Diseases

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Uterine Fibroids, also known as Uterine Leiomyomas, are common benign smooth muscle tumours affecting Uterus, usually seen at the age around 50. It is one of the leading causes of the hysterectomy as they manifest no symptoms in their early stages.

Cause

Etiology of Fibroids is not known. Hereditary factor is an inevitable among the early onset fibroids. Most fibroids are hormonal level dependent. Risk factors comprises Obesity, PCOS, Diabetes, hypertension, never having pregnancy.

Pathophysiology

The actual mechanism is unknown. Most fibroids are dependent on oestrogen and progesterone having a mitogenic action on leiomyoma cells.

Signs & Symptoms

Most of the women have no symptoms, typically found during middle and later reproductive years. Some of them may have abdominal pain or heavy periods. They may have pain during sex or lower back ache, pressure over bladder resulting in urinary frequency or over rectum causing constipation. Symptoms depend on the position of fibroid. Fibroids rarely hinder pregnancy or typical cause of infertility. In some submucosal position that may interfere with the function of the lining and the ability to implant an embryo. But during pregnancy they may cause miscarriage, bleeding or premature labour.

Some large fibroids can extend out through cervix or even vagina. Fibroids appear to be round, well circumscribed, non-encapsulated, formed of normal cells, size varying from microscopic to lesions of considerable size. Typically lesions are felt by the patient herself as a grapefruit or bigger through the abdominal wall.

Fibroids may be single or multiple of varying size, myoclonal tumours showing chromosomal abnormalities. Secondary change of fibroids includes haemorrhage, necrosis, calcification and cystic. They tend to calcify after menopause.

Usually after menopause, fibroids tend to decrease in size. Growth even after menopause signals malignancy.

Location and Classification

Type and position of a fibroid is important factor for determining prognosis. A small lesion may be symptomatic while a large one remains asymptomatic according to the position. Fibroids are classified into:-

(i) Intramural Fibroids: are the most commonly seen, located within the uterine muscular wall, larger in size, asymptomatic, gradually grows inwards distorting the uterine cavity.

(ii) Subserous Fibroids: are located on the surface of the uterus, growing outward from the surface and remain attached by a peduncle and may progress to get detached from uterus to form parasitic leiomyoma.

(iii) Submucosal Fibroids: are located in the muscle beneath the endometrium of the uterus, distorting the uterine cavity, inducing heavy bleeding and infertility, however small lesions. A pedunculated submucosal fibroid may extend through cervix.

(iv)Cervical Fibroids: are rare fibroids, located in the cervical wall.

Ayurvedic management of Fibroid

Ayurveda medicine has a strong influence in controlling sex hormones; production, maintaining normal level and functioning. Ayurveda advices a proper healthy diet for normal functioning of all hormones. Hence regulating the heavy bleeding and lower back ache.

The strict dietary regime will help in reducing the fibroid size and aching pain.

Panchakarma has an effect on glands and circulatory system that may give an effort to decrease the progression in growth. The purificatory therapy is essential to normal production of hormones.

Yoga therapy is also advised for normal functioning of the uterus and maintaining a balance in hormonal levels.

Ayurveda also manages the risks factors such as obesity, diabetes and PCOS.