Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentComplicationsCopingFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Complications
Coping
Frequently Asked Questions
Submucosaluterine fibroids are non-cancerous (benign) tumors that grow in the womb (uterus) just under the surface of its lining (endometrium).
Although these are the least common type of uterine fibroid, they often cause the most problems, including menstrual bleeding that can lead to low red blood cell counts (anemia). If you have symptoms of uterine fibroids, you should see a provider to find out if you have submucosal fibroids and get treatment.
This article will discuss what submucosal fibroids are, their symptoms and risk factors, and how they can be treated.
Verywell / Jessica Olah
Symptoms of Submucosal Fibroids
Submucosal fibroids are associated with heavy menstrual bleeding. They are thought to be the cause of 5% to 10% of cases of abnormal uterine bleeding.
Clusters and SizesFibroids can be a single growth or a cluster of growths. Some fibroid clusters are as small as 0.04 inches (1 mm). Others can be more than 8 inches (20 cm) in diameter. Single uterine fibroids can grow to the size of a watermelon.
Clusters and Sizes
Fibroids can be a single growth or a cluster of growths. Some fibroid clusters are as small as 0.04 inches (1 mm). Others can be more than 8 inches (20 cm) in diameter. Single uterine fibroids can grow to the size of a watermelon.
Symptoms of submucosal fibroids include:
Causes of Submucosal Fibroids
The exact cause of fibroids is unknown, but there are some risk factors that make you more likely to have them.
Age
Fibroids become more common as people with uteruses get older, particularly around age 30 and lasting through menopause.
A person’s age at first menstruation also affects their risk for fibroids:
A later-than-typical onset of menopause may increase the risk of fibroids. Aftermenopause, fibroids will often shrink.
Family History
If you have a uterus and a family member who has/had fibroids, you’re at an increased risk of developing uterine fibroids. If a parent had fibroids, your risk is about three times higher than average.
Ethnicity
A person’s race/ethnic background also plays a role in their risk for fibroids.
How Uterine Fibroids Are Diagnosed
While the cause of the discrepancy is not known,health disparitiesand medical racism are thought to have a significant role.
More studies are needed to look at the causes, diagnosis, and treatment of fibroids in Black people with uteruses.
Medical care for uterine fibroids also needs to be developed with an awareness of the differences to make diagnosis, prevention, and treatment of fibroids in Black people more effective.
Hormones
The sex hormones estrogen and progesterone appear to play a major role in the growth of uterine fibroids.
Body Size/Shape
People with uteruses who are overweight are at higher risk for fibroids. People who are very overweight are at a higher risk than people who are less overweight.
Research has shown that obesity is associated with a higher likelihood of uterine fibroids, but it is not clear if obesity causes fibroids or if fibroids are just more common in people who have obesity.
The results of a study in 2014 showed that the presence of uterine fibroids is positively associated with:
The participants in the study who showed the highest risk for fibroids had higher
Diet
What people with uteruses eat may affect their risk for fibroids.
An increased incidence of uterine fibroids has been associated with:
Parity
The number of children a person has given birth to (parity) may affect their risk of developing fibroids.
The risk of developing fibroids in people who have had multiple births is reduced, while never having given birth (nulliparity) may increase the risk of fibroids.
When Are Fibroids a Medical Emergency?Seek immediate medical attention if:You have severe vaginal bleeding.You have new or worsening belly or pelvic pain.
When Are Fibroids a Medical Emergency?
Seek immediate medical attention if:You have severe vaginal bleeding.You have new or worsening belly or pelvic pain.
Seek immediate medical attention if:
How Submucosal Fibroids Are Diagnosed
Auterine fibroidor fibroid cluster is sometimes found during a pelvic exam as part of a routine physical, a gynecological exam, or prenatal care.
To help see the size of the fibroid or fibroid cluster better, a provider may use common objects to make a comparison.
For example, a fibroid might be compared to:
Imaging tests and procedures can be done to get a better view of the fibroids and the areas of the body they are affecting.
Tests that can be used to look at fibroids include:
Sometimes, a provider may want to do surgery to make or confirm a diagnosis of fibroids. Types of surgeries for fibroids include:
Treatment for Submucosal Fibroids
The goals of treatment for fibroids include:
Which treatment is used for fibroids depends on factors such as:
Watchful Waiting
Fibroids do not always need treatment. If the fibroids are not causing problems or symptoms, a “wait and see” approach can be taken.
Hysterectomy
Hysterectomyis a surgery to remove the uterus. It may or may not involve the removal of one or both ovaries and/or fallopian tubes. If the ovaries are removed along with the uterus,menopause will begin immediately.
Types of hysterectomies include:
A hysterectomy completely eliminates fibroids and the symptoms that come with them. It also guarantees the fibroids will not come back.
That said, a hysterectomy has risks and disadvantages, including:
The National Institute for Health and Care Excellence (NICE) recommends that hysterectomy should be considered only when:
Myomectomy
During amyomectomysurgery, uterine fibroids are removed but the uterus is left intact.
There are three types of myomectomies:
A myomectomy usually allows the uterus to return to normal functioning, with periods remaining or returning.
A myomectomy also makes future pregnancies possible, but the pregnancy may need to be monitored for risks and a cesarean section might be needed, depending on how deep the fibroids were and if any spanned a large part of the uterine wall.
Recovery from the procedure can take up to six weeks.
Unlike with a hysterectomy, fibroids can return after a myomectomy, with a recurrence rate of 15% to 30% at five years, depending on the size and extent of the fibroids.
A myomectomy may have surgery-related complications including bleeding and infection.
A Warning About Laparoscopic Power MorcellationLaparoscopic power morcellation is a procedure that uses a medical device to break uterine fibroids into small pieces, allowing them to be removed through a small incision in the abdomen.The Food and Drug Administration (FDA) has issued a warning about laparoscopic power morcellation because if the person also has uterine cancer, the procedure may cause cancer to spread within the abdomen and pelvis. This can make the cancer harder to treat.
A Warning About Laparoscopic Power Morcellation
Laparoscopic power morcellation is a procedure that uses a medical device to break uterine fibroids into small pieces, allowing them to be removed through a small incision in the abdomen.The Food and Drug Administration (FDA) has issued a warning about laparoscopic power morcellation because if the person also has uterine cancer, the procedure may cause cancer to spread within the abdomen and pelvis. This can make the cancer harder to treat.
Laparoscopic power morcellation is a procedure that uses a medical device to break uterine fibroids into small pieces, allowing them to be removed through a small incision in the abdomen.
The Food and Drug Administration (FDA) has issued a warning about laparoscopic power morcellation because if the person also has uterine cancer, the procedure may cause cancer to spread within the abdomen and pelvis. This can make the cancer harder to treat.
Uterine Fibroid Embolization (UFE)
Uterine fibroidembolization(UFE) is a procedure for treating fibroids. A thin catheter is inserted into the artery at the groin or wrist through a small incision and guided to the fibroid’s blood supply.
Small particles (about the size of grains of sand) are released and float downstream to block the small blood vessels, depriving the fibroid of nutrients.
The lack of blood supply causes the fibroid to soften, bleed less, and shrink in size. About 90% of people who have UFE report significant improvement in their symptoms. For some people, their symptoms go away completely.
Some advantages of UFE are:
Some disadvantages of UFE are:
Endometrial Ablation
Endometrial ablationis a procedure that uses heat to destroy the lining of the uterus (endometrium).
It is usually done to stop heavy menstrual bleeding, but it can also be used to treat small fibroids. It is not effective for large fibroids or for fibroids that have grown outside of the interior uterine lining.
It can be done on an outpatient basis and is a quick procedure, taking as few as 10 minutes to complete. While recovery typically takes a few days, watery or bloody discharge can last for several weeks.
This procedure usually stops monthly menstruation. When the flow is not stopped completely, it is usually significantly reduced.
Endometrial ablation is not recommended for people who wish to become pregnant.
The procedure reduces the chances of pregnancy but does not eliminate the possibility. Since the procedure increases the risks of complications, including miscarriage andectopic(tubal) pregnancies, people who have endometrial ablation must take steps to prevent pregnancy.
Endometrial ablation may delay or make it harder to diagnose uterine cancer in the future because postmenopausal bleeding or irregular vaginal bleeding can be warning signs of uterine cancer.
People who have endometrial ablation should continue to have recommended pap smears and pelvic exams to monitor their uterus and cervix.
Ultrasound Guided Radiofrequency Ablation
With this minimally invasive procedure, high-energy waves are used to generate heat that destroys fibroids.
Using ultrasound, a provider verifies the correct placement of the radiofrequency device within each fibroid before ablation is performed.
The procedure is usually done on an outpatient basis and is considered relatively low-risk.
Magnetic Resonance-Guided Focused Ultrasound (MRgFUS)
Magnetic resonance-guided focused ultrasound (MRgFUS) is a non-invasive procedure that takes about three hours to do. It is a relatively new treatment for fibroids.
While the person with fibroids is in amagnetic resonance imaging (MRI)machine, a radiologist identifies and targets the fibroids.
High-intensity ultrasound waves are used to heat and destroy uterine fibroids while the person is in the MRI machine. The procedure uses a device called the ExAblate, which combines MRI with ultrasound.
Although MRgFUS has a low risk of complications and a short recovery time, it does have some limitations, including:
Medications
While medications do not cure fibroids, they can help manage fibroids and the symptoms of them.
Hormone Therapy
Some medications typically prescribed for birth control can also be used to help control symptoms of fibroids. They do not cause fibroids to grow and can help control heavy bleeding.
These medications include:
Another type of medication used to treat fibroids isgonadotropin-releasing hormone agonists (GnRHa), most commonly a drug called Lupron.
GnRHa can shrink fibroids and is sometimes used before surgery to make fibroids smaller and easier to remove.
GnRHa side effects can include:
Most people with uteruses do not menstruate when taking GnRHa. This can help people with anemia from heavy bleeding recover to a normal blood count.
Since GnRHa can cause bone thinning, they are generally only used for 6 months or less.
Cost is a consideration when choosing the treatment, too, as the drugs are quite expensive. Insurance companies may not cover all or any of the costs.
Oriahnn: A New MedicationIn May 2020, the FDA approved a medication called Oriahnn for the treatment of heavy menstrual bleeding in premenopausal people with uterine fibroids.The capsule contains elagolix, estradiol, and norethindrone acetate.
Oriahnn: A New Medication
In May 2020, the FDA approved a medication called Oriahnn for the treatment of heavy menstrual bleeding in premenopausal people with uterine fibroids.The capsule contains elagolix, estradiol, and norethindrone acetate.
In May 2020, the FDA approved a medication called Oriahnn for the treatment of heavy menstrual bleeding in premenopausal people with uterine fibroids.
The capsule contains elagolix, estradiol, and norethindrone acetate.
Other medications used to treat fibroids include:
Complications with Submucosal Fibroids
Submucosal fibroids often cause more bleeding problems than other types of fibroids because they can crowd the uterine space. Even very small submucosal fibroids may cause symptoms.
Submucosal fibroids are also the most likely type of fibroid to lead to pregnancy and fertility problems, including:
Other complications of fibroids can include:
Coping with Submucosal Fibroids
If you have symptoms of fibroids, talk with your provider about treatment. Symptom management may not be enough.
To help cope with fibroid symptoms while you’re waiting for treatment, you can:
More Information on FibroidsIf you have uterine fibroids and are looking for guidance and support,The White Dress Project—a nonprofit organization that is primarily made up of cisgender women who have shared their fibroid journeys—is a great place to turn to.Other helpful resources include:The Fibroid FoundationCARE About FibroidsUterine Fibroids: Removal Support GroupUterine Fibroid Support & Resource Group
More Information on Fibroids
If you have uterine fibroids and are looking for guidance and support,The White Dress Project—a nonprofit organization that is primarily made up of cisgender women who have shared their fibroid journeys—is a great place to turn to.Other helpful resources include:The Fibroid FoundationCARE About FibroidsUterine Fibroids: Removal Support GroupUterine Fibroid Support & Resource Group
If you have uterine fibroids and are looking for guidance and support,The White Dress Project—a nonprofit organization that is primarily made up of cisgender women who have shared their fibroid journeys—is a great place to turn to.
Other helpful resources include:
Summary
While submucosal fibroids are the least common type of uterine fibroids, they can cause serious and unpleasant symptoms such as excessive menstrual bleeding.
If you are experiencing symptoms of fibroids, make an appointment to see a healthcare provider, especially if you are or plan to become pregnant.
Several treatments exist for submucosal fibroids that can get rid of fibroids for good or help manage the symptoms they cause.
Frequently Asked QuestionsDrinking green tea could be helpful in relieving fibroid symptoms. A 2013 study suggests that the flavanol EGCG, found in green tea, may reduce the size of uterine fibroids and improve symptoms of anemia and blood loss.In traditional Chinese medicine, Gui Zhi Fu Ling Tang (a combination of herbs), is used to treatmenstrual cramps and fibroids.Talk to your healthcare provider before taking any herbs or supplements.Thegrowth of fibroidsvaries. One study suggested that average fibroid growth is 89% per 18 months. This means a 2 cm fibroid (about the size of a blueberry) is likely to take about four to five years to double its diameter.It also found that very small fibroids tend to grow more quickly than larger ones.The pressure of the fibroid(s) against the uterine wall can cause the endometrial tissue whose lining is shed during menstruation to bleed more than usual.Also, fibroids do not allow the uterus to contract well enough to effectively stop menstrual bleeding.Fibroids also produce growth factors (proteins) that stimulate the blood vessels of the uterus causing more blood in the uterine cavity and heavier periods.The hormones released during pregnancy to support the growth of the fetus can also cause fibroids to get bigger, which can cause pre-term labor or complications during delivery.If fibroids are discovered before or during pregnancy, your healthcare provider will monitor them for changes and complications.
Drinking green tea could be helpful in relieving fibroid symptoms. A 2013 study suggests that the flavanol EGCG, found in green tea, may reduce the size of uterine fibroids and improve symptoms of anemia and blood loss.In traditional Chinese medicine, Gui Zhi Fu Ling Tang (a combination of herbs), is used to treatmenstrual cramps and fibroids.Talk to your healthcare provider before taking any herbs or supplements.
Drinking green tea could be helpful in relieving fibroid symptoms. A 2013 study suggests that the flavanol EGCG, found in green tea, may reduce the size of uterine fibroids and improve symptoms of anemia and blood loss.
In traditional Chinese medicine, Gui Zhi Fu Ling Tang (a combination of herbs), is used to treatmenstrual cramps and fibroids.Talk to your healthcare provider before taking any herbs or supplements.
Thegrowth of fibroidsvaries. One study suggested that average fibroid growth is 89% per 18 months. This means a 2 cm fibroid (about the size of a blueberry) is likely to take about four to five years to double its diameter.It also found that very small fibroids tend to grow more quickly than larger ones.
The pressure of the fibroid(s) against the uterine wall can cause the endometrial tissue whose lining is shed during menstruation to bleed more than usual.Also, fibroids do not allow the uterus to contract well enough to effectively stop menstrual bleeding.Fibroids also produce growth factors (proteins) that stimulate the blood vessels of the uterus causing more blood in the uterine cavity and heavier periods.
The pressure of the fibroid(s) against the uterine wall can cause the endometrial tissue whose lining is shed during menstruation to bleed more than usual.Also, fibroids do not allow the uterus to contract well enough to effectively stop menstrual bleeding.
Fibroids also produce growth factors (proteins) that stimulate the blood vessels of the uterus causing more blood in the uterine cavity and heavier periods.
The hormones released during pregnancy to support the growth of the fetus can also cause fibroids to get bigger, which can cause pre-term labor or complications during delivery.If fibroids are discovered before or during pregnancy, your healthcare provider will monitor them for changes and complications.
The hormones released during pregnancy to support the growth of the fetus can also cause fibroids to get bigger, which can cause pre-term labor or complications during delivery.
If fibroids are discovered before or during pregnancy, your healthcare provider will monitor them for changes and complications.
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25 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Cruz MSDDL, Buchanan EM.Uterine fibroids: diagnosis and treatment.AFP. 95(2):100-107.Cleveland Clinic.Uterine fibroids.USA Fibroid Centers.Submucosal fibroids: What Are They?Office On Women’s Health.Uterine fibroids.Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894.Uterine fibroids: overview.Institute for Quality and Efficiency in Health Care(IQWiG).Stewart EA, Nicholson WK, Bradley L, Borah BJ.The burden of uterine fibroids for African-American women: results of a national survey. Journal of Women’s Health. 22(10):807-816.Wise LA, Palmer JR, Cozier YC, Hunt MO, Stewart EA, Rosenberg L. Perceived racial discrimination and risk of uterine leiomyomata.Epidemiology. 2007;18(6):747-757. doi:10.1097/EDE.0b013e3181567e92Mount Sinai.Uterine fibroids and hysterectomy.Yang Y, He Y, Zeng Q, Li S.Association of body size and body fat distribution with uterine fibroids among Chinese women.Journal of Women’s Health. 23(7):619-626. doi:10.1089/jwh.2013.4690Dalton-Brewer N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep. 5(2):110-118.National Institute of Child Health and Human Development.What are the risk factors for uterine fibroids?MyHealth Alberta.Uterine fibroids: care instructions.MedlinePlus.Uterine fibroids.Harvard Health.What to do about fibroids.Khan A, Shehmar M, Gupta J.Uterine fibroids: current perspectives.IJWH.Cleveland Clinic.Myomectomy.U.S. Food and Drug Administration.Laparoscopic power morcellators.Johns Hopkins.Is uterine fibroid embolization (UFE) the right treatment for you?Healthlink BC.Uterine fibroid embolization (UFE).Cleveland Clinic.New medication gets FDA approval for fibroid-associated menstrual bleeding.UCLA Health.Medications for fibroids.Harvard Health.What is a submucosal uterine fibroid?Roshdy E, Rajaratnam V, Maitra S, Sabry M, Allah AS, Al-hendy A.Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomized controlled clinical study.Int J Womens Health. 5:477-86. doi:10.2147/IJWH.S41021Uterine fibroid incidence and growth in an ultrasound-based, prospective study of young African Americans.American Journal of Obstetrics and Gynecology. 223(3):402.e1-402.e18. doi:10.1016/j.ajog.2020.02.016USA Fibroid Centers.Causes of irregular periods: do fibroids cause heavy bleeding?
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cruz MSDDL, Buchanan EM.Uterine fibroids: diagnosis and treatment.AFP. 95(2):100-107.Cleveland Clinic.Uterine fibroids.USA Fibroid Centers.Submucosal fibroids: What Are They?Office On Women’s Health.Uterine fibroids.Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894.Uterine fibroids: overview.Institute for Quality and Efficiency in Health Care(IQWiG).Stewart EA, Nicholson WK, Bradley L, Borah BJ.The burden of uterine fibroids for African-American women: results of a national survey. Journal of Women’s Health. 22(10):807-816.Wise LA, Palmer JR, Cozier YC, Hunt MO, Stewart EA, Rosenberg L. Perceived racial discrimination and risk of uterine leiomyomata.Epidemiology. 2007;18(6):747-757. doi:10.1097/EDE.0b013e3181567e92Mount Sinai.Uterine fibroids and hysterectomy.Yang Y, He Y, Zeng Q, Li S.Association of body size and body fat distribution with uterine fibroids among Chinese women.Journal of Women’s Health. 23(7):619-626. doi:10.1089/jwh.2013.4690Dalton-Brewer N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep. 5(2):110-118.National Institute of Child Health and Human Development.What are the risk factors for uterine fibroids?MyHealth Alberta.Uterine fibroids: care instructions.MedlinePlus.Uterine fibroids.Harvard Health.What to do about fibroids.Khan A, Shehmar M, Gupta J.Uterine fibroids: current perspectives.IJWH.Cleveland Clinic.Myomectomy.U.S. Food and Drug Administration.Laparoscopic power morcellators.Johns Hopkins.Is uterine fibroid embolization (UFE) the right treatment for you?Healthlink BC.Uterine fibroid embolization (UFE).Cleveland Clinic.New medication gets FDA approval for fibroid-associated menstrual bleeding.UCLA Health.Medications for fibroids.Harvard Health.What is a submucosal uterine fibroid?Roshdy E, Rajaratnam V, Maitra S, Sabry M, Allah AS, Al-hendy A.Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomized controlled clinical study.Int J Womens Health. 5:477-86. doi:10.2147/IJWH.S41021Uterine fibroid incidence and growth in an ultrasound-based, prospective study of young African Americans.American Journal of Obstetrics and Gynecology. 223(3):402.e1-402.e18. doi:10.1016/j.ajog.2020.02.016USA Fibroid Centers.Causes of irregular periods: do fibroids cause heavy bleeding?
Cruz MSDDL, Buchanan EM.Uterine fibroids: diagnosis and treatment.AFP. 95(2):100-107.
Cleveland Clinic.Uterine fibroids.
USA Fibroid Centers.Submucosal fibroids: What Are They?
Office On Women’s Health.Uterine fibroids.
Information NC for B, Pike USNL of M 8600 R, MD B, Usa 20894.Uterine fibroids: overview.Institute for Quality and Efficiency in Health Care(IQWiG).
Stewart EA, Nicholson WK, Bradley L, Borah BJ.The burden of uterine fibroids for African-American women: results of a national survey. Journal of Women’s Health. 22(10):807-816.
Wise LA, Palmer JR, Cozier YC, Hunt MO, Stewart EA, Rosenberg L. Perceived racial discrimination and risk of uterine leiomyomata.Epidemiology. 2007;18(6):747-757. doi:10.1097/EDE.0b013e3181567e92
Mount Sinai.Uterine fibroids and hysterectomy.
Yang Y, He Y, Zeng Q, Li S.Association of body size and body fat distribution with uterine fibroids among Chinese women.Journal of Women’s Health. 23(7):619-626. doi:10.1089/jwh.2013.4690
Dalton-Brewer N.The role of complementary and alternative medicine for the management of fibroids and associated symptomatology.Curr Obstet Gynecol Rep. 5(2):110-118.
National Institute of Child Health and Human Development.What are the risk factors for uterine fibroids?
MyHealth Alberta.Uterine fibroids: care instructions.
MedlinePlus.Uterine fibroids.
Harvard Health.What to do about fibroids.
Khan A, Shehmar M, Gupta J.Uterine fibroids: current perspectives.IJWH.
Cleveland Clinic.Myomectomy.
U.S. Food and Drug Administration.Laparoscopic power morcellators.
Johns Hopkins.Is uterine fibroid embolization (UFE) the right treatment for you?
Healthlink BC.Uterine fibroid embolization (UFE).
Cleveland Clinic.New medication gets FDA approval for fibroid-associated menstrual bleeding.
UCLA Health.Medications for fibroids.
Harvard Health.What is a submucosal uterine fibroid?
Roshdy E, Rajaratnam V, Maitra S, Sabry M, Allah AS, Al-hendy A.Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomized controlled clinical study.Int J Womens Health. 5:477-86. doi:10.2147/IJWH.S41021
Uterine fibroid incidence and growth in an ultrasound-based, prospective study of young African Americans.American Journal of Obstetrics and Gynecology. 223(3):402.e1-402.e18. doi:10.1016/j.ajog.2020.02.016
USA Fibroid Centers.Causes of irregular periods: do fibroids cause heavy bleeding?
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