The Different Types of Fibroids and Where They Grow

There are four types of fibroids, some more problematic than others

Uterine fibroids are extremely common The incidence rate is unknown and varies by study, but they can be detected in up to 80% of women by 50 years of age. Many people with fibroids don’t know they have them because many fibroids are asymptomatic. In other cases, fibroids can cause symptoms like heavy periods, pain, or trouble getting pregnant. 

The symptoms and severity can depend on what types of fibroids a person has, as well as their location and size. Symptoms overlap among the different types, but certain types can be more likely to cause certain symptoms. The most common symptom of all fibroids is heavy or prolonged menses.

Fibroids are all made up of muscle fiber that originates in the uterus. However, they are categorized by where they grow and the shape they take.

Here’s what you should know about the different types of fibroids. 

Types of Fibroids

Verywell / Julie Bang

Pedunculated Fibroids

Pedunculated fibroids are fibroids that grow on a long stalk.

The three other types of fibroids are characterized by where they develop, but two of these types can occur as pedunculated fibroids as well.

No matter where they occur, pedunculated fibroids can be painful because the stalk that they grow on can twist, cutting off blood supply to the fibroid and causing shooting pain.

Subserosal Fibroids

Subserosal fibroids grow on the outside of the uterus. They are the most common type of fibroid.

Some subserosal fibroids grow directly on the uterus, while others are attached to the uterus by a thin stalk of tissue—these are known as pedunculated subserosal fibroids.

Since subserosal fibroids grow on the outside of the uterus, they don’t cause many issues with the reproductive system. However, they can cause other symptoms as they grow and compress the surrounding organs, like the bladder.

People with subserosal fibroids might:

  • Feel bloated or have heaviness in their abdomen
  • Become constipated or need to urinate frequently

If you have a pedunculated subserosal fibroid, you might experience occasional sharp pain if the fibroid twists. 

Intramural Fibroids

Intramural fibroids occur in the wall of the uterus, beneath the endometrium. These are a common type of fibroid.

Intramural fibroids can affect the function of the uterus and the surrounding organs, depending on where they grow and put pressure. Intramural fibroids can cause long, heavy periods, back pain, and frequent urination. 

Intramural fibroids are further classified by where they occur:

  • An anterior intramural fibroid grows at the front of the uterus.
  • A posterior intramural fibroid grows at the back of the uterus.
  • A fundal intramural fibroid grows on the top wall of the uterus.

Submucosal Fibroids

Submucosal fibroids are the most rare type of fibroids, and often the most problematic.

They grow underneath the lining of the uterus, which is known as the endometrium. Since the endometrium is shed monthly during a person’s menstrual cycle, having fibroids here can lead to complications with periods, including heavy bleeding and long periods. 

Submucosal fibroids can cause trouble with fertility. About 1% to 2% of infertility cases are attributed to fibroids, most often submucosal fibroids. These fibroids can distort the uterus and other reproductive organs such as the fallopian tubes, making it difficult for a person to get pregnant.

They can also grow on stalks, extending through the endometrium into the open space of the uterus. These fibroids—known as pedunculated submucosal fibroids—can increase the risk of miscarriage or birth defects.

Symptom Differences

Fibroid symptoms depend on where the fibroids grow and how they develop. Your symptoms might give you a clue as to what type of fibroids you have.

  • Pedunculated fibroids can cause sharp pain if they become twisted.
  • Subserosal fibroids cause complications with the organs surrounding the uterus, including the bladder and rectum. The symptoms can include frequent urination and constipation. 
  • Submucosal fibroids cause issues with the reproductive tract, including heavy periods and trouble conceiving and carrying a pregnancy to term. 
  • Intramural fibroids can cause symptoms that mimic those of subserosal or submucosal fibroids.

Treatment Differences

The treatment for fibroids can be complex and highly individualized. You should speak to your doctor about your goals for treatment, and whether you want to be able to get pregnant after treatment. Many treatments for fibroids are suitable only for people who do not want to become pregnant in the future. 

In some cases, you won’t need to treat your fibroids at all. Fibroids need to be treated only if they’re causing symptoms, like heavy bleeding or trouble getting pregnant.

Common treatments for fibroids include:

  • Hormonal treatments, like birth control pills and IUDs containing levonorgestrel (or progesterone), which can prevent fibroid growth and reduce symptoms like heavy bleeding
  • Surgical options, ranging from fibroid removal to a full hysterectomy
  • Uterine fibroid embolization, a procedure to cut off blood flow to the fibroids, which causes them to shrink
  • Myolysis, or focused ultrasound surgery, a procedure that kills off the fibroid tissue using heat, cold, or high-frequency ultrasound 
  • Medication, including a new treatment called relugolix—an oral GnRH antagonist—that is approved for use by the Food and Drug Administration (FDA) in combination with estrogen and progesterone for the treatment of heavy menstrual bleeding

The only cure for fibroids is a full hysterectomy. If you opt for a different procedure, you may need additional fibroid treatments in the future, since fibroids are likely to grow back.

Frequently Asked Questions

What kinds of fibroids warrant hysterectomy?

The only foolproof cure for fibroids is a hysterectomy, or surgery to remove the uterus. If you have lots of symptoms and want a permanent solution to your fibroids, a hysterectomy is a good choice. However, you will not be able to get pregnant in the future if you have a hysterectomy. 

How do you shrink fibroids?

There are various treatments designed to shrink fibroids. Some medications that induce menopause can reduce fibroid size. Surgical procedures including embolization and myolysis can also cause fibroids to shrink, which reduces symptoms in some cases. 

What size fibroids should be removed?

Whether or not a fibroid should be removed will depend on the types of symptoms it is causing you. There is no clearly defined size that warrants fibroid removal, but if your fibroids are causing symptoms, you should speak with your doctor about the best course of treatment. 

A Word From Verywell

Knowing about the different types of fibroids can be helpful for understanding your health. However, it’s also important to recognize that many people have more than one type of fibroid. The protocol for treating fibroids is highly individualized. Your doctor will help walk you through the benefits and drawbacks of various types of treatment so that you can decide which is best for you. 

5 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. De La Cruz MSD, Buchanan EM. Uterine fibroids: diagnosis and treatmentAm Fam Physician. 2017;95(2):100-107.

  2. MedlinePlus. Uterine fibroids.

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

  4. USA Fibroid Centers. What are intramural fibroids?

  5. MidcityOBGYN. What is a submucosal fibroid and how can it be treated?

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.