Many couples plan to have a child, but despite trying every possible way, the little one still doesn’t come. One common cause that many women may overlook is submucosal uterine fibroids, which can lead to infertility because the fibroid interferes with embryo implantation and hinders the uterus from expanding during pregnancy, and it may also make miscarriage more likely because the fibroid can distort the uterine cavity. Therefore, pelvic examination and ultrasound are important and should not be overlooked.
Get to Know Uterine Fibroids (Uterine Fibroids)
Masses found in a woman’s uterus can be either polyps or tumors; the most commonly found are uterine fibroids. They are classified by location: fibroids on the outer surface of the uterine wall, fibroids within the uterine muscle or uterine wall, and fibroids in the uterine cavity.
Submucosal fibroids occur when a uterine fibroid bulges into the uterine cavity for no clearly known cause. This can lead to various abnormal symptoms, resulting in infertility and a higher chance of miscarriage. Importantly, women of all ages can develop this condition.
What Is the Difference Between a Polyp and a Myoma/Fibroid?
Many people confuse uterine cavity polyps and fibroids. Although they can cause similar abnormal symptoms, such as heavy menstrual bleeding or infertility, these two types of lesions differ in their tissue of origin as follows:
- Endometrial polyp: Caused by abnormal growth of “endometrial cells.” It typically appears as a soft tissue mass that protrudes and extends into the uterine cavity.
- Uterine fibroid (Fibroid): Caused by abnormal growth of “uterine muscle cells.” It typically appears as a firmer, denser mass. It can grow on the outer surface of the uterus, within the muscle layer, or protrude into the uterine cavity.
Causes of Submucosal Uterine Fibroids
Although medicine still does not know the exact cause of uterine fibroids, several important factors are associated with the condition, as follows:
- Estrogen: This female sex hormone plays an important role in stimulating the growth of submucosal uterine fibroids.
- Obesity: People who are overweight are at higher risk because subcutaneous fat can be converted into estrogen, which stimulates thickening of the endometrium.
- Genetics: Those with a family history of uterine fibroids are more likely than usual to be diagnosed with this condition.
- Lifestyle behaviors: Continual consumption of red meat or high-fat foods, as well as accumulated stress, may affect hormonal balance in the body.
Why Do Submucosal Uterine Fibroids Cause Infertility or Make Miscarriage More Likely?
Medically, submucosal uterine fibroids are considered a major obstacle to fertility for the following main reasons:
- Interfering with embryo implantation: A fertilized embryo needs an optimal area in the uterine cavity to implant. If a fibroid blocks the appropriate site, implantation may fail.
- Distorting the uterine cavity: As a fibroid grows, it can deform or narrow the uterine cavity, leaving insufficient space for fetal growth and increasing the risk of miscarriage.
- Competing for blood supply and nutrients: Fibroids also require blood to grow, which can reduce the blood supply that should nourish the uterine lining or the embryo, affecting embryo development.
- Creating an unfavorable uterine environment: Fibroids may trigger chronic inflammation of the endometrium, which is not conducive to implantation and embryo survival.
What Are the Symptoms of Submucosal Uterine Fibroids?
Many women may have this condition without realizing it. Observing abnormal changes in the body is therefore important. Common symptoms and warning signs that indicate you should see a doctor include:
- Heavy menstrual bleeding
- Menstrual blood clots
- Periods lasting longer than 1 week or unusually prolonged
- Severe menstrual cramps
- Abnormal bleeding between periods
- Frequent urination
*Some patients may have no symptoms.
Diagnosis of Submucosal Uterine Fibroids
To clearly determine the location and size of the fibroid, doctors use effective diagnostic methods as follows:
- Pelvic examination and transvaginal ultrasound: A preliminary examination that helps visualize uterine fibroids clearly. In particular, during the period when the follicle is growing but ovulation has not yet occurred (around day 12 of the menstrual cycle), results may be clearer.
- Hysteroscopy: This method is very important because it allows the doctor to view the inside of the uterine cavity through a small camera to diagnose lesions and assess the appropriate treatment approach.
- Injection of contrast medium or saline into the uterine cavity: To help expand the uterine cavity so the boundaries of the fibroid can be seen more clearly on ultrasound.
Are Submucosal Uterine Fibroids Dangerous?
In general, uterine fibroids are common benign tumors (non-cancerous). The chance of developing into cancer is very low. However, the danger of this condition often comes from its interference with daily life and overall health, such as heavy blood loss during menstruation that may lead to anemia, severe abdominal pain, or large fibroids compressing nearby organs and causing dysfunction.
Severity of Submucosal Uterine Fibroids
The severity of this condition directly affects the reproductive system and pregnancy. If left untreated and not managed promptly, it may lead to the following:
- Difficulty conceiving
- Higher risk of miscarriage
- Preterm birth
- Abnormal placental implantation
- Postpartum hemorrhage
How to Treat Submucosal Uterine Fibroids
Treatment for submucosal uterine fibroids can be performed through hysteroscopic surgery via the vagina. Currently, with advanced minimally invasive surgery (MIS – Advanced Minimally Invasive Surgery), there is no need to worry about open abdominal surgery, complications from infection are reduced, recovery is faster, and you can return to normal life within 1–3 weeks. After surgery, patients must use contraception for at least 1 month before trying to conceive again.
Even after surgical treatment of submucosal uterine fibroids, they can recur. Therefore, for those who want to have a child, transvaginal ultrasound with an obstetrician-gynecologist should be performed to check for submucosal uterine fibroids during the time when the follicle is growing but ovulation has not yet occurred—day 12 of the menstrual cycle, counting from the first day of menstruation—for the most accurate results. Importantly, regular annual pelvic examinations should be prioritized, especially for women aged 40 years and older, who should not neglect this at all.
Self-Care to Reduce the Chances of Developing Submucosal Uterine Fibroids
Although it cannot be completely prevented, lifestyle changes can help reduce risk or slow the severity of the condition as follows:
- Maintain a healthy weight: Stay within the standard range to reduce fat accumulation that can be converted into estrogen.
- Eat a healthy diet: Focus on vegetables, fruits, and whole grains; avoid excessive high-fat foods and red meat.
- Exercise regularly: To help maintain hormonal balance in the body.
- Have an annual pelvic exam: Especially for women aged 40 years and older, or those planning to have a child, to detect abnormalities early and treat them in the early stages.
Bangkok Hospital Infertility Center Is Ready to Care for All Women’s Health Concerns
Women’s health issues and infertility require understanding and attentive care. Bangkok Hospital Infertility Center is ready to provide comprehensive diagnostic services, family planning, and treatment for gynecologic conditions, including hysteroscopic surgery for submucosal uterine fibroids, with a team of specialized obstetricians-gynecologists and standardized medical technology. The focus is on effective care and treatment so that every woman can be healthy and ready for pregnancy.
Article Summary
Submucosal uterine fibroids are an important cause of infertility and an increased risk of miscarriage. Understanding the causes, observing abnormal symptoms, and undergoing regular diagnostic checkups are therefore essential. Early detection helps doctors plan appropriate treatment, increases the chance of pregnancy, and reduces the risk of miscarriage in the future.
Frequently Asked Questions (FAQ) About Submucosal Uterine Fibroids
1. Can submucosal uterine fibroids become cancer?
The chance that uterine fibroids become cancer is very low; most are benign tumors. However, if a fibroid is found to grow rapidly in an abnormal manner, the doctor may consider additional detailed examinations for safety.
2. If I have fibroids but no symptoms, is surgery necessary?
If the fibroid is small and does not affect health or daily life, the doctor may recommend monitoring symptoms and periodic ultrasound examinations. However, for those planning to have a child, the doctor may consider surgical removal to reduce the chance of miscarriage and increase the chance of pregnancy.
3. After hysteroscopic surgery for submucosal uterine fibroids, how long is the recovery period?
Patients undergoing hysteroscopic surgery typically recover quickly and can return to normal life within 1 week. However, heavy lifting should be avoided early on, and contraception should be used for the period specified by the doctor before attempting pregnancy.
4. If I have submucosal uterine fibroids, can I exercise?
You can exercise as usual, and exercise also helps maintain hormonal balance, except in cases of severe abdominal pain or significant abnormal bleeding, in which case you should consult a doctor for appropriate advice regarding the level of exercise.
