibroid shrinks.

This procedure is most often used with fibroids that are 2 centimeters or wider, and it’s most effective for subserosal fibroids (those that grow outside the womb).

A downside of this procedure is that 10% of people have fibroids that will regrow within two years, and the procedure will have to be repeated. 

Myomectomy

Some people with fibroids choose to have a myomectomy. This is a procedure to remove fibroids and repair the uterus. Myomectomy is a major surgery that is performed under general anesthesia and requires a hospital stay. 

Those who wish to become pregnant after having a myomectomy should speak with a healthcare provider about the benefits and risks.

In some cases, a myomectomy can lead to a hysterectomy (removal of the uterus). In other cases, people who have had a myomectomy will need to deliver by a cesarean section in the future.

Frequently Asked Questions

What might cause a pedunculated fibroid to twist?

Sudden movements like jumping, flipping, or twisting can cause a pedunculated fibroid to twist or flip. This can be quite painful. As a fibroid grows, it’s more likely to twist.

How fast do fibroids grow?

The rate of fibroid growth is unpredictable, even within one person. On average, fibroids increase 89% in 18 months. Research has found that fibroids larger than 2 centimeters usually grow more slowly than fibroids that are smaller than 1 centimeter. That means that a 2-centimeter fibroid would take roughly four years to double in size. 

Why do fibroids cause heavy bleeding?

Fibroids, especially those that are within the uterus, can increase menstrual bleeding because they put pressure on the uterine walls. These fibroids originate in the lining of the uterus, which is shed during a period, and thus are more likely to cause heavier periods.

If you’re experiencing heavy periods, speak with a healthcare provider, since this can increase your risk of anemia

How do you deal with fibroids during pregnancy?

In most cases, fibroids do not cause pregnancy complications. However, fibroids within the womb can slightly increase your risk of miscarriage.

In rare cases, the position of a fibroid might interfere with a vaginal delivery and mean that a pregnant person needs a cesarean section.

A Word From Verywell

Learning that you have uterine fibroids can be scary. In addition, pedunculated fibroids can be painful. However, there are treatments available that can help keep fibroids from interfering with your life. Fibroids are almost never cancerous, and they’re unlikely to interfere with fertility. 

Still, it’s important to find a trusted healthcare provider who can answer your questions about pedunculated fibroids. That way, you can feel empowered to select a treatment option that is right for you. 

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  1. MedlinePlus. Uterine fibroids. Updated June 14, 2021.

  2. Fibroid Treatment Collective. Pedunculated fibroids and the benefit of UAE. Updated April 8, 2009.

  3. Baird DD, Patchel SA, Saldana TM, et al. Uterine fibroid incidence and growth in an ultrasound-based, prospective study of young African AmericansAmerican Journal of Obstetrics and Gynecology. 2020;223(3):402.e1-402.e18. doi:10.1016/j.ajog.2020.02.016