What Are Subserosal Fibroids?
Subserosal fibroids are a type of uterine fibroid that forms on the outer surface of the uterus and can extend into the pelvic cavity. They develop beneath the uterus's outermost layer, called the serosa, and can vary widely in size and shape. They may be attached directly to the uterus or grow on a stalk.
Typically benign, subserosal fibroids can appear individually or in clusters. Like other types of fibroids, they can cause various symptoms that may significantly affect your daily life.
Symptoms of Subserosal Fibroids
Subserosal fibroids can cause a variety of mild-to-severe symptoms, including the following:
- Pelvic pain or discomfort
- Heavy menstrual bleeding
- Irregular or prolonged periods
- Pain during sex
- Pressure or fullness in the lower abdomen or pelvis
- Frequent urination or difficulty emptying your bladder
- Constipation
- Back pain
- Difficulty getting pregnant
It's important to note that not all women with subserosal fibroids experience symptoms. Some fibroids may be discovered incidentally during a routine pelvic exam or imaging test.
Causes and Risk Factors of Subserosal Fibroids
While the exact cause of subserosal fibroids remains unclear, several factors are believed to contribute to their development:
- Hormonal imbalances, particularly elevated estrogen and progesterone levels
- Family history of fibroids
- Age, with the highest risk during the 30s and 40s
- Obesity, which can raise estrogen levels
- Diets high in red meat and low in fruits, vegetables, and dairy
- Vitamin D deficiency
- Ethnicity, as African American women are more likely to develop fibroids
- Early onset of menstruation
- Chronic stress, which may indirectly affect hormone levels
These factors can help you better understand your risk and guide proactive health discussions with your provider.
Diagnosis of Subserosal Fibroids
Proper diagnosis of subserosal fibroids is essential for developing an effective treatment plan. If you’re experiencing symptoms, your healthcare provider may recommend diagnostic tests to confirm the presence of subserosal fibroids and evaluate their size and location.
How Are Subserosal Fibroids Diagnosed?
The diagnostic process typically begins with a thorough medical history and physical examination, including a pelvic exam. Your provider will assess for any abnormalities in the size or shape of the uterus.
If fibroids are suspected, imaging techniques are used to confirm the diagnosis and determine the type, size, and exact location.
Common Diagnostic Imaging Techniques for Subserosal Fibroids
These diagnostic imaging techniques help your healthcare provider confirm the diagnosis, assess the impact of subserosal fibroids on surrounding organs, and develop a personalized treatment plan:
- Ultrasound: A non-invasive test that uses sound waves to create images of the uterus. Both transabdominal and transvaginal ultrasounds are commonly used.
- MRI (Magnetic Resonance Imaging): Provides detailed images of the uterus and surrounding tissues, helping to differentiate fibroids from other conditions.
- Hysterosonography (Sonohysterography) uses saline to expand the uterine cavity during an ultrasound, enhancing views of fibroids near the uterine lining.
- CT Scan: Occasionally used to provide additional information about larger fibroids and their impact on adjacent organs.
- Hysteroscopy: A minimally invasive procedure where a tiny camera is inserted into the uterus to visualize fibroids and other abnormalities directly.
Treatment Options for Subserosal Fibroids
Treating subserosal fibroids often depends on their size, location, severity of symptoms, and the patient’s overall health and goals. The most common treatment options include a combination of non-surgical approaches and minimally invasive procedures, with surgery being a last resort in rare cases.
Non-Surgical Treatment for Subserosal Fibroids
Common first-step treatments include the following:
- Observation: Fibroids can be monitored through regular check-ups and imaging for women with mild or no symptoms to ensure they don’t grow or cause complications.
- Medications: Hormonal therapies, such as birth control pills or GnRH agonists, can help manage symptoms like heavy bleeding and pain. Other medications may target specific symptoms, such as anti-inflammatory drugs for pain relief.
Minimally Invasive and Surgical Treatment Options
While some fibroid cases may require surgical intervention, most women can find relief through non-surgical or minimally invasive options, with Uterine Fibroid Embolization (UFE) being a leading choice.
UFE is a non-surgical procedure that targets the blood supply feeding the fibroid, effectively causing it to shrink over time. This outpatient treatment at Texas Endovascular is highly effective in relieving symptoms while preserving the uterus. For women looking to avoid surgery, UFE is a safe and proven option with minimal recovery time.
In rare cases, when other treatments are not effective or appropriate, surgical options for subserosal fibroid removal may include the following interventions:
- Myomectomy: Surgical removal of fibroids while keeping the uterus intact, often recommended for women who wish to maintain fertility.
- Hysterectomy: Complete removal of the uterus, typically reserved for severe cases where other treatments have failed, or symptoms are debilitating.
It’s essential to consult with a fibroid specialist to discuss the risks and benefits of each treatment option. Together, you can create a personalized care plan that aligns with your health needs and lifestyle goals.
Complications During Pregnancy and Childbirth
Depending on the size and location of the fibroids, women may face fertility challenges. Small subserosal fibroids that do not distort the uterine cavity are generally unlikely to affect pregnancy. However, larger fibroids or those located in specific areas can interfere with conception, implantation, or fetal development.
The position of a subserosal fibroid plays a significant role in its impact on fertility and pregnancy:
- Fibroids near the fallopian tubes can obstruct the movement of eggs or sperm, making conception more difficult.
- Fibroids on the front of the uterus may create a physical barrier, preventing implantation or increasing the risk of miscarriage.
- Fibroids on the back or sides of the uterus are less likely to affect conception or pregnancy.
Subserosal fibroids can also lead to the following pregnancy complications:
- Preterm labor
- Preterm birth
- Abnormal fetal positioning
In very rare cases, a large subserosal fibroid may require surgical removal during pregnancy if it causes severe symptoms or completely obstructs the birth canal. Proactive monitoring and consultation with a specialist are essential for managing these risks.
When to Seek Medical Help for Subserosal Fibroids
While many subserosal fibroids remain asymptomatic and do not require immediate intervention, certain signs and symptoms may indicate the need for medical attention. Early evaluation and monitoring can help prevent complications and ensure appropriate care.
Signs You Should See a Doctor About Subserosal Fibroids
You should visit a fibroid specialist if you are experiencing the following:
- Persistent pelvic pain or pressure
- Heavy or prolonged menstrual bleeding
- Difficulty urinating or frequent urination caused by pressure on the bladder
- Constipation or difficulty with bowel movements due to fibroid pressure
- Pain during intercourse
- Unexplained fatigue, often a result of anemia from heavy bleeding
- Difficulty conceiving or recurrent miscarriages
The Importance of Regular Check-ups and Monitoring
Even if you aren’t experiencing severe symptoms, regular check-ups are crucial for tracking the size and growth of subserosal fibroids. Periodic monitoring ensures that potential complications, such as pressure on surrounding organs or rapid fibroid growth, are addressed early.
If you notice any changes in your symptoms or are considering pregnancy, consulting with a fibroid specialist can provide clarity and guide you toward effective management or treatment options. Seeking timely medical care is key to maintaining overall health and quality of life.
Contact the helpful team at Texas Endovascular today to learn more and schedule your consultation at one of our convenient locations.
