Myomas are most common problems in these days. Myomas are the most common tumors found in the genital tract and affect more than one in four pre-menopausal women. Although the majority of fibroids remain small and asymptomatic, one third grows considerably in size, can weigh over 10kg. Incidences of Myoma are not usually found in women under 30 years old. Uterine fibroids or Myoma are benign tumors that originate from the smooth muscle layer and accompanying connective tissue of the uterus. Most fibroids develop in an intramural location (within the muscular wall of the uterus), but some also develop on the outside or in the internal cavity of the uterus. Uterine Myoma being the one of most common benign tumors in women amongst all neoplasms is responsible for a large number of hysterectomies.
Myoma is a disorder of Artava vaha srotas (menstrual channels) which occurs due to vitiation of Kapha dosha, Vata dosha and Rakta dhatu (Blood tissue). There can be Pitta displacement also. Therefore the treatment is to bring balance of all the three doshas and Rakta and sufficiently sustained over time to eradicate Kapha. Uterine Myoma, which is also called leiomyoma or fibroid of the uterus, can grow on the uterine wall and push out into the bladder, bowel or intestine. They can also grow within the uterine wall, or even project from the wall of the uterus on a narrow stalk into the uterine cavity. Myoma can be as small as a pea or as large as a football and are almost always benign, no matter how large they get. Having uterine Myoma does not increase one's risk of cancer. If a Myoma or cluster of Myomas is particularly large or is growing on the outside of the uterine wall, it can sometimes push the uterus aside or force it to grow abnormally. A uterine growth may also put pressure on the bladder or intestines. On rare occasions, a large Myoma may block the opening of the uterus.
Doshas and the reproductive system
The physiology of the reproductive system as a whole is governed by pitta and apana vata, yet the organs themselves are endowed with the qualities of kapha. Kapha is the growth-promoting (anabolic), structure-forming dosha that generates and sustains creation. Together with rasa dhatu (plasma tissue) it offers the nourishment required to rebuild the endometrial lining and has an unctuous quality that lubricates the uterus and other organs of the reproductive system. Kapha also offers stability and strength to the uterus, particularly via its muscle tissue, which maintains uterine shape, tone and power to contract.
Pathogenesis of Myoma
According to Ayurveda, a uterine fibroid or raktagulma is caused by over-production of improperly formed kapha and aggravated apana vata (one of the five types of Vata, the seat of which is the reproductive system and anus) along with vitiated Rakta dhatu (Blood tissue). Due to excessive mental stress, long-term emotional suppression, lack of exercise, intake of large quantity of food, consumption of excessive junk food, red meat, heavy and oily food, wheat, refined sugar and excess dairy, and suppression of natural urges aggravates the Agni (digestive fire) gets vitiated and leads to Ama (metabolic toxin) formation and vitiates kapha dosha. This vitiated kapha gets carried by vata dosha into the reproductive system where it is unable to conduct its normal physiological functions. Instead it accumulates, blocks the movement of apana vata in the Artava vaha srotas (menstrual channels) and gets pushed by vitiated vata into the muscle tissue of the uterus. As a result, dysfunction of the muscle tissue develops, leading to abnormal tissue metabolism and growth, i.e. the formation of one or several deep-seated, expansive and immovable Gulma (myoma / fibroid tumors). Also in present day scenario, all woman work and usually they don't have so much of time for their health. Sometimes due to their inability to follow proper care pertaining to health because of change in lifestyle is one of the positive factors of Myoma. Ideal dietary regimen can't be followed during menstrual period, post natal period and after abortion. This leads to Uterine fibroid / Myoma which can be compared to Rakta Gulma as per Ayurveda.
Symptoms of Myoma
The most common symptoms are weakness, abdominal swelling, bloating and heavy sensations in the lower abdomen associated with or without pain. In some cases Myomas cause kashtartava (dysmenorrhoea), katisula (back pain), anapatya (infertility), raktapradara (includes menorrhagia and inter-menstrual bleeding), shula (abdominal and pelvic pain or tenderness) and pandu (anaemia).
Ayurvedic approach to the treatment of Myoma
Panchakarma therapy offers a ray of hope for uterine Myoma, for which no effective medical treatment is available in modern science. Management of fibroid has become a global challenge. Treating the physical manifestations involves Ayurvedic formulations, cleansing treatments, diet and lifestyle changes that will correct the quantity and quality of the doshas, balance the movement of apana vata and kindle agni (digestive fire). A lekhana (scraping, clearing) approach is required to both clear congestion from the digestive tract and channels of circulation, and to reduce the mass of fibrotic tissue. An effective & safe treatment of fibroid is a matter of great concern for physicians as well as surgeons. Ayurvedic treatment is non-invasive and in Ayurveda a large number of drugs possessing anti neoplastic properties have been mentioned, many recipes of drugs mentioned in the texts for the management of fibroid.
Combined effects of all therapies – Abhyanga (Therapeutic body massage), Swedana (Sudation therapy), Niruha-basti (Therapeutic medicated enema through the anal route), Anuvasana-basti (Therapeutic oil enema through the anal canal) & Uttara-basti (Introducing medicated oil or herbal decoction in intrauterine cavity) and suitable internal herbs helps in pacifying the vitiation of Dosha & Dhatu & causing breach in pathogenic process of the disease.
Effect of Uttara-basti (Introducing medicated oil or herbal decoction in intrauterine cavity) in Garbhashaya (Uterus)
The medicated herbs administered in Uttara basti through the intrauterine route, enter the artavavaha strotas (menstrual channels) & causes pacification of doshas. Uttara-basti stimulates the organs & also increases the blood supply, which favors absorption of drugs & excretion of waste products. The vaginal passage & uterus are also purified & mollified by Uttara-basti with medicated herbs, helps to revitalize the hormonal system, giving youthfulness & stamina to the body. Uttara-basti also gives vibrant energy to the female organs. Thus non invasive treatments are available in Ayurveda for the management of Myoma / Uterine fibroid. In present world everyone is just running in Rat race which is an endless run and we are exhausted and we forget about following a regular routine. Avoiding physical and mental over strain, adopting suitable diet regimen and lifestyle in spite of our busy schedule reduces the risk of Myoma and helps in effective management.
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