Fibroid is the commonest non-cancerous tumour of the uterus and also the commonest benign solid tumour in females.
It has been estimated that about 20% of women over the age of 30 have fibroid in their wombs.
These are more common in nulliparous or in those having one-child infertility.
The prevalence is highest between 35-45 yrs.
Risk factors
Increased risk is seen in nulliparity,
Obesity
Women over the age of 30
Family history of fibroid
However, the fibroid grows rapidly during pregnancy or among pill users. However, after delivery the size reduces to normal. In menopausal age also the fibroid shrinks.
Types of Fibroid
Fibroid on the body of the uterus: fibroid are mostly located in the body of the uterus and are usually multiple.
Types:
1) Interstitial
2) Subserous
3) Submucous
Interstitial or intramural (75%): these fibroid appear in the lining of the uterus (endometrium), and this is the commonest fibroid. The importance is that when the fibroid enlarges it stretches the uterus.
Subperitoneal or subserous (15%): the subserous fibroid grows out of the uterus (serosa).
Pedunculated fibroid. When the subserosal fibroid develops a stem like structure then it is called as Pedunculated fibroid.
Submucous (5%): the submucosal fibroid grows on the body of the uterus (myometrium). Usually, they are not common and when it occurs, causes heavy bleeding and causes a problem to become pregnant. Submucous fibroid can make the uterine cavity irregular and distorted.
Symptoms of the fibroid uterus:
The majority of fibroid are asymptomatic; a small submucous fibroid may produce more symptoms than a big subserous fibroid.
Menstrual abnormalities like-
Menorrhagia (30%) is the classic symptom of symptomatic fibroids. The menstrual loss is progressively increased with successive cycles.
Metrorrhagia or irregular bleeding may be due to ulceration of submucous fibroid, torn vessels, associated endometrial carcinoma.
Dysmenorrhea: the congestive type- it is due to pelvic congestion or endometriosis. Spasmodic type is associated with extrusion of polyp and its expulsion from uterine cavity.
Infertility: infertility may be the major complaint due to distortion of the uterus, preventing rhythmic contractions, congestion and dilatation of the endometrial venous Plexus.
Dyspareunia-(painful coition)
Abdominal swellings (lump): sense of heaviness in the abdomen.
Pressure symptoms: pressure of the fibroid in the posterior wall may cause constipation, dysuria, and retention of urine.
Signs of the fibroid uterus
Pallor-due to heavy menses
On palpation may the fibroid may feel in the abdomen when the size is increased, it is soft in consistency.
Investigation
Complete blood count
USG abdomen
Treatment.
Usually seedling fibroid and small fibroid if symptoms free no treatment is needed. Usually, fibroids won’t cause any problems during pregnancy.
But large fibroid needs surgery.
Homeopathic treatment
Medium-sized tumors respond very well to homeopathic treatment. The symptoms such as dysmenorrhea, heavy and prolonged bleeding, painful coition, etc.; can be managed by homeopathic medicines. Homeopathy not only removes the symptoms but cures the fibroid. But large and multiple fibroid need surgery.
