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Intramural Fibroids - Causes, Symptoms, Diagnosis, and Treatment

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An intramural fibroid is a benign tumor that develops in the space between the uterine muscles. Read to know details about its causes, symptoms, and treatment.

Medically reviewed by

Dr. Sunita Kothari

Published At December 23, 2022
Reviewed AtFebruary 28, 2023

What Are Uterine Fibroids?

Uterine fibroids are benign tumors that grow in and on the uterus. Although not all fibroids cause symptoms, when they do, those symptoms may include painful sex, frequent urination, back pain, and heavy menstrual bleeding. Larger fibroids can be treated with medication or surgery, while smaller fibroids frequently do not require treatment.

The locations of fibroids in and on the uterus are known by a variety of names. These names describe the location of the fibroid as well as its attachment.

A person may have uterine fibroids in the following places-

  • Intramural Fibroids - The uterus's wall has these fibroids embedded within it, which can be compared to a house's walls.

  • Submucosal Fibroids - The fibroids develop within the uterine cavity (where a baby grows during pregnancy). The growths descend into the uterus's middle, where there is an empty space.

  • Subserosal Fibroids - These fibroids are connected closely to the exterior wall of the uterus and are situated on the outside of the uterus.

  • Pedunculated Fibroids - These fibroids are the least typical type and are also found outside the uterus. Pedunculated fibroids, on the other hand, have a short stem that connects them to the uterus. Since they have a stalk before a much wider top, they are frequently compared to mushrooms.

Size and Number of Fibroids - Fibroids can develop as a cluster or as a single nodule (one growth). Fibroid clusters can be as small as 1 mm or as large as 20 cm (8 inches), or even more. They can grow to be the size of a watermelon in some cases.

What Are Intramural Fibroids?

The noncancerous tumor, known as an intramural fibroid, develops in the muscles of the uterus. Intramural fibroids can be as small as a pea or as large as a grapefruit in size. Intramural fibroids can be of different types-

  1. Anterior Intramural Fibroid - An anterior intramural fibroid is a uterine fibroid located in the front of the uterus.

  2. Posterior Intramural Fibroid - The posterior intramural fibroid is found at the back of the uterus.

  3. Fundal Intramural Fibroid - The fundal intramural fibroid is found in the upper part of the uterus (fundus).

What Are the Causes of Intramural Fibroids?

It is unclear what specifically causes intramural fibroids. Many medical professionals think that an abnormal muscle cell in the middle layer of the uterine wall is the origin of fibroids. This cell quickly multiplies and develops a tumor when estrogen, the main female hormone, has an effect on it.

What Are the Symptoms of Intramural Fibroids?

The signs and symptoms of intramural fibroids are similar to those of other fibroid types. While many people have mild symptoms, some people have more severe symptoms, such as-

  • Pelvic pain.

  • Heavy and irregular menstrual bleeding.

  • Pain in the lower back region.

  • Bleeding in between periods.

  • Painful sexual intercourse.

  • Chronic vaginal discharge.

After menopause, the body's hormone levels begin to decline, which causes the symptoms of uterine fibroids to stabilize or disappear.

How Are Intramural Fibroids Diagnosed?

Intramural fibroids and other kinds of fibroids are frequently found during a routine pelvic or abdominal examination. There may be additional methods for diagnosing these growths, such as-

  • X-rays.

  • Pelvic MRI (Magnetic Resonance Imaging) Scan- By utilizing magnets and radio waves, this test produces precise images of the internal organs.

  • Hysteroscopy- During a hysteroscopy, the doctor will use a scope (a thin, flexible tube with a camera on the end) to examine the uterus for fibroids. The scope is moved into the uterus after passing through the vagina and cervix.

  • Transvaginal Ultrasound or Ultrasonography- With the help of sound waves, this non-invasive imaging test produces an image of the internal organs. The ultrasound procedure can be carried out either transvaginally or transabdominally, depending on the size of the uterus.

  • Endometrial Biopsy.

What Is the Treatment of Intramural Fibroids?

The doctor will monitor symptoms for any changes and examine whether the fibroids have grown bigger. If the patient starts to exhibit serious symptoms, the doctor might suggest additional treatment methods like-

  • Medications - Any medication a patient takes should be discussed with their doctor. Before beginning a new medication, the patient should always talk to their doctor to discuss any potential side effects.

  1. Over-the-counter (OTC) pain medications like Acetaminophen and Ibuprofen.

  2. Iron supplements for patients who have excessive bleeding. This is given to avoid anemia.

  3. The use of birth control can aid in reducing excessive menstrual bleeding. They consist of intrauterine devices, intravaginal contraceptives, injections, and oral contraceptives (IUDs).

  4. Gonadotropin-Releasing Hormone (GnRH) Agonists- This medication causes medical menopause and lowers estrogen levels. The goal is to reduce or remove the fibroid. However, these treatments are only temporary, and the fibroids may return if the patient stops taking them.

  5. Oral therapies using drugs like Elagolix or Tranexamic acid control heavy uterine bleeding in patients who have not achieved menopause.

  • Surgical Management - When discussing the various fibroid surgery options, there are a number of things to consider. In addition to the size, location, and number of fibroids, the patient's desire for future pregnancies can also be a key consideration when creating a treatment plan. While other surgical options can either harm or remove the uterus, some preserve the uterus and allow the patient to conceive in the future.
  1. Myomectomy - Using a myomectomy, the doctor can get rid of the fibroids without harming the uterus.

  2. Hysteroscopy - The entire uterus will be removed during this surgery to stop further complications from fibroids.

  3. Uterine Artery Embolization (UAE) - By using this method, the fibroid's blood supply is cut off. A UAE aims to reduce the fibroid's size or eliminate it.


Uterine fibroids are a common condition many people suffer from at some point in their lives. The tumors are typically slow-growing and noncancerous (benign) in more than 99 % of cases. Intramural fibroids can be easily treated. Intramural fibroids rarely manifest any symptoms. However, if they do, this condition can make women very uncomfortable. To get a thorough diagnosis, a woman must make an appointment with her doctor if she experiences any unusual bleeding or other symptoms. The doctor can offer suggestions for specific treatments or advice on managing the discomfort.

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Dr. Sunita Kothari
Dr. Sunita Kothari

Obstetrics and Gynecology


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