Hello XXXXXXX
Thanks for your query.

Uterine fibroids are non-cancerous tumors that develop within, or are attached to, the uterine wall. Also called fibromyomas, leiomyomas or myomas, uterine fibroids are quite common. Studies have revealed that about 25 percent of women have fibroids large enough to cause symptoms, and 30-50 percent of women actually have fibroid tumors that are asymptomatic. Fibroids are also much more common among black women. Uterine fibroids are of three types, subserosal fibroids, intramural fibroids and submucosal fibroids,

Subserosal uterine fibroids develop on the outer surface of the uterus and continue to grow outwards, giving the uterus a knobby appearance. At times, these fibroids tumors may be connected to the uterus by the means of a long stalk or a stem-like base. Such stalked fibroids are called pedunculated subserosal fibroids. These fibroids are often difficult to distinguish from an ovarian mass.

Over time, subserosal uterine fibroids may grow quite large but, unlike submucosal fibroids, which can greatly disrupt the shape of the uterine cavity as they develop beneath the uterine lining, these fibroids do not typically affect the size of the uterus’ cavity. Like intramural fibroids, which grow inside the wall of the uterus, subserosal fibroids are also quite prevalent among women in their prime reproductive age.

In the majority of women, subserosal fibroids produce no symptoms. Problems are customarily caused by large and pedunculated subserosal fibroids tumors. Some of the typical symptoms experienced by women with subserosal fibroids include:
Pelvic pain
Back pain
Constipation and bloating
A generalized feeling of heaviness or pressure
Frequent urination
Kidney damage due to compression of the ureter
Abdominal cramping and pain
At times, pedunculated subserosal fibroids can twist and cause pain
As subserosal fibroids are located on the outer surface of the uterus, they typically do not affect a woman’s menstrual flow.

Generally, it is believed that subserosal fibroids do not cause infertility. However, in reality, a large and pedunculated subserosal fibroid may have a severe impact on fertility and pregnancy. As these fibroid tumors are located on the outer surface of the uterus, when they grow in size, they start exerting pressure on the surrounding organs and in some extreme case they may even obtain their blood supply from these organs.
Sometimes, enlarged subserosal fibroids may compress the fallopian tubes. In these instances, infertility can occur due to the blockage of the fallopian tube, thereby preventing sperm and egg from meeting. Often, large subserosal fibroids may distort the pelvic anatomy to such an extent that it becomes difficult for the fallopian tube to collect an egg at the time of ovulation. Here again the end result is infertility.

Subserosal fibroids may also interfere with a pregnancy. During the course of pregnancy, these uterine tumors grow with the uterus and the baby. As a result, your uterus becomes cramped and crowded, affecting not only the development of the foetus, but also contributing to pregnancy complications and difficulties in labour.

Unfortunately, medicinal treatment for subserosal fibroids does not exist. Medical therapy is attempted only to alleviate symptoms caused by these uterine fibroids, and all these medical treatments are temporary in nature.
Surgical treatment is most effective in the case of subserosal fibroids. Due to their placement on the surface of the uterus, laproscopy is considered to be the most practical technique for their removal. In laparoscopic myomectomy, the laparoscope is placed in the abdomen through the belly button. This instrument plucks the pedunculated subserosal fibroids, cuts them into small pieces and finally removes them.

Laparoscope can also be used for myolysis in which subserosal fibroid tumors are not removed but destroyed by blocking their blood supply. Uterine artery embolization is another method for the treatment of subserosal fibroids. Like myolysis, this procedure looks to treat uterine fibroids by cutting off their blood supply.

A 2.5 cm fibroid would not require removal if not symptomatic.
You should definitely see a consultant before trying before a baby since you are 39, and would need assessment anyways.
There is not lifestyle / diet modifications to treat fibroids.

Take care, and feel free to discuss further.

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Hello XXXXXXX
I wish you could upload the complete ultrasound report using the button on the right hand side of the page.
Enlarged ovaries could be due to polycystic ovaries.
The symptoms are due to your fibroid .
Consider removal if the symptoms are intractable.

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