Myomas, or uterine fibroids, are the most commonly occurring benign tumors of the female reproductive organs, and are found in approximately 20% of women over the age of thirty-five. Because fibroids contain estrogen receptors, they tend to be larger in the reproductive years or during pregnancy, and often shrink dramatically in size after menopause. They are more common in overweight women, and women of certain ethnic backgrounds.
Chinese medical treatment of uterine fibroids
Chinese medicine is able to address many of the underlying causes of fibroid growth, additionally providing safe treatment for many of the associated symptoms:
Acupuncture helps to normalize the functioning of the endocrine system, thus creating a better hormonal environment for reducing the size of fibroids. Research has shown that acupuncture reduces the proliferation of abnormal cells when performed near the site of the fibroid.
Reproductive organ massage enhances blood flow into the uterus, allowing for higher nutrient and oxygen levels to reach the fibroid, as well as enabling removal of waste products as the fibrin proteins break down. Manual therapy allows for faster breakdown of the fibrous tissue.
Chinese herbs stimulate detoxification pathways in the liver, allowing for excess levels of estrogen to be purged from the body. Once estrogen levels are regulated, fibroid growth is halted and the tissue begins to shrink.
Nutritional supplements of many kinds are useful in the treatment of fibroids. Enzyme therapy helps to dissolve the fibrous tissue that composes fibroid tumors, while fiber binds to estrogen and carries it out of the body. Other supplements may be used depending on the presentation of individual patients, and dietary changes may also enhance the overall results of treatment.
Diagnosis of uterine fibroids
Diagnosis is usually made with gynecologic ultrasonagraphy (ultrasound). Magnetic resonance imaging (MRI) or laparoscopy are less commonly used options. Many fibroids can be externally palpated, depending on their size and location, and are often discovered during routine physical examination.
Fibroids are named according to their location:
- Intramural fibroids are located within the uterine wall
- Subserosal fibroids are found underneath the mucosal (peritoneal) surface of the uterus. They can also grow out to become pedunculated fibroids
- Submucosal fibroids are located in the muscle beneath the endometrium of the uterus
- Cervical fibroids are located in the wall of the cervix
Symptoms of uterine fibroids
While the majority of fibroids are asymptomatic, a small percentage of women have difficult symptoms related to the location, size and number of the fibroids.
Commonly encountered symptoms include:
- Heavy or painful periods
- Back pain
- Abnormal bleeding
- Abdominal swelling or discomfort
- Urinary frequency or retention
- Painful defecation
- Pain during intercourse
- Bleeding during pregnancy
- Fetal malposition
- Premature labor
Western treatment of uterine fibroids
Uterine fibroids do not always require treatment; often if no symptoms are present, careful monitoring is sufficient. In cases that do require treatment, medication or surgery are both options, depending on the severity of the fibroids, and whether or not the patient wishes to have children.
Oral contraceptive pills may be used in an attempt to manage symptoms.
GnRH analogs (gonadatropin-releasing hormone analogs) create an artificial menopause, and may be used short-term for symptom management.
Myomectomy involves surgical removal of the fibroid itself.
Hysterectomy removes the entire uterus; fibroids are not able to recur, thus eliminating the need for further treatment.
Uterine artery embolization is used to occlude both uterine arteries, reducing blood supply
to the fibroid and causing it to shrink. This procedure is not always successful, and significant adverse results are possible.
High intensity focused ultrasound (HIFU) is a relatively new procedure wherein fibroid tissue is ablated using ultrasound waves.