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Fibroids

Fibroids are non-cancerous tumours that grow in or around the womb (uterus). The growths are made up of muscle and fibrous tissue and vary in size.
They are sometimes known as uterine myomas or leiomyomas. 40% of women developing them at some point in their life. women aged 30-50 years. African Caribbean origin. overweight or obese women : the level of oestrogen in the body. Women who have had children have a lower risk of developing fibroids and the risk decreases further the more children you have.

Causes Pathophysiology
unknown. Linked to the hormone oestrogen. Develop during a womans reproductive years (from approximately 16 to 50 years of age) when oestrogen levels
are at their highest and they tend to shrink when oestrogen levels are low, such as after the menopause.

Location and classification


Fibroids can grow anywhere in the womb and vary in size considerably. Some can be the size of a pea whereas others can be the size of a melon. The main types of fibroids are: Intramural fibroids commonest - develop in the muscle wall of the womb Subserosal fibroids - fibroids that develop outside the wall of the womb into the pelvis and can become very large Submucosal fibroids - fibroids that develop in the muscle layer beneath the inner lining of the womb and grow into the middle of the womb In some cases, subserosal or submucosal fibroids are attached to the womb with a narrow stalk of tissue. These are known as Pedunculated fibroids. Fibroids may be single or multiple. Most fibroids start in an intramural location, that is the layer of the muscle of the uterus. With further growth, some lesions may develop towards the outside of the uterus or towards the internal cavity. Secondary changes that may develop within fibroids are hemorrhage, necrosis, calcification, and cystic changes

Patient presents with


Many women are unaware they have fibroids as they do not have any symptoms. Women who do have symptoms may experience:
Heavy periods or painful periods, Anaemia and debilitation, Bulging of the abdomen, Compression syndrome on organs, Frequency of urination, Constipation and bloating, Dyspareunia (painful sex), LBP &sciatica pain,

In rare cases, fibroids can cause significant complications such as infertility and problems during pregnancy. May be the cause of miscarriage, bleeding, premature labour, or interference with the position of the foetus.

Treatment
Reduce heavy periods - Levonorgestrel intrauterine system tranexamic acid NSAIDS contraceptive pill injected progesteron. Medication to shrink fibroids - Gonadotropin releasing hormone are hormones given by injection and work by making your body release a small amount of the hormone oestrogen, which causes your fibroids to shrink. - Sometimes, a combined with low doses of hormone replacement therapy (HRT) : Osteoporosis Surgery Hysterectomy Myomectomy -

Osteopathic Management
Pathophysiology: reduce congestion/inflammation of the uterus Aims: (structural/visceral/craneal ttt) Impact on the symp. (T11-T12) and parasymp. (S2-S4) Thoracic and pelvic diaphragm (pelvic floor) Restrictions in hips (arcuate tendon) and SIJ Adhesion of the peritoneum, uterus or any scar tissue in the abdominal wall Lymphatic pumping and Batsons venous plexus Dietary advice:
Anti-inflammatory nutrients: fish oils, turmeric, pineapple Anti-oxidative nutrients: cherry juice, blueberries Vit D: PF disorders