Uterine Fibromyoma (FIBROID)
It is commonly known as fibroid but the correct terminology should be fibromyoma or myoma .As it develops from the muscular layer of the uterus. The fibroid is an admixture of muscle tissue and fibrous tissue. It is benign in nature.
- Heredity as it runs in families heredity can be one of the causes for the formation of fibroid.
- It can also occur during the reproductive period due to increased blood supply to the uterus.
- It also depends on the hormone estrogen for its growth.
- The associated factors along with fibroid are endometrial hyperplasia and infertility.
This is the commonest type of neoplasm in a women. Negroes get fibroid 3 times more then the whites.
Location of the fibroids
In order to understand the location of the fibroid in the uterus let us understand the structure of the uterus in brief. It is a internal genital organ also known as the womb. It is situated in the center of the pelvic cavity.
Parts of the uterus:
It is divisible in two parts by the slight constriction at the level of the internal os.
- Corpus or Body: The corpus is further divided into fundus the part which lies above the openings of the uterine tubes (Where the fallopian tubes are attached refer the diagram).The body proper is triangular and lies between the opening of the fallopian tubes and the isthmus.
- Isthmus: it is the constricted part which measures about 0.5 cm and is situated between the body and the cervix.
- Cervix: it is the lower most part of the uterus which is almost cylindrical in shape and a part of it is incorporated within the vagina. It is divided in to the supravaginal part which lies above the vagina and the vaginal part which lies within the vagina. The vaginal portion is also known as portio vaginalis .There is an opening at the lower end of the portio vaginalis which is known as the external os.
In women who have not given birth the vaginal part of the cervix is conical In shape and the external os looks circular. In women who have given birth to a child it is cylindrical in shape and the external os has bilateral slits which is caused due to the tear of the circular muscles surrounding the external os during child birth and it gives rise to anterior and posterior lip of the cervix.
- Cavity: If the cavity of the uterus is studied in sections; in the sagittal section the cavity of the corpus is narrow slit but on coronal section it is triangular in shape and the uppermost part is called the base this communicates into the lumen of the fallopian tubes on either sides.
The cervical canal is spindle shaped which opens above in the uterine cavity through the internal os and below into the vagina through the external os. The length of the uterine cavity from the external os to the fundus is about 6.5 cm of which 2.5cm is the length of the cervical canal.
- The Fallopian tubes: Either of a pair of tubes extending from the uterus to the paired ovaries in the human female also called oviducts, technically known as the uterine tube. At one end the long, slender fallopian tube opens into the uterus; the other end expands into a funnel shape near the ovary. The epithelium that lines the tube is covered with cilia that beat continuously toward the uterus
The Fibroid of the uterus maybe present in the Body of the uterus that is known as Corporeal this is the commonest type. The other type is found in the cervix of the uterus.
Interstitial ( Intramural) : It grows in the substance of the uterine wall and may remain as such in especially when they are small or maybe sub mucus or subserous. The posterior wall of the uterus is the commonest site for the development of the fibroid.
Subserous (Sub peritoneal): The fibroid lies underneath the peritoneum
(Peritoneum is the serous membrane that lines the abdominal and uterine cavity) and it can be sessile or pedunculated.If it grows between the layers of the broad ligament of the uterus then it develops ligamentory fibroids.
Submucous: mostly it is a single fibroid which grows beneath the mucous membranes of the uterus and projects itself in the uterine cavity. It maybe sessile or pedunculated in character. Due to the expulsive force of the uterus the sessile growth can change its character.
The following things can happen to a sub mucus fibroid.
Clinical features of corporeal fibromyoma
- Formation of sub mucus fibroid polypus
- It can become infected with pus formation and erosion of the same.
- This is the commonest variety which can undergo malignant changes
- It may rarely cause inversion of the uterus due to the expulsive force of the uterus.
Uterine fibroid arises during the menarche (beginning of the menses) till menopause. During the age of 35-45 fibroids are more evident. After menopause the fibroids shrink and never develops freshly this occurs due to the hormonal changes that take place in the body after menopause. Sometimes the menopause can be delayed due to the fibroids.
Most of the women suffering from fibroid are symptomless.
The following symptoms can be seen in some of the patients:
- Menorrhagia: excessive bleeding during the menstrual cycle this is the commonest symptom which often becomes a regular feature with passage of clots.
- Metorrhagia: irregular bleeding is a feature of submucous fibroid with ulceration or rarely endometrial carcinoma.
- Dysmenorrhoea: Pain in the abdomen and lower back can also be noticed. The pain is unbearable in nature.
- Leucorrhea: This is the white discharge and it occurs particularly if there is a fibroid polyp.Abdominal lump the woman comes with the complaint that she feels a lump in the abdomen. The lump has to be big enough which corresponds to 14 weeks of pregnancy to be palpable.
Infertility about 30 % of the females can suffer from infertility due to uterine fibroids. Pressure symptoms like frequency of urination or urgency to urinate as a result of the pressure of the fibroid on the bladder.
- Anemia: it can develop due to the excessive bleeding but it is a gradual process. The patient may suffer from palpitation and weakness. Pain this is a rare symptoms.
Pain can develop due to the following reasons.
- If a fibroid polyp is being expulsed
- Derangement of the blood supply to the fibroid.
- Twisting of the Subserous fibroid.
- When there is excessive bleeding anemia can be present
- On examination of the abdomen there is a feeling of a lump. The surface of the lump maybe smooth .There is dullness on percussion of the area.(A type of Physical examination).
- Bimanual examination confirms that the uterus is enlarged in size. Then the uterine fibroid is carefully assessed for red degeneration, infection and rarely for sarcoma.
- USG-Abdomen and pelvis
- Urinary pregnancy test
- Complete blood count
- Erythrocyte sedimentation rate (E.S.R)
- Laparoscopy and Laprotomy.
These are not the common type of fibroids .They contribute 1-2 % of all types of the uterine fibroids.
- It can be located at the portio vaginalis (Please refer to the image) and it can project in the vagina and become polypoidal.
- At the supravaginal cervix the fibroid can be situated in the following positions
- Anteriorly it pushes the urinary bladder up
- Posterior it obliterated the pouch of Douglas and can cause pressure on the rectum.
- Lateral in the broad ligament due to this the ureter is pushed laterally but it remains below the fibroid.
- Central it causes expansion of the cervix from all the sides.
It doesn't cause any menstrual disorder but it causes pressure symptoms like frequency of urination, defecation on straining, Constipation. It can also cause problems during child birth.
- On examination of the abdomen the uterus and its parts are felt separate being situated on the top of a firm pelvis mass.
- Examination through vagina (Per vaginum)
- The cervix of the uterus is felt expanded due to the filling up by the tumor. A mass can be felt which is fixed to the cervix which is pushed high up behind the symphysis pubis.
- The feature of the mass is its firmness, fixity, pelvic position and the attachment to the cervix. The body of the uterus is felt separate from the mass.
- Examination through the rectum under anesthesia and sounding the cervical canal are essential steps for diagnosis.
- Urine analysis
- Urine culture to know the infection
- Renal function tests
The conservative treatment for fibroid includes treating anemia, oral contraceptive pills –progestin only drugs to control the blood flow, pain killers for dysmenorrhoea and if the fibroid is big then with surgical removal –laproscopy or hysterectomy is done.
Scope of Homeopathy:
The first question that comes to the mind is how these Homeopathic medicines are going to help in fighting the disease. As we all know in a diseased state the internal bodily mechanisms do not work in a harmonious way. So to bring back the lost harmony to its original balanced state the correct Homeopathic medicine has to be given.
The homeopathic medicine acts at 3 levels the Psyche, Neuro, Endocrines at the level of the psyche it helps to bring balance which in turn will affect the neurological balance and the correct secretion of the hormones which play an important role in maintaining the harmonious flow. The homeopathic medicines do not treat the disease but it helps in bringing back the lost imbalance back to its normal state.
To find the correct Homeopathic remedy one needs a complete case study so all the aspects of the emotional nature, Fears, Social relations, family relations, ups and downs in life have to be taken into consideration. Also the past history, problems in adjusting, Family history of any major illnesses have to be mentioned.
Once the correct remedy is given the body starts it own healing process.The Homeopathic remedies stimulate the internal healing mechanism of the body .In this way the patient starts recovering .A proper feedback has to be given by the patient when he is under medication so that the case can be assessed and the desired result is obtained.
Homeopathy acts on' Individual' in disease rather than the 'disease' in individual. So the correct constitutional remedy that is selected on basis of detailed case history acts at the root cause of disease gently without causing any other side-effects.
Homeopathy treats the hormonal imbalance and restores the estrogen levels and restricts the blood supply to the fibroid thereby preventing its further growth.
Thus, the fibroid starts to shrink and further development of the fibroid to other locations is prevented.
How Happy Livin will help you:
Dr.Joshi is a leading name in the field of Homeopathy who has around 16 years of experience in treating the patient in the classical way as intended by our Founder of Homeopathy - Dr.Samuel Hahnemann.
There is an attempt to bring the best quality of treatment at your doorstep.
A thorough case-taking is done at your convenience and after careful analysis of the same, the best quality Homeopathic medicines procured from Germany are delivered at your doorstep in a week's time along with certain health tips, dietary instructions to be followed according to the disease condition.