Uterine fibroids(Leiomyomas )
Leiomyomas are benign smooth muscle neoplasms that typically originate from the myometrium. They are often referred to as uterine myoma
1.Estrogen Effects -Uterine leiomyomas are estrogen- and progesterone-sensitive tumors .Consequently, they develop during the reproductive years. After menopause, leiomyomas generally shrink, and new tumor development is infrequent.
- Leiomyomas themselves create a hyperestrogenic environment, which appears requisite for their growth and maintenance.
- First, leiomyoma cells contain a greater density of estrogen receptors, which results in greater estradiol binding.
- Second, these tumors convert estradiol to the weaker estrone.
- A third, conversion of androgens to estrogen.
2.Early menarche- Increased years of estrogen exposure
3.Obesity ,Elevated BMI- Increased conversion of androgens to estrogens
4.Affected family member-Increased Genetic differences in hormone production or metabolism
5.PCOS -Increased Unopposed estrogen secondary to anovulation
6.Postmenopausal – Hypoestrogenism so fibroid development is infrequent.
7.Increased parity- Decreased Break in chronic estrogen exposure; uterine remodeling during postpartum involution,so fibroid development is infrequent.
8.Vitamin D deficiency
9.Having a diet higher in red meat and lower in green vegetables, fruit and dairy drinking alcohol, including beer.
Classification of Uterine Leiomyoma
- Subserosal leiomyomas
- Intramural leiomyomas
- Submucous leiomyomas
- Parasitic leiomyomas
Grossly, leiomyomas are round, pearly white, firm, rubbery tumors that on cut-surface display a whorled pattern). A typically involved uterus contains 6 to 7 tumors of varying size. The typical appearance of leiomyomas may change if normal muscle tissue is replaced with various degenerative substances following hemorrhage and necrosis.
Necrosis and degeneration develops frequently in leiomyomas because of the limited blood supply within these tumors. Leiomyomas have a lower arterial density compared with the surrounding normal myometrium. Moreover, their lack of vascular organization leaves some tumors vulnerable to hypoperfusion and ischemia.
- Bleeding. This is the most common symptom and usually presents as menorrhagia. The pathophysiology underlying this bleeding may relate to dilatation of venules. Bulky tumors are thought to exert pressure and impinge on the uterine venous system, which causes venous dilatation within the myometrium and endometrium
- Pelvic Discomfort and Dysmenorrhea.
- Urinary frequency,
- Incontinence of urine
- Acute Pelvic Pain. This is a less frequent complaint with leiomyomas, but is most often seen with a degenerating or prolapsing leiomyoma.
- Infertility and Pregnancy Wastage. Occlusion of tubal ostia and disruption of the normal uterine contractions that propel sperm or ova. Distortion of the endometrial cavity may also diminish implantation and sperm transport. Importantly, leiomyomas are associated with endometrial inflammation and vascular changes that may disrupt implantation
- Avoid chemical pesticides, chemical fertilizer for farming
- Avoid herbicides
- Avoid weedicides
- Avoid rodenticide
- Eat organic fruits, vegetable
- Regular exercise
- Eating foods high in fiber
- Drinking an adequate amount of fluids
- Avoid alcohol
- Avoid tobacco
- Blood CBC, β-hCG level, ESTROGENs,PROGESTRON,LIPID PROFILE,FBS
- ULTRASOUND ABDOMEN