Uterine fibroid is a lumps formed within the muscular structure of uterus commonly they are benign (non-cancerous) tumor from smooth muscles originates from the smooth muscle layer of the uterus. Fibroids may be multiple and if the uterus contains too many lumps to count, it is referred to as diffuse uterine leiomyomatosis. The malignant lumps of a fibroid are rare and termed as leiomyosarcoma.

Other common names of uterine fibroids are uterine leiomyoma, myoma, fibromyoma.

Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. While most fibroids are asymptomatic, they can grow and cause heavy and painful menstruation, painful sexual intercourse, and increase in urinary frequency and urgency. They rarely affect pregnancy.

Epidemiology

Globally approximately more than 235 million women are affected with uterine fibroids as of 2010 (6.6% of females). About 20–40% of women will be diagnosed with fibroids at some point in their life but only a fraction of those will cause problems or require treatment.

Leiomyomata are more common in obese women. Fibroids are dependent on estrogen and progesterone to grow and therefore relevant only during the reproductive years, they are expected to shrink after menopause.

Uterine fibroids have strong association with genetic factors.

Signs and Symptoms

Fibroids, particularly when small, may be entirely asymptomatic. Symptoms actually depend on the location of the lesion and its size. Important symptoms include abnormal menstruation bleeding, heavy or painful periods, abdominal discomfort or bloating, painful defecation with or without cramps, back ache, increase urinary frequency or retention, and in some cases, infertility. There may also be pain during intercourse, depending on the location and size of the fibroid. During pregnancy they may also be the cause of miscarrige, bleeding, premature labor, or interference with the position of the fetus.

While fibroids are common, they are not a typical cause for infertility. Typically in such cases a fibroid is located in a sub-mucosal position and it is thought that this location may interfere with the function of the lining and the ability of the embryo to implant. Also larger fibroids may block the fallopian tubes.

Types

Growth and location are the main factors that determine if a fibroid leads to symptoms and problems. A small lesion can be symptomatic if located within the uterine cavity while a large lesion on the outside of the uterus may go unnoticed. Different locations are classified as follows:

Intramural fibroids are located within the wall of the uterus and are the most common type; unless large, they may be asymptomatic. Intramural fibroids begin as small nodules in the muscular wall of the uterus. With time, intramural fibroids may expand inwards, causing distortion and elongation of the uterine cavity.
Sub-serosal fibroids are located underneath the mucosal (peritoneal) surface of the uterus and can become very large. They can also grow out in a papillary manner to become pedunculated fibroids. These pedunculated growths can actually detach from the uterus to become a parasitic leiomyoma.
Sub-mucosal fibroids are located in the muscle beneath the endometrium of the uterus and distort the uterine cavity; even small lesions in this location may lead to bleeding and infertility. A pedunculated lesion within the cavity is termed an intracavitary fibroid and can be passed through the cervix.
Cervical fibroids are located in the wall of the cervix (neck of the uterus). Rarely fibroids are found in the supporting structures (round ligament, broad ligament, or uteroscral ligament) of the uterus that also contain smooth muscle tissue.
Fibroids may be single or multiple. Most fibroids start in an intramural location, which is the layer of the muscle of the uterus. With further growth, some lesions may develop towards the outside of the uterus or towards the internal cavity. Secondary changes that may develop within fibroids are hemorrhage, necrosis, calcification, and cystic changes.

Extra uterine fibroids

Fibroids of uterine origin located in other parts of the body, sometimes also called parasitic myomas have been historically extremely rare, but are now diagnosed with increasing frequency.

They are in most cases still hormone dependent but may cause life threatening complications when they appear in distant organs. Some sources suggest that a substantial share of the cases may be late complications of surgeries such as myomectomy or hysterectomy. Particularly laparoscopic myomectomy using a morcellator has been associated with a substantially increased risk of this complication.

Investigation and Diagnosis

During a bimanual examination typically can identify the presence of larger fibroids, ultrasound has evolved as the standard investigation to evaluate the uterine fibroids. Sonography will depict the fibroids as focal masses with a heterogeneous texture, which usually cause shadowing of the ultrasound beam. The location can be determined and dimensions of the lesion measured. Also magnetic resonance imaging (MRI) can be used to define the depiction of the size and location of the fibroids within the uterus.

Imaging modalities cannot clearly distinguish between the benign and the malignant uterine fibroids, however, the latter is quite rare. Fast growth or unexpected growth, such as enlargement of a lesion after menopause, raise the level of suspicion that the lesion might be a sarcoma. Also, with advanced malignant lesions there may be evidence of local invasion. A more recent study has suggested that diagnostic capabilities using MRI have improved the ability to detect sarcomatous lesions. Biopsy is rarely performed and if performed, is rarely diagnostic. Should there be an uncertain diagnosis after ultrasounds and MRI imaging, surgery is generally indicated.

Other imaging techniques that may be helpful specifically in the evaluation of lesions that affect the uterine cavity are TVS (Trans vaginal sonography, hysterosalpingography or sonohysterography.

Homeopathic treatment

Treatment for Uterine Fibroids is very effective, non-invasive, safe and inexpensive. Homeopathic remedies will promote the immune function and maintain Uterine health. Homeopathic constitutional treatment shrink the fibroid, stop the unwanted growths, clean up the Uterus, balance the female hormonal levels and will enable you to continue living with your reproductive organs as a whole by not allowing the Uterine Fibroids to appear again. The goal of this Homeopathic approach is to enliven the body’s natural healing and self-repair ability to treat the underlying condition, to prevent it and to create the highest state of health and well-being.

Best part of Homeopathy is reassuring and helpful for both physical and emotional aspects, in addition to relief from their Fibroids, experience an enhancement in self-awareness and well being after the treatment.

Here are a few remedies frequently used in the cases of uterine fibroids�

Aurum muraticum natronatum
Belladonna
Sepia
Pulsatilla
Natrum muraticum
Lachesis
Phosphorus
Lycopodium
Medorrhinum
Thuja occi.
Viburnum opu and many more.

Watch the video on Uterine Fibroids with Dr Deepak Sharma at HWC

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