- Histologically, this tumor is composed of smooth muscle and fibrous connective tissue, so named as uterine leiomyoma, myoma or fibromyoma.
- It has been estimated that at least 20 percent of women at the age of 30 have got fibroid in their wombs.
- A high incidence of 10 percent prevails in England. Additionally, In colored races (black women), the incidence is even higher. [1]
Uterine Fibroid
Definition:
Uterine Fibroid is the commonest benign tumour of the uterus and also the commonest benign solid tumour in female. Histologically, this tumour is composed of smooth muscle and fibrous connective tissue, so named as uterine leiomyoma, myoma or fibromyoma.[1
Overview
Causes
- Chromosomal abnormality
- Epidermal growth factor, Insulin-like growth factor-1, Transforming growth factor, Stimulate the growth of leiomyoma either directly or via estrogen
- positive family history
- Estrogen and progesterone are incriminated as the cause [1]
Risk Factors
Increased risk i.e.
- Nulliparity
- Obesity
- Hyper estrogenic state
- Black women
Reduced risk i.e.
- Multiparity
- Smoking [1]
Pathophysiology
- Genetic predisposition
- Menstrual cycle–related mitotic dysregulation
- Myometrial cell phenotype transformation in response to ischemia
- An inherent myometrial predisposition to fibroid formation. [4]
Types
- Body
- Interstitial or intramural (75%)
- Sub peritoneal or subserous (15%)- Subserous fibroid, Broad ligament, Wandering
- Submucous (5%)- Pedunculated, Sessile
Cervical e.g.–
- Anterior
- Posterior
- Lateral
- Central
Pseudo cervical fibroid [1]
Sign & Symptoms
Menstrual problems
- Menorrhagia
- Dysmenorrhea
Abdominal discomfort
- Feelings of pressure
Abdominal distension
Urinary problems
- Frequency of micturition
- Urinary retention
Bowel problems
Subfertility i.e.
- Difficulty in conceiving
- Pregnancy loss
- Intrapartum bleeding (particularly Caesarian section) [3]
Investigation
A hemoglobin concentration i.e.:
- In brief, It will help to indicate anaemia if there is clinically significant menorrhagia.
Ultrasonography i.e.:
- Generally, It is the mainstay of diagnosis to distinguish between a fibroid and an ovarian mass.
- Furthermore, In the presence of large fibroids, ultrasonography is helpful to exclude hydronephrosis from pressure on the ureters. [2]
Saline Infusion Sonography (SIS)
Magnetic resonance imaging (MRI)
Laparoscopy
Hysteroscopy
HSG
Uterine curettage [1]
Diagnosis
- Ultrasonography is very useful as a first line, unless the uterus is either very large or distorted leading to difficulty in visualizing the ovaries.
- Under these circumstances an MRI scan can give excellent visualization of the uterus and ovaries.
- In addition, enhancement with gadolinium gives an indication of the vascularity of the uterus.
- Biopsy of the fibroid is not commonly undertaken. [3]
Differential Diagnosis
Differential Diagnosis i.e.:
- Pregnancy
- Full bladder
- Adenomyosis
- Myohyperplasia
- Ovarian tumor
- TO mass [1]
Treatment
Drugs used to minimise blood loss i.e.:
- Antiprogesterones (Mifepristone)
- Danazol
- GnRH analogs: e.g.Agonists, Antagonists
- LNG–IUS
- Prostaglandin synthetase inhibitors
Surgical Treatment i.e.:
- Myomectomy
- Embolotherapy [1]
Homeopathic Treatment
Homeopathic Treatment of Uterine Fibroid:
Thalspi Bursa Pastoris – For Uterine Fibroids with Prolonged Menses
Thalspi Bursa is one of the top-grade medicines for treating uterine fibroids with prolonged menses. The menses continue for 10-15 days. Menses appear very frequently as well. The next menstrual cycle appears even before recovery from the periods has occurred. Menstrual bleeding is profuse, with the presence of large clots. Violent uterine colic during menses may also arise. Cramping pain in the uterus during menstruation in uterine fibroids cases is also suggestive of use of Thalspi Bursa Pastoris.[2]
Calcarea Carb – For Heavy Periods from Uterine Fibroids
Calcarea Carb is a very useful medicine for treating heavy periods from uterine fibroids. Menses continue for long and may even appear early. Vertigo during menses may arise. Leucorrhea of thick, milky or yellow color is another complaint that may attend.
Belladonna and Sepia Officinalis – For Uterine Fibroids where Menses are Painful
When the menses are painful Belladonna and Sepia Officinalis are well-indicate medicines for uterine fibroids. When there is cramping pain in the uterus during menses, the menses are bright red in colour and profuse at that time belladonna is use. While in case of griping, burning or bearing down pains during menses use Sepia Officinalis. Menses start early and are quite copious. Fainting and chilliness during menses may attend. Sepia Officinalis is also indicate when there is painful intercourse in uterine fibroids.[2]
Ustilago Maydis – For Uterine Fibroids with Dark Menstrual Bleeding
Ustilago Maydis is a highly suitable medicine for uterine fibroids where menstrual bleeding is dark. Clots may also be present in menstrual blood. Uterine bleeding may be stringy in nature.[2]
Sabina Officinalis – For Uterine Fibroids where Clots Pass with Menstrual Blood
In the case of menstrual bleeding with clots in uterine fibroid cases, Sabina Officinalis is a significant medicine. The slightest motion increases menstrual bleeding. Pain from sacrum to pubis is another attending feature. During menses, pain in the uterus may be present that gets better by lying on the back. Uterine pain may extend to the thighs. Other symptoms include foul, acrid, corrosive, yellow leucorrhea.[2]
Fraxinus Americana – Excellent Homeopathic medicine for uterine fibroids with bearing down sensation
Fraxinus Americana is a top-grade medicine for uterine fibroids where indicating feature is a bearing down sensation in the pelvis from uterine fibroid.[2]
Trillium Pendulum and Kali Carbonicum – For Uterine Fibroids with Back Pain during Menses
In uterine fibroid cases with back pain during the menstrual cycle, Trillium Pendulum comes highly recommended. The pain may radiate to the hips from the back during menses. Tight binding of the back and hips provides relief. Menstrual bleeding is bright red and gushing. The slightest movement worsens uterine bleeding. Trillium Pendulum is also use for inter-menstrual bleeding every two weeks. Another attending feature is faintness from uterine bleeding. Kali Carbonicum is select when there is violent back pain during menses. The pain gets better from sitting and pressure. The menstrual flow is also copious.[2]
Erigeron Canadensis – For Frequent Urination in case of Uterine Fibroids
Erigeron Canadensis is a beneficial medicine for treating frequent urination in case of uterine fibroids. In some cases, painful urination may also arise. The attending features are excessive menstrual bleeding which is bright red in colour. Erigeron Canadensis is also indicate for inter-menstrual bleeding from slight exertion.[2]
China Officinalis and Ferrum Met – For Uterine Fibroids with Heavy Bleeding and Anemia
Both China Officinalis and Ferrum Met are effective medicines for treating uterine fibroids with heavy bleeding and anemia.
Among them, China Officinalis works best when there is profuse, dark menstrual bleeding, clots in menstrual blood, exhaustion and anemia. Fainting spells may also arise.
Ferrum Met is best use where the symptoms include pale, watery, heavy and prolonged menses leading to anemia. Menstrual flow get worse by the slightest movement. Lower back pain or abdomen pain during menses may be present.[5]
Diet & Regimen
Do’s …
Load up on fresh fruits and vegetables.
Basically, A recent study found that eating plenty of fruits like apples and tomatoes, and cruciferous vegetables like broccoli and cabbage, could lower the risk of developing fibroids. Additionally, eating healthier choices like organic fruits and vegetables and whole-grain foods could help improve your symptoms.[4]
Keep an eye on your blood pressure.
Researchers have shown a strong link between fibroids also high blood pressure. In detail, Talk to your doctor about how to manage your blood pressure, either with diet, lifestyle, or medication.
Manage your stress level.
While researchers are still examining the impact of stress on fibroids, some studies suggest the two may link. Try relaxation techniques like yoga, massage, also tai chi to help manage your stress. Some women find that alternative therapies like acupuncture can help relieve their period pain, too.[4]
Make yourself comfortable.
If you’re having painful periods because of your fibroids, try lying down and elevating your legs with a pillow. Or lie on your side and bring your knees into your chest to take the pressure off your back.
Talk to your doctor before trying any supplements.
There is some research that suggests supplements like vitamin D could be helpful in lowering your risk for fibroids.
While some alternative medicine practitioners recommend supplements like raspberry leaf tea to support pregnancy and treat issues like PMS but not for fibroids. That’s because the tea can have an estrogen-like effect on the body and make your problem worse. That’s why it’s always important to discuss all medications and supplements — even if they’re natural — with your doctor. They could have side effects you’re not aware of.[4]
Don’ts …
Don’t eat a diet full of processed foods, red meats, and high-fat dairy. Studies show that eating these foods can make your fibroids worse. The same goes for alcohol and caffeine.
Don’t skip your workouts. One study found that women who exercised the most (about 7 hours per week of activities like running, dancing, or walking) had the lowest chance of developing fibroids. Exercise can also help keep your blood pressure down.
Don’t overdo it on the sugar. A study found that a higher risk of fibroids can link to eating a high-sugar diet .
Don’t smoke. Experts believe that smoking can increase your period pain because it reduces the amount of oxygen that gets to your pelvic region.[4]
FAQs
Frequently Asked Questions
What is Uterine Fibroid?
Uterine Fibroid is the commonest benign tumour of the uterus and also the commonest benign solid tumour in female.
Homeopathic Medicines used by Homeopathic Doctors in treatment of Uterine Fibroid?
- Thalspi Bursa Pastoris
- Calcarea Carb
- Belladonna
- Sepia Officinalis
- Ustilago
- Sabina
What are the main causes Uterine Fibroid?
- Chromosomal abnormality
- Epidermal growth factor, Insulin-like growth factor-1, Transforming growth factor
- Positive family history
- Estrogen and progesterone
What are the symptoms of Uterine Fibroid in women?
- Menorrhagia
- Dysmenorrhea
- Feelings of pressure
- Frequency of micturition
- Urinary retention
- Abdominal distension
- Difficulty in conceiving
- Pregnancy loss
Give the types of Uterine Fibroid?
- Body
- Cervical
- Pseudo cervical fibroid
References:
- DC Dutta’s Textbook of Gynecology (PDF Drive)
- Gynecology by Ten Teachers
- Dewhurst_s_Textbook_of_Obstetrics_and_Gynaecology_7th_ed
- Clinical_Gynecology
- https://www.drhomeo.com/uterine-fibroids/homeopathic-remedies-for-uterine-fibroids-treatment/