Uterine fibroids otherwise known as leiomyomas are benign/ non cancerous growths in the uterus which usually appear during the childbearing age in the females. The fibroids are composed of same lining as of the uterus but are a bit dense then the uterine lining.
The fibroids are never associated with predisposition of cancer and never turn malignant/ cancerous. There could be single fibroid or more then one as well and the size may vary from a seedling to large enough to enlarge the size of uterus and become palpable. Mostly women have no symptoms from the fibroid and spend almost normal life with them but in some cases they trouble a lot.
In many cases uterine fibroids are accidentally diagnosed during a pelvic examination or ultrasound.
Risk factors for development of fibroids:
- Age: the risk of developing fibroids increases with age upto the menopausal age as fibroids are oestrogen dependant. After menopause there in natural production of oestrogen decreases and the fibroids shrink afterwards.
- Oral contraceptive pills: much use of OCPs increase the risk of development of fibroids.
- Obesity: obese women are more prone to development of fibroids.
- Race: black women are three times more vulnerable to development of fibroids.
- Family history: those who have family history of fibroids are more likely to develop fibroids.
Types of fibroids:
Depending on the location; fibroids can be of following types:
Subserosal fibroids: are located beneath the outermost layer (serosa) of the uterus.
Submucosal fibroids: are located in the uterine cavity beneath the innermost layer of the uterus (mucosa).
Intramural fibroids: are located within the wall of the uterine lining.
Pedunculated fibroids: can grow inside or outside of the uterus but are attached through a stalk to the uterus.
SYMPTOMS & CAUSES
- Heavy bleeding during menses
- Bleeding for more then a week during menses
- Pressure in pelvic region along with pain
- Frequent urge to pass urine due to pressure on bladder by the fibroid
- Pain in legs
- Difficulty in clearing of bowels causing constipation.Sometime pain during sexual intercourse is also seen.
- Exact cause of development of fibroids is not known but family history of fibroids predispose to development of fibroids.
- Often gene changes are also seen in the fibroid cells.
- Fibroids are oestrogen dependant.
DIAGNOSIS & TREATMENT
Pelvic examination and ultrasound are enough to diagnose fibroid
Usually when symptoms are not much severe conservative treatment is done as the fibroids automatically shrink after menopause due to natural deprivation of oestrogen. Otherwise following treatments are given:
- Progestin-releasing intrauterine device is inserted which relieves the heavy bleeding but doesn’t shrink the fibroid.
- Gonadotropin releasing hormone agonists suppress production of oestrogen and progesterone and thus put the female into temporary postmenopausal state. Thus fibroid starts to shrink.
- Medicines for heavy bleeding are given.
- More so uterine artery embolization is done which cuts down the blood supply to the fibroid. Thus the fibroid shrinks and die.
- Dilatation & curettage: scrapping of the bulky uterine lining is done to relieve heavy bleeding.
- Myomectomy: surgical removal of fibroid is done and uterus is preserved.
- Hysterectomy: uterus is removed if nothing works.
Management of a case of fibroid includes:
- Educate the patient about the condition and the treatment procedure.To combat heavy blood loss give dietary advice to the patient.
- Treat anaemia in cases of heavy blood loss. Ask patient to do regular physical exercise.
- Watchful waiting of the condition should be done as the fibroid is ultimately going to shrink automatically after menopause.
- If the patient is having pain, then pain management should be done.
- Ask the patient to keep check over any new symptom.
Homeopathic management includes selection of a medicine after thorough case analysis. Medicines are to taken only after consulting a homeopath.
DO’S AND DON’TS
- Keep check over the symptoms.
- Maintain hygiene.
- Do regular physical exercise.
- Take healthy nutritional diet.Use hot water bottle to relieve pain.
- Don’t smoke.
- Don’t be stressed.