Intramural Leiomyoma of the Uterus: Causes, Symptoms, and Treatment

An intramural leiomyoma of the uterus, commonly called an intramural fibroid, is a noncancerous growth that develops within the muscular wall of the uterus (the myometrium). It is the most common type of uterine fibroid and can vary in size, from small nodules to large masses that distort the uterus. While not cancerous, intramural fibroids can lead to significant discomfort and health issues if left untreated.

What Is an Intramural Leiomyoma?

An intramural leiomyoma develops when smooth muscle cells of the uterine wall begin to multiply abnormally, forming a firm, rubbery mass. As the fibroid grows, it expands within the myometrium, potentially altering the uterus’s shape or size. These fibroids often go unnoticed in their early stages but may eventually cause symptoms due to pressure on surrounding organs or interference with normal uterine function.

Causes and Risk Factors

While the exact cause of intramural leiomyoma is unknown, several factors contribute to its development:

Hormonal Influence: Estrogen and progesterone—female reproductive hormones—stimulate the growth of fibroids. They often enlarge during pregnancy and shrink after menopause when hormone levels drop.

Genetic Predisposition: Women with a family history of uterine fibroids are more likely to develop them

Age: Fibroids commonly appear between the ages of 30 and 50.

Obesity: Excess body fat increases estrogen production, encouraging fibroid growth.

Lifestyle and Environmental Factors: Diets high in red meat, stress, and exposure to certain chemicals may increase risk.

Common Symptoms

Many women with intramural leiomyomas experience no symptoms. However, when fibroids enlarge, they can lead to several noticeable issues:

Heavy or Prolonged Menstrual Bleeding: This may cause anemia over time.

Pelvic Pain or Pressure: Discomfort may result from fibroid expansion within the uterine wall.

Abdominal Swelling: Large fibroids can make the abdomen appear bloated or enlarged.

Frequent Urination: Pressure on the bladder reduces its capacity.

Constipation or Back Pain: Larger fibroids can press on nearby organs or nerves.

Fertility Challenges: In some cases, fibroids may interfere with implantation or pregnancy.

The intensity of these symptoms depends on the size, number, and location of the fibroids.

Diagnosis

Diagnosis begins with a pelvic examination. If fibroids are suspected, imaging tests such as ultrasound or MRI are used to confirm their presence, determine size, and locate them within the uterus. MRI scans are especially helpful in mapping multiple fibroids before treatment planning.

Blood tests may also be recommended to check for anemia caused by heavy menstrual bleeding.

Treatment Options

Treatment depends on symptom severity, fibroid size, location, and the patient’s fertility goals.

1. Watchful Waiting

If fibroids are small and cause no significant symptoms, regular monitoring may be all that’s required. Many fibroids shrink naturally after menopause.

2. Medication

Medications can help manage symptoms but usually do not remove fibroids. Common options include:

Hormonal therapies such as birth control pills or hormonal IUDs to reduce bleeding.

Gonadotropin-releasing hormone (GnRH) agonists to temporarily shrink fibroids.

Nonsteroidal anti-inflammatory drugs (NSAIDs) to ease pain.

3. Minimally Invasive Procedures

Uterine Fibroid Embolization (UFE): A catheter blocks blood flow to fibroids, causing them to shrink.

MRI-guided Focused Ultrasound: Uses ultrasound waves to destroy fibroid tissue without surgery.

Radiofrequency Ablation: Heat energy is used to reduce fibroid size and relieve symptoms.

4. Surgical Options

Myomectomy: Removes fibroids while preserving the uterus—ideal for women who wish to maintain fertility.

Hysterectomy: Complete removal of the uterus. This is a definitive solution but eliminates future pregnancy possibilities.

Managing Daily Life with Intramural Fibroids

Lifestyle adjustments can help manage mild symptoms and support treatment:

Maintain a balanced diet rich in fruits, vegetables, and whole grains.

Reduce red meat and processed food intake.

Exercise regularly to maintain a healthy weight and improve hormone balance.

Manage stress through yoga, meditation, or breathing techniques.

When to See a Doctor

Consult a gynecologist if you experience heavy bleeding, persistent pelvic pain, or difficulty conceiving. Early diagnosis allows for more treatment options and reduces complications like anemia or severe uterine enlargement.

Empowering Women Through Awareness

An intramural leiomyoma of the uterus is not life-threatening, but it can significantly affect quality of life. Understanding your body, recognizing symptoms early, and discussing treatment options with your healthcare provider ensures timely care and better outcomes. With modern medical advancements and minimally invasive therapies, women today have more control than ever over their reproductive health and well-being.