FIBROMYOMA - AYURVEDIC MANAGEMENT.pdf

Fibromyomas, commonly known as uterine fibroids, are benign tumors that develop in the muscular wall of the uterus. They can cause a variety of symptoms, including heavy menstrual bleeding, pelvic pain, and reproductive issues. While conventional treatments often focus on surgical interventions or hormonal therapies, Ayurveda offers a holistic approach that emphasizes balance, natural remedies, and lifestyle modifications.This presentation aims to provide valuable insights into the Ayurvedic approach to managing fibromyomas, promoting awareness of alternative treatment options for those affected by this condition.

1. UTERINEFIBROIDS
Presentedby
Dr ShanmugalogaS
Pg scholar
Dept of Shalya tantra
GAMC, BENGALURU

2. FIBROMYOMA,themostcommonbenigntumors
whichdevelopfromuterinemyometriumin
womenofreproductiveagegroup
PROTECTIVEFACTORS:
Multiparity
Menopause
UseofOCP
Useofdepoprovera
RISKFACTORS:
PositiveF/H/O
Earlymenarche
Obesity
Vit D defeciency
High BP

3. CLASSIFICATION
INTRAMURAL SUBMUCOSAL SUBSEROSAL CERVICAL&BROAD
LIGAMENT
Occurrence-75%
commonest
Occurrence-5%Less
common
Veryrare
Causesmenorrhagia
thanpressure
symptoms
Causesmaximal
menstrualsymptoms-
menorrhagia,
metrorrhagia
Causespainand
pressuresymptomsto
adjacentorgans.

4. PATHOPHYSIOLOGY-
Genetic Predisposition
Hyper estrogenic state
Biologicfactors

5. FIBROIDS –IMPACT IN FERTILITY:
Dependsuponthelocation&size
1)MayhinderthetransportofSpermforimplantation
2)Submucosalfibroidsinfluence(reduces)thelevelofIL-10
&glycodelin-supportsimplantationandearlyembryonic
development
3)Inflammatoryreactionsinuterus–hinderimplantation
4)presenceoffibroidsleadtochangeinendomyometrial
junctionalzonewhichregularlyconsistsofmacrophages&
naturalkillercells-contributetoendometrial
decidualisationduringimplantation.Fibroidsare
associatedwithreductionofthosecells

6. PROBLEMS DURING PREGNANCY:
1)Abnormalitiesinplacentalattachment
2)Mayrestrictthegrowthofthebaby
3)Increasetheriskofpretermdelivery
4)BreechpresentationinsteadofCephalic

7. DIAGNOSIS
Pelvic ultrasonography
Transvaginal ultrasound
Magnetic resonance imaging
HEMOGLOBIN LEVEL- to know the severity of bleeding &
for pretreatment evaluation

8. TREATMENT CRITERIA
SITE – SIZE- AGE-HB &PCV
1) Fibroid size <6 cm
2) Pain & pressure symptoms
3) Abnormal uterine bleeding
4)Rapid growth / growth after menopause
5)Infertility/ recurrent pregnancy loss
6)Hemodynamic status

9. EXPECTANT MANAGEMENT MEDICALMANAGEMENT SURGICALMANAGEMENT
Criteria-
1)Fibroid size of 5-6cm
2)Symptomsnotaffectingthe
qualityoflife
*Pteducation
*Followupafter4-6months
*SymptomaticRx
1)Emergencysuppressionof
heavybleeding
2)Bleeding&pelvicpainwill
respondtoNSAID,tranexamic
acid
3)GnRHagonistspriorto
surgerytoshrinkthesizeof
fibroids
4)OCPforwhodon’tdesire
pregnancy
1)Infailureofothertreatment
2)Severesymptomsaffecting
qualityoflife
If fertility desirable
*myomectomy–disadvantage
isrecurrence
If fertility Not desirable
*Hysterectomy-defenitivecure

10. Ayurvediccorrelation
MAMSA GRANTHI
REF :CHA.CHI.12/81
ANGAIHI EKADESHESVA ANILADHIBHI SYAAT SWAROOPADHARI
SPHURANAHA SIRADHIBHI/ GRANTHI MAHANMAMSA BHAVATI //

REF: AH. U.29/6
MAMSALAIHI DUSHITAM MAMSAHARAIHI GRANTHIMAVAHETH/
SNIGDHAM MAHANANTAM KATINAM SIRANADDHAM
KAPHAKRITIM//

11. NIDANAM
REF:CHARAKAM/VIMANASTHANAM/6/15
ABHISYANDABHOJYANISTHULANICHAGURUNICHA/
MAMSAVAHANIDUSHYANICHASWAPATHAMDIVA/
REF:ASTANGAHRIDAYAM/UTTARASRHANAM/29/6
MAMSALAIHIDUSHITAMAHARAIHIGRANTHIMAVAHETH/

12. DOSHADUSYAINSAMPRAPTI:
Kapha pradhana vatadhidhosham involvement
•as per astanga hridaya/uttarasthanam/29/1-2- KAPHA VATA
MAMSAAN MEDO ASRK
•as per susrutha samhita / nidana/11/3 - VATADAYO
MAMSASRUK CHA DUSHTAHA

13. Mamsavriddhijansamsodhanam sastraksara Agni karma bhi(A.S)
Shodanam-virecanammoreeffectivethanvamanam
Shamanam-accordingtodoshapredominance
Vasti- yogavasti is preferrable
Shatavari /shatapushpa tailaanuvasana
Jeevaniya tailam/Madhukadhitailamanuvasanam
Rasnadhi anusvasanam/asthapanam – in pain/pressure
symptoms
Chandanadhi niruha/kushadhiasthapana vasti/mustadhi
yapanavasti/Rodhradhi asthapana vasti- in bleeding conditions
GENERALTREATMENTPRINCIPLES:

14. Snehapanam
•sukumaragritam-Heavy
bleeding/pressuresymptoms
•Varunadhigritam-ifno
bleeding
•Dadimadhigritam/mridwikadhi
gritam-ifhbislow
Nasyam
Avapidananasyam–sheeta
sthambam
•Vasaswarasam
•Ksheeram
•shatapushpakalkam
•Shatavarikalkam
Yonipichu
Vatapradhanam:
•Dhanwantaramtailam
•Dineshavalyadhitailam
Pittashamanam:
•Nalpamaradhitailam
•Dhatakipushpam+
chandanadhichurnam+madhu
Raktasthanapam
Madhumadhukarudhira
mocarasamrktapaalalodhra
gairikapriyangusarkaralajaiti
dashemanisonitashapanam
bhavanti/(cha/sutra/4/18)

15. DOSHAPRADHANYACHIKITSA:
VATA PITTA KAPHA
vata dominant-
pressure /
pain symptoms-
vatakapha
shamanaa,
vatanulomana
pitta dominant-
menorrhagia/
metrorrhagia-
sthambana,
raktaprasadanam,
pittavatashamanam
Kapha dominant-
mostly
asymptomatic
kaphavata
shamana,lekhanam,
ksharaprayoga

16. VATA PITTA KAPHA
sukumara kashyam
saptasaram ks
chiruvilwadhi ks
Hinguvachadhi CH
Dhanwantara tailam
sahacaradhai tailam
chandraprabhavati
lodhradhi kasaya
sukumara ks
trayanthyadhi ks
asokavalkala ch
pusyanuga CH
sudharshana CH
shatavari gritam
tiktaka/ mahatiktaka
gritam
draksha gritam
chandraprabhavati
Shiva gulika
Varandhi ks
triphala ks
guggulu tiktaka ks
chitrakasavam
nimbamrutasavam
lohasavam
hinguvacadhi CH
guggulupanacapala CH
shaddharana ch
navaayasa lauham
kancanara guggulu
triphala guggulu
chandraprabha vati

17. PATHYA&APATHYA:

18. ASANAS:

19. THANKYOU