Fundal Fibroid: Symptoms, Causes & Treatment Options
So you’ve had an ultrasound or MRI and the report mentions a “fundal fibroid.” You’re wondering what that means and whether you should be concerned. The good news is that uterine fibroids are common and almost always non-cancerous. Many cause no symptoms and never require treatment.
A fundal fibroid is a growth in the upper part of the uterus. The location can influence the symptoms it causes and which treatments might be appropriate. The size and precise position of the growth also matter.
If your doctor determines treatment is necessary, you have options beyond surgery. Uterine fibroid embolization (UFE) is a minimally invasive, non-surgical treatment that shrinks fibroids by cutting off their blood supply. This procedure can relieve fibroid-related symptoms while preserving the uterus.
Understanding where your fibroid is located and how it affects your health will help you make informed decisions with your doctor. Here’s what to know about fundal fibroids, from diagnosis to treatment.
Key Takeaways
- Fundal defines the location. It means the fibroid is in the upper, rounded part of the uterus. It doesn’t describe a distinct type of growth.
- Most fundal fibroids are benign. Many cause no symptoms and are discovered during imaging for another reason.
- Size and position matter. A fundal fibroid can cause heavy periods, pelvic pressure or pregnancy-related concerns, depending on its characteristics.
- Treatment depends on your circumstances. Options range from monitoring and medication to UFE or surgery. Your doctor will help you weigh the benefits and risks of each approach.
What Is a Fundal Fibroid?
A fundal fibroid is a growth (usually non-cancerous) located in the fundus, which is the rounded upper portion of the uterus, above the openings to the fallopian tubes. “Fundal” refers to the fibroid’s location within the uterus, not how it grows within the uterine tissue. The fibroid’s position within the uterine wall determines which type it is:
- Intramural: The fibroid has developed within the muscular wall of the uterus.
- Subserosal: The fibroid has developed on the outside of the uterus and may grow outward.
- Submucosal: The fibroid has developed beneath the uterine lining and may extend into the uterine cavity.
A fundal fibroid can belong to any of these categories. That distinction matters because two fibroids in the same general area affect the uterus in different ways.
Fibroids are very common. The National Institutes of Health (NIH) reports that uterine fibroids occur in about 20% to 80% of women by age 50, depending on the population and how fibroids are identified. Many never cause noticeable problems.
How Fundal Fibroids Are Diagnosed
Many fundal fibroids are discovered incidentally during an examination performed for another reason. You might learn about one during a pregnancy scan or an exam to investigate an unrelated concern. Your doctor also may recommend imaging if you have symptoms associated with fibroids, or if an earlier scan revealed a growth that needs closer evaluation.
Common diagnostic tools include:
- Ultrasound: A pelvic ultrasound, often performed transvaginally, can identify fibroids and show their size and location.
- MRI: Magnetic resonance imaging provides more detailed pictures of the uterus and can help clarify a fibroid’s size, position and relationship to surrounding structures.
Your doctor will review your menstrual history, symptoms and medical history. Depending on your circumstances, additional testing may help assess whether the fibroid is contributing to heavier bleeding or other concerns.
Your healthcare provider’s goal is to understand the growth well enough to determine whether monitoring or treatment makes sense. Finding a fundal fibroid doesn’t automatically mean you need a surgical procedure.
Fundal Fibroid Symptoms
Many women with a fundal fibroid have no symptoms at all. When symptoms occur, they often depend on the growth’s size and exact location, including whether it affects the uterine cavity or presses against nearby organs.
Possible symptoms include:
- Heavy menstrual bleeding: Periods may become heavier than usual or last longer.
- Painful periods: Menstrual cramps may become more uncomfortable.
- Pelvic pressure or heaviness: A larger fibroid can create a feeling of fullness or pressure in the lower abdomen.
- Frequent urination: A fibroid that presses against the bladder may increase the urge to urinate.
- Lower back pain: Pressure from a fibroid can contribute to discomfort in the pelvis or lower back.
These symptoms aren’t unique to fibroids, however. Other conditions can cause similar problems, so your doctor will look at the full picture rather than relying on symptoms alone.
If your fibroid isn’t causing problems, your doctor may recommend monitoring it instead of treating it. If symptoms develop or the growth changes, you can revisit the options together.
For more information about common signs of uterine fibroids, see the NIH’s uterine fibroid overview.
Why Fundal Position Matters for Treatment Choice
A fibroid’s location is just as important as its size in evaluating treatment options.
The fundus sits near the openings of the fallopian tubes, which carry eggs toward the uterus. Depending on its exact position, a fibroid in this area may affect the shape of the uterine cavity or interfere with an egg’s normal passage through the openings of the tubes.
A growth that changes the uterine cavity’s shape may have different implications for implantation and pregnancy than one that grows outward from the uterine wall. The distinction between intramural, subserosal and submucosal fundal fibroids helps doctors assess these differences.
Size also matters. A small fibroid that doesn’t distort the uterine cavity may need nothing more than observation. A larger growth may cause pressure, alter the uterus’s shape or require closer monitoring.
However, a fundal fibroid isn’t automatically more dangerous than a fibroid elsewhere in the uterus. Its clinical significance depends on its characteristics and your individual circumstances.
These details help your doctor determine whether treatment is necessary and, if so, which approach offers the most benefits with the fewest risks.
Fundal Fibroids and Pregnancy
Most pregnancies involving a fundal fibroid proceed normally. However, the effects of a fundal fibroid on pregnancy depend on its size, position and relationship to the uterine cavity.
Some larger fibroids can distort the uterine cavity, potentially affecting an egg’s implantation. Depending on their precise location, fibroids may also interfere with the openings of the fallopian tubes. Fibroids during pregnancy can be associated with complications, although many women with fibroids have healthy pregnancies.
If you’re pregnant and have a fundal fibroid, your obstetrician may recommend monitoring its size and location as your pregnancy progresses. The appropriate approach depends on the details of your situation.
If you’re planning to become pregnant, discuss your fibroid with your gynecologist before deciding whether treatment is necessary. The same is true if you’re considering treatment and want to preserve the option of having children.
UFE deserves particular consideration in this conversation because its effects on future fertility and pregnancy aren’t fully established. Although pregnancies after UFE are possible, the evidence doesn’t establish that this procedure is the best choice for someone planning a pregnancy. Myomectomy, which surgically removes fibroids while preserving the uterus, is another option to discuss.
Read more about fibroids and pregnancy.
Treatment Options for Fundal Fibroids
If your fundal fibroid isn’t causing symptoms or other concerns, treatment may not be necessary. Your doctor may recommend periodic monitoring instead.
If treatment is appropriate, the best option depends on your symptoms, the fibroid’s size and position, your medical history and whether you want to become pregnant in the future.
Uterine Fibroid Embolization (UFE)
UFE is a minimally invasive, non-surgical treatment that shrinks fibroids by reducing their blood supply. An interventional radiologist guides a thin catheter into the blood vessels supplying the uterus and injects tiny particles that block blood flow to the fibroids. Without their usual blood supply, the fibroids shrink over time.
Because UFE shrinks fibroids by cutting off their blood supply rather than removing them surgically, it may be the best option for some patients. It doesn’t require an abdominal incision and is generally performed as an outpatient procedure.
UFE can relieve symptoms such as heavy menstrual bleeding and pelvic pressure while preserving the uterus. However, it isn’t the right choice for everyone, and it doesn’t guarantee that symptoms will disappear or that additional treatment won’t be needed.
Future pregnancy plans are especially important when considering UFE. Pregnancy after the procedure is possible, but the effects on fertility and pregnancy outcomes remain uncertain. If you hope to conceive, discuss those uncertainties with your gynecologist and an interventional radiologist before making a decision.
Learn more about uterine fibroid embolization and whether it may be appropriate for your situation.
Hormonal Medications
Hormonal medications may help manage heavy menstrual bleeding and other symptoms associated with fibroids. Depending on the medication, they may regulate menstrual cycles or reduce bleeding, but they don’t necessarily eliminate the fibroid itself.
Your doctor can explain which medications may be appropriate based on your symptoms, health history and reproductive plans.
Myomectomy
Myomectomy is a surgical procedure that removes fibroids while leaving the uterus in place. It may be appropriate when a fibroid causes significant symptoms or affects fertility.
The surgical approach depends on the number, size and location of the fibroids. Recovery and potential complications vary with the procedure. If you’re considering future pregnancy, ask your doctor how myomectomy compares with other treatments for your circumstances.
Hysterectomy
A hysterectomy removes the uterus and permanently ends the possibility of carrying a pregnancy. It may be considered when fibroids cause substantial problems and other treatments aren’t appropriate or haven’t provided sufficient relief.
Because it’s major surgery and eliminates the possibility of future pregnancy, your doctor will discuss the implications before recommending this procedure.
Your doctor will work with you to determine which treatment best fits your needs. Ask about expected benefits, risks, recovery and the likelihood of needing additional treatment before making your decision.
When to See a Specialist
Consider scheduling an appointment with a gynecologist or fibroid specialist if you’re experiencing heavy or painful periods, pelvic pressure, frequent urination or other symptoms that may be related to a fibroid. A consultation is also worthwhile if you’re planning a pregnancy and have a known fundal fibroid, or if an imaging report indicates that a fibroid has grown or needs monitoring.
You don’t have to wait until symptoms become disruptive to ask questions. A specialist can review your imaging, explain what the fibroid’s location means and discuss whether monitoring or treatment is appropriate.
If you’re exploring non-surgical options, an interventional radiologist can explain how UFE works and whether it may be suitable for you.
Understanding Your Options
A fundal fibroid is a growth in the upper part of the uterus, not a separate type of fibroid. Many are discovered by chance, cause no symptoms and never require treatment.
However, if treatment is necessary, the fibroid’s size, precise location, symptoms and your plans for pregnancy all help determine the best approach. UFE offers a minimally invasive option for many patients who want relief without surgery, but its benefits and risks must be weighed against other treatments, particularly when future pregnancy is a consideration.
You deserve clear information about your options and the chance to discuss your concerns with a specialist. Vascular Interventional Partners’ VIP Fibroid Center can help you explore whether UFE may be appropriate for your situation.
Frequently Asked Questions
What does “fundal” mean in a fibroid diagnosis?
Fundal means the fibroid is located in the fundus, the rounded upper part of the uterus. It refers to the growth’s location rather than its type. The fibroid may be intramural, subserosal or submucosal, depending on where it grows in relation to the uterine wall and lining.
How do doctors determine if a fibroid is in the fundus?
Doctors typically use pelvic ultrasound, often transvaginal ultrasound, to identify a fibroid and determine its location. An MRI may provide more detail if needed. Your doctor will interpret the imaging alongside your symptoms and medical history to decide whether monitoring or treatment is appropriate.
How common are fundal fibroids?
Uterine fibroids are very common, and affect an estimated 20% to 80% of women by age 50, according to the NIH. That figure includes fibroids in all uterine locations, not just the fundus. Many cause no symptoms and are discovered during imaging for unrelated reasons.
Does having a fundal fibroid mean I need surgery?
No. Many fundal fibroids don’t require treatment, particularly when they cause no symptoms or other concerns. Depending on your circumstances, options include monitoring, medication, UFE or surgery. Your doctor will explain the benefits and risks of each approach.
Is UFE a good option if I have a fundal fibroid and want to get pregnant?
UFE can preserve the uterus, and pregnancy afterward is possible. However, its effects on fertility and pregnancy outcomes remain uncertain. If you hope to conceive, discuss UFE, as well as alternatives such as myomectomy with your gynecologist and an interventional radiologist before choosing a treatment.