Saturday, August 27, 2011

Fibroids and Uterine Bleeding

Fibroids, also known as Fibromyoma uteri or leiomyoma uteri, are benign tumors originated from the muscle tissue that adhere to either the inner or outer of the uterine wall. According to the statistic from National Uterine Fibroid Foundations approximately 80% of all women have uterine fibroids with the majority usually have no symptoms. Every 10 minutes, 12 hysterectomies are performed in the United States alone.

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Symptoms
Most common symptoms of fibroids uterine bleeding and pelvic pressure, but most women with small fibroids tumor are experience no symptoms at all, depending to the location and size of the tumors.
1. Uterine bleeding
Prolonged and/or profuse uterine bleeding are one of most common symptoms of fibroids, but women with submucous fibroids are particularly prone to this complication.
2. Pelvic pressure
It can be caused by the size and location of the fibroids as it can interfere with bowel movements and painful defecation or urinary frequency and incontinence.
3. Painful periods and sexual intercourse
As the result of over size fibroid.
4. Abdominal discomfort or bloating
As the result of over size fibroid.
5. Painful Defecation
As the result of over size fibroid.
6. Backache
As the result of the pressure of oversize fibroids.
7. Anemia
It may be result of heavy bleeding.
8. Infertility
Although it is considered uncommon affected only 3% of all cases , but it can happen, if the fibroids are in the stage of severity. In a study of "Pregnancy-related changes in the size of uterine leiomyomas" by Neiger R, Sonek JD, Croom CS, Ventolini G. Source Department of Obstetrics and Gynecology, Wright State University, Dayton, Ohio, USA. rneiger@mvh.org for evaluated 137 leiomyomas in 72 women (average, 2.3 +/- 1.8 per woman). Each underwent an average of 3.7 +/- 2.1 scans. The average gestational age at the time of first assessment was 14.4 +/- 5.4 weeks. The average diameter of the leiomyomas at the first study was 34.2 +/- 23 mm. On average, there was no significant change in the size of leiomyomas during pregnancy. We found that the size, location and our ability to visualize leiomyomas varied significantly during pregnancy. Four of the 72 women had obstetric complications related to the presence of leiomyomas., researchers concluded that The findings of our longitudinal sonographic assessment of 137 uterine leiomyomas suggest that despite the commonly held belief that they tend to enlarge during the course of pregnancy, this phenomenon is in fact quite rare.

9. Miscarriage
If the fibroid are growth large enough, it can interfere and cause miscarriage.

10. Premature labor
It may be as as result of the fibroid interfering with growth of the fetus.

11. Etc.

Diagnosis
If you are experience certain symptoms of the above, it is advised that you should check with your doctor for fibroids. After taking the family history and physical exam, including
1. Pelvic examination
Pelvic examination taken when there is no menstruation and advised not to have sex for at least 24 hours, is type of complete physical exam of a woman pelvic organ by a medical instrument to detect any infection, abnormal cells growth such as cysts, fibroid, Etc. The pap test usually is also taken. If your doctor found any abnormal cells growth or suspected uterine cancer, further tests may be suggested, icluding

2. Pelvic ultrasound
Ultrasound allows your doctor to visualize the kidneys and around structures and to assess blood flow to the uterus as well as looking for any abnormal cells growth mass, including fibroids.

3. Pelvic MRI
MRI (magnetic resonance imaging) is one of many advanced technology used to visualize internal structures cross sectional imaging of your body used effectively in providing the better details of the fibroids in the uterus and surrounding areas.
4. Etc.

Causes and risk factors
1. Recurrent miscarriage
Women who have family history of miscarriage with fibroids are at higher riks of recurrent miscarriages.

2. Age and before menopause
Women who are over the age of 30 are at increased risks of fibroids.

3. Hormone estrogen
According to the article of "Fibroid Research Update from the American Society of Reproductive Medicine Conference" posted on fibroids-a gynecologist's second opinion, the author indicated that Women with fibroids have normal blood levels of estrogen and progesterone. Estrogen dominance does not cause fibroids. Fibroid cells can make their own estrogen, so the level of estrogen inside fibroids is higher than in blood or other tissues.

4. Hormone progesterone
in a study of "Progesterone Is Essential for Maintenance and Growth of Uterine Leiomyoma" by Ishikawa H, Ishi K, Serna VA, Kakazu R, Bulun SE, Kurita T. Endocrinology. 2010 Apr 7, researchers found that found that estrogen plus progesterone stimulated growth of fibroid cells, and this growth was blocked with anti-progesterones. Withdrawal of progestrone caused fibroid tissue to shrink. Interestingly, estradiol (estrogen) without progesterone had no effect in this study.

5. Xanoestrogen
According to the study of "Xenoestrogens the cause of Uterine Fibroid Tumors ( Myomas ) by Elizabeth Smith, M.D.

6. Heridity
Women who have a family history of fibroid are at greater risk of developing fibriod.

7. Etc.

Prevention
A. How to prevent
1. Exercise
Exercise increases blood flow to the uterus thus reducing the risk of fibroids
2. Avoid excessive animal fat and trans fat
Animal fat and tran fat enhance the over production of estrogen in the body, thus increasing the risk of fibroids.

3. Fried food
They contain high amount of fat and trans fat.

4. Excessive drinking
excessive damage the liver function in controlling the production of prostaglandin hormones, that cause heavy menstruation and menstrual cramps and pain.

5. Smoking
Smoking increase the risk of free radical attacks and free radical chain attacks and decrease the immune system in fight against irregular cells growth.

6. Etc.

B. Diet (please read 100+ Healthy Foods Classification for more information)
1. Whole grains
Whole gains contains high amounts of fiber which help to detoxify the environment toxins accumulated in the body including xanoestrogen and enhance the liver function in reducing the risk of over production of prostaglandin hormone that can lead to uterine bleeding.


2. Vegetables and fruits
Vegetables and fruits contain high amount of antioxidants of which can increase immune system fighting against the irregular cells growth and damage from free radicals attack.


3. Soy
Soy contains high amount of antioxidants and phytoestrogen that can promote the immune system as well as balance the levbels of estrogen and progesterone hormones.

4. Legumes and beans
Legumes and beans contain are rich in phytoestrogens and act as fibroid fighters.

5. Water
Drinking 8 cups of water a day increases the blood flow of the uterus, thus reducing the risk of fibroid growth.

6. Etc.

C. Nutritional supplements
1. Omega 3 and 6 fatty acids
Balancing Omega 3 and 6 fatty acids can enhance the liver function and protect against the over production of prostaglandins hormone, thus reducing the uterline muscle constraction.

2. Antioxidants scavengers
Vitamin A, C, E are antioxidant scavengers, they protect the cells against the free articles and chain free articles attack and ehance the immune system in fighting against irregular cells growth icluding the cells of the muscle tissue that adhere to either the inner or outer of the uterine wall.
a. Vitamin A
b. Vitamin C
c. Vitamin E
For more information of antioxidant, please visit: Antioxidants and cancers and diseases

3. Vitamin D
In a study of "Vitamin D inhibits proliferation of human uterine leiomyoma cells via catechol-O-methyltransferase." by Sharan C, Halder SK, Thota C, Jaleel T, Nair S, Al-Hendy A, researchers found that Vitamin D inhibits growth of human fibroid cells a deficiency of vitamin D might allow fibroids to grow. The authors reference another article that found that while 45% of African-American women have vitamin D deficiency, only 4% of white women have this deficiency.

4. Iron
It is beneficial for women with heavy and profused menstrual flow as a result of oversize fibroid.

5. Phytoestrogen
Phytoestrogens are plant base weak estrogen, they can help to inhibit the rpoduction of bad estrogen by occupying the estrogen receptors sites and balance the levels of estrogen and progesterone, thus reducing the risk of fibroid's growth.

6. Resveratrol
According to the articles of "Resveratrol and Fibroids" posted in Resveratrol, 60 Resveratrol benefits report on online medical research, the author indicated that recent studies conducted by a fibroid research team headed by Dr. Bill Catherino and published and presented at the American Society of Reproductive Medicine Conference in Atlanta indicated that Resveratrol decreases the growth and induce fibroid cell death in vitro.

7. Etc.

Treatments
A. In conventional medicine
According to the study of "Uterine Myomas: An Overview of Development, Clinical Features, and Management" by Wallach, Edward E. MD; Vlahos, Nikos F. MD, researchers indicated that Treatment choices are wide and include pharmacologic, surgical, and radiographically directed intervention. Most myomas can be followed serially with surveillance for development of symptoms or progressive grow. The past century has witnessed development of highly sophisticated diagnostic and therapeutic technology for myomas. The tools currently at our disposal permit greater management flexibility with safe options, which must be tailored to the individual clinical situation.
A. Medication
1. Oral contraceptive pills
a. According to the article of "American Society of Reproductive Medicine Patient Booklet: Uterine Fibroids, 2003" Published by the American Society for Reproductive Medicine under the direction of the Patient Education Committee and the Publications Committee., Oral contraceptive pills can be prescribed to reduce uterine bleeding and cramps.

b. Levonorgestrel (a progestin)
With the implant of the Mirena if the fibroids are small enough to keep the device in place, Levonorgestrel release from the device can effectively shrink the fibroids. According to the study of "The effectiveness of the levonorgestrel-releasing intrauterine system in menorrhagia: a systematic review" by Antony Stewart, Carole Cummins, Lisa Gold, Rachel Jordan, Wendy Phillips researchers found thatEffectiveness and cost effectiveness relative to other treatments and the effect on surgical waiting lists can only be established in larger trials measuring patient-centred outcomes in women with menorrhagia.

2. GnRH(Gonadotropin-releasing hormone) agonist
GnRH agonist, Lupron is effective to decrease in GAGs, leading to the shrinking of the fibroids by dehydrating them. Some researchers suggested that Lupron increase the production of estradiols thus reducing the production of estrogen that cause fibroid to shrink.

3. Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs therapy is one most effective medicine to relieve menstrual cramping and reduce heavy menstrual bleeding for many women with fibroids as the medication reduce inflammation by inhibiting the effects caused by over production of prostaglandins hormones.

4. Etc.

A. 2. Surgery
1. Myomyectomy
a. Most women with fobrois do not need suhery, unless the sympyoms have become so sever, depending the size and location of fibroids. Myomyectomy is a procedure to remove the fibroids that cause sever symptoms but does not interfere with future conception by uterus reconstruction.
b. Risk and side effect
b.1. Surgerical and anesthesia risk
b.2. New fibroid develop
b.3. Scar tissue that may cause infertiltiy
b.4. Childbirth complcation.
b.5. Etc.

2. Hysterectomy
a. Hysterectomy is the surgical procedure to remove the entire uterus, if infertility is not the concern or you have exausted other options. Please make sure you under stand the risks and side effects of hysterectomy before operating.
b. Risks and side effects
b.1. Surgical and anesthesia risks
b.2. Infertility
b.3. decreased sexual desire
b.4. Depression
b.5. Etc.

3. Fibroid embolization
Uterine artery embolization (UAE) is surgical procedure to shrink the fibroids by cutting off the blood supply to the woman's uterus performed by a radiologist. According to the ACOG NEWS RELEASE, January 30, 2004, ACOG Office of Communications, (202) 484-3321
communications@acog.org "ACOG Issues Opinion on Uterine Artery Embolization For Treatment of Fibroids" the release indicated that To date, most data on patient satisfaction, fibroid and uterine size reduction, fertility, and complications are from case reports. In general, the reports have shown a short-term reduction in the size of fibroids and uteri, as well as short-term improvement in menstrual bleeding and other symptoms caused by fibroids. The complication rates associated with UAE are low, but in rare cases can include hysterectomy and death. ACOG recommends that all patients be informed about the potential complications with UAE.
Approximately 50 pregnancies have been reported in women who have had UAE. Nearly 60% of the resulting births were delivered by cesarean, 28% were preterm births, and 13% of patients had postpartum hemorrhage. According to ACOG, this procedure is still considered investigational for patients who may want to become pregnant, as further data are needed to draw conclusions about the safety of UAE in these patients.

4. Surgery with the guide of MRI (magnetic resonance image)
These 2 techniques are new and required further study
a. Ultrasound waves
With the guide of MRI to the precised location of the fibroids in the uterus, then using utrasound waves to destroy them
b. Laser beams
With the guide of MRI to the precised location of the fibroids in the uterus, then using laser beam to destroy them

6. Etc.

B. Herbs
Please consult with your doctor or specialist in the related fields before applying
1. Curcumin
In a study of "Inhibitory effect of curcumin on uterine leiomyoma cell proliferation." by Tsuiji K, Takeda T, Li B, Wakabayashi A, Kondo A, Kimura T, Yaegashi N., researchers found that found that curcumin significantly inhibited ELT-3 cell proliferation. PPARγ was expressed in ELT-3 cells and curcumin acted as a PPARγ ligand. This inhibitory effect of curcumin was attenuated by the treatment of cells with PPARγ antagonist and concluded that these experimental findings in vitro show that the inhibitory effect of curcumin on ELT-3 cell proliferation occurs through the activation of PPARγ. Curcumin may be useful as an alternative therapy for uterine leiomyoma.

2. Chaste berry tree
Chjaste berry tree contains high amounts of phytoestrogen and condidered as the queen herb in herbal medicine as it balance the levels of estrogen and progesterone in the women body. According to the article of "Help for Women With Fibroids" By Susun Weed, the authors write that Vitex or chasteberry tincture, 25-30 drops two to four times daily, often shrinks small fibroids within two months. But results come from long-term use - up to two years.

3. Red Clover
Red Clover has a rich source of phytoestrogen and has been used in herbal medicine to treat fibroids as its function of balance the levels of estrogen and progesterone in the women body by its activity on estrogen receptors. According to the article of Red Clover: Herbal Remedies by Jennifer Brett, N.D., the author wrote that what this means is that some substances in plants produce the same effects in humans as some hormones. Isoflavones in red clover are able to bind to estrogen -- and possibly other -- receptors. They appear to have moderate hormonal effects .

4. Evening Primrose Oil
Evening Primrose Oil helps regulate hormone production and may even shrink fibroids. According to "Uterine fibroid tumors (myomas), like breast fibrocysts, are a product of estrogen dominance (too much estrogen). Estrogen stimulates their growth, and lack of estrogen causes them to atrophy." John Lee, M.D

5. Burdock Root
Burdock Root contains high amount of arctigenin, a natural tumor inhibitor which can help stop and reduce the growth of fibroids.

6. Etc.

C. Traditional Chinese medicine
Please consult with your doctor or specialist in the related fields before applying
1. In Traditional Chinese Medicine, fibroids are classified commonly as the result of either Yin Deficiency Fire, Liver Qi Stagnation with Spleen Qi Deficiency or Qi and Blood Stagnation.In this article, I would like to provide you with Chinese herbs formula Qui Zhi Fu Ling Wan. According to The Pharmacopoeia of the People's Republic of China (PPRC) is the official pharmacopoeia of China. The most recent English edition was published in 2000 and comprises two volumes. Volume 1 covers the Traditional Chinese Materia Medica, including Traditional Chinese Patent Medicines, while Volume 2 is dedicated to conventional pharmaceuticals. Gui zhi Fu ling Wan is a brown pill used in Traditional Chinese medicine to "activate blood circulation, to remove blood stasis and mass in the abdomen".

2. Ingredients
a. Gui Zhi ( Cinnamon twig)
Main use: Promotes sweating, Releases the Exterior; Warms the channels, Tonifies the Yang,...
b. Fu Ling (Poria)
Main use:
Eliminates Water, Strengthens the Spleen,..
c. Mou Tan Pi
Main use: Clears Heat, Cools and Moves Blood, Eliminates Blood accumulation,...
d. Tao Ren (Peach Seed)
Main use: Moves Blood, Eliminates accumulations, Moistens the Intestines,...movement;
e. Shao yao (Peony)
Main use: removes blood stasis, Relieves pain
, Regulates & harmonizes Qi & blood, Clears Heat,...

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http://medicaladvisorjournals.blogspot.com/

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