How do fibroids affect menstrual periods?

Doctor's Answers 1


Fibroids are smooth muscle tumours that arise from the muscle wall of the uterus - as such, they can generally be placed at 3 different sites: serosal (outer layer of the uterus), intramural (middle layer), or submucosal (inner layer).

Serosal fibroids can grow to a very large size without causing any symptoms. This is because the abdominal/ pelvic cavity has a lot of space for it to expand.

Submucosal ones, on the other hand, push into the uterine cavity and distort the womb lining (endometrium). The endometrium is the part that sheds at the end of every menstrual cycle, resulting in bleeding (menses). Thus, any distortion of the endometrium can result in a disturbance of the menses, either causing heavier bleeding, prolonged bleeding or irregular bleeding. Compared to serosal ones, submucosal ones can be as small as 1 cm to cause menstrual disturbances.

Intramural fibroids sit in between and if they grow, can either elongate the uterine cavity or start pushing against the endometrium. In this way, they may also cause the menses to be heavier.

If you have fibroids as large as 6cm and do not have any change in menstrual pattern, they are unlikely to be submucosal in location at the moment.

Best regards

Dr Fong Yoke Fai

Similar Questions

Are there any lifestyle or diet choices that can help to shrink fibroids?

There is curently no conclusive scientific evidence of any links between diet, and shrinking fibroids. There is also no scientific evidence that avoiding certain foods prevents the recurrence of fibroids. Having said that, there are ongoing studies looking into diet and lifestyle as contributory factors for fibroids. Of note, the exact cause of fibroids is unknown till date. However, there is: A genetic element – you are more likely to develop them if someone else in your family had it. An association with higher levels of oestrogen (a female hormone).

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Can I safely resume taking my contraceptive pills if I have stopped taking it for a period of time?

I suggest to have a scan done by your gynae to check the lining of the endometrium. It is not uncommon after prolonged use that the lining thins out by quite a bit so there is nothing much to shed as a “period” as such after cessation of the pills. This situation is generally temporary, and the periods should come back soon. A second possibility is that you naturally had infrequent cycles (say every 3-4 months) due to irregular ovulation. The pill will mask this and make it seem like your periods come every month.

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Dr Jasmine Mohd


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