Uterine Fibroid

The fibroid is tumor found in the female uterus. The fibroid is a tumor growing on the wall of the uterus (female reproductive organ). Fibroids occur either singly or in clusters.

A fibroid is a benign (not cancerous) growth (tumor) from the muscular layer of the uterus (womb).The term “FIBROID” is a popular use, the correct terminology should be fibromyoma or myoma as it is muscle tissue (of the wall of the uterus) in origin containing fibrous tissue as admixture but not purely fibrous tissue in origin.

Estrogen is the main hormone which plays important role in the formation of the fibroid.
A fibroid is an abnormal growth of the muscle tissues in the wall of the uterus.

Estrogen receptors are present in the muscle cells and lead to abnormal increased growth of cells forming fibroid. A fibroid tumor is a mixture of abnormal growth of muscle tissue of uterus and some part of the fibrous tissue.
The fibroid is the commonest form of tumor in a woman.

Age / Sex groups affected by Uterine Fibroid

Uterine fibroids arise during menarche till the menopause. Development to fibroid is highest at the age of 35-45 years. Fibroids can also be seen in young girls of 10-12 age groups.
Fibroids are a female uterine tumor. Early marriage is also one of the causes to the development of fibroids.

Race affected by Uterine Fibroid

Fibroids are more common in African woman. They are affected three times more than a woman of any other race.
In England, almost one tenth of gynecological cases suffer from fibroids.

Causes of Uterine Fibroid

• Fibroids rarely occur after menopause and before puberty.
• Heredity is a factor as it runs in families.
• Estrogen growth hormone.
• Human placental lactogen.

Classification of Uterine Fibroid

INTERSTITIAL (intramural)
Fibroids grow in the tissues of the wall of the uterus. When the size of fibroid is small it remains as it is on the wall. Then fibroid, if grows in size depending upon the direction of growth, become either a subserous fibroid or submucous fibroid.
This type of fibroid is commonest. Posterior wall of the uterus is the most common site where fibroids occur.

SUBSEROUS (sub peritoneal)
This type of fibroid is present under the peritoneum and can be sessile or pedunculated. When this type of tumor grows in broad ligament it is called as a ligamental fibroid.
Very rarely this tumor gets detached from the uterus and gets attached to the surrounding tissue. Rarely this type of fibroid gets ruptured and may cause severe hemorrhage in the Intra peritoneal space.

SUBMUCOUS
When fibroid grows towards the mucous membrane of the uterus and enters the uterus cavity it forms this type of fibroid. This type of fibroid is usually single or present with peduncle when grows in size. This type of fibroid ends usually in the following ways
• polyp formation
• chance of infection
• more commonly converted to malignant ( cancerous ) form
• this type of fibroid rarely be a cause of uterus prolapse

Uterine Fibroid Signs and Symptoms

• Menorrhagia (abnormal, prolong and heavy menses )
• Metrorrhagia ( irregular menses )
• Dysmenorrhoea ( painful menses )
• White discharge from vagina
• Abdominal lump is seen in some cases where size of tumor is very large
• Infertility, about 30% of female suffering from fibroids are infertile
• Palpitation and weakness occurs due to anemia (due to heavy menstrual bleeding )
• Pain is a rare symptom
• Pressure on urinary bladder in some cases where fibroid size is large and pressing the bladder
• During pregnancy, if fibroids are present and of large size can also cause abortion

Investigations of Uterine Fibroid

PHYSICAL EXAMINATION
• On palpating abdomen, there is firm irregular lump seen arising out of the pelvis.
• On percussion, a lump shows dullness
Bimanual examination
Per vagina
• This examination confirms whether the uterus is enlarged, or any modularity in pelvic position
• Uterus feels harder than it does when the enlargement is due to pregnancy.
Per rectum
• Helpful to confirm the examination.
Clinical examination of the patient can help to diagnose other investigation to confirm the disease is as following

Laboratory test
• Hb
• TLC
• DLC
• Platelet count
• BT, CT
• Blood urea, creatinine
Pelvic ultrasound
Laparoscopy
Hysteroscopy
IVP

Differential diagnosis of Uterine Fibroid

• Ovarian tumor
• Tubo ovarian mass
• Endometrial carcinoma ( cancer )
• Pregnancy
• Metropathica haemorrhagia
• Adenomyosis
• Pelvic kidney

Complications of Uterine Fibroid

• Anemia is severe due to blood loss in hemorrhage.
• Sarcoma.
• Infection of the fibroid can lead to suppuration and septic fever.

Treatment of Uterine Fibroid

• Fibroids with no symptom require no treatment but follow up is required every 6 months.
• Fibroids with the symptom of heavy bleeding, patient are advised to take home rest with stoppage of household work.
• When patiently suffers from bleeding fibroid and Hb is below 8 gm% then blood transfusion is given.

Diet / management of Uterine Fibroid

• Diet to control uterine fibroids should consist of vegetables, fruits, seeds, fish, and nuts.
• Diet to avoid is dairy product beef, pork, chicken, and turkey.
• Uterine fibroid occurs in those females who are prone to have fatty food, stress, smoking, caffeine, and alcohol.
• Use of almond oil will change body chemistry to alkaline this will help to reduce growth of tumors
• Detoxifying food help to remove the toxin from a body and lead to reduce fibroid growth.
• Beet and beet greens in diet help to reduce fibroids.
• Pears are also very helpful to fight against tumor growth as it contains phytonutrient , ellagic acid, boron, lignin.

Homeopathic treatment for Uterine Fibroid

Fraxinus Americans
• Enlargement of the uterus.
• Fibroids with bearing down sensation.
• Leucorrhoea (vaginal discharge ) watery
• Fibroids with bearing down pain cramping in feet, worse in afternoon and night.
• Prolapse of the uterus due to the large size of fibroids.

 Aurum muriaticum natronatum
• The best remedy for uterine tumors.
• Uterus fills up with the pelvis.
• Complication of uterine fibroids like the ossified uterus.
• Also indicated for chronic metritis and prolapse of the uterus.

Calcarea flourica
• Given to those female patients who suffer from multiple fibroids.
• Fibroids are stony hard.
• Glands are hard, stony.

Iridium palladium
• A Very good remedy for fibroids associated with signs of anemia.
• Also, help in the formation of red blood cells.

Lapis alba
• Fibroid tumors with intense burning pains through the part with profuse hemorrhages.
• Also acts well on the connective tissue around the glands of the uterus.
• Indicated in uterine carcinoma.

Ustilago
• The flabby condition of the uterus.
• The uterus is hypertrophied with the fibroids/cervix bleeds easily.
• Climacteric oozing of dark colored blood from vagina forming long black strings.

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