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Uterine Fibroids

Definition:
Uterine fibroids are noncancerous growths of the uterus that often appear during your childbearing years. Also called fibromyomas, leiomyomas or myomas, uterine fibroids aren’t associated with an increased risk of uterine cancer and almost never develop into cancer.

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As many as three out of four women have uterine fibroids, but most are unaware of them because they often cause no symptoms. Your doctor may discover them incidentally during a pelvic exam or prenatal ultrasound.

In general, uterine fibroids cause no problems and seldom require treatment. Medical therapy and surgical procedures can shrink or remove fibroids if you have discomfort or troublesome symptoms. Rarely, fibroids can require emergency treatment if they cause sudden, sharp pelvic pain.

Uterine fibroids (singular Uterine Fibroma) (leiomyomata, singular leiomyoma) are benign tumors which grow from the muscle layers of the uterus. They are the most common benign neoplasm in females, and may affect about 25% of white and 50% of black women during the reproductive years. Uterine fibroids often do not require treatment, but when they are problematic, they may be treated surgically or with medication — possible interventions include a hysterectomy, hormonal therapy, a myomectomy, or uterine artery embolization. Uterine fibroids shrink dramatically in size after a woman passes through menopause.

Fibroids are named according to where they are found. There are four types: Intramural fibroids are found in the wall of the womb and are the most common type of fibroids. Subserosal fibroids are found growing outside the wall of the womb and can become very large. They can also grow on stalks (called pedunculated fibroids). Submucosal fibroids are found in the muscle beneath the inner lining of the womb wall. Cervical fibroids are found in the wall of the cervix (neck of the womb). In very rare cases, malignant (cancerous) growths on the smooth muscles inside the womb can develop, called leiomyosarcoma of the womb.

Symptoms:

Many women with uterine fibroids have no symptoms. If you have symptoms, they may include:

*Heavy or painful periods or bleeding between periods
*Feeling “full” in the lower abdomen
*Pain during sex
*Lower back pain
*Reproductive problems, such as infertility, multiple miscarriages or early labor
*Heavy menstrual bleeding
*Prolonged menstrual periods or bleeding between periods
*Pelvic pressure or pain
*Urinary incontinence or frequent urination
*Constipation
*Backache or leg pains

The names of fibroids reflect their orientation to the uterine wall. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus, and pedunculated fibroids hang from a stalk inside or outside the uterus.

.Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, the fibroid begins to die. Byproducts from a degenerating fibroid can seep into surrounding tissue, causing pain and fever. A fibroid that hangs by a stalk inside or outside the uterus (pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.

Fibroid location influences your signs and symptoms:

*Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are thought to be primarily responsible for prolonged, heavy menstrual bleeding.

*Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing constipation, or on your spinal nerves, causing backache.
Causes:
Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). A single cell reproduces repeatedly, eventually creating a pale, firm, rubbery mass distinct from neighboring tissue.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, in extreme cases expanding the uterus so much that it reaches the rib cage.

Doctors don’t know the cause of uterine fibroids, but research and clinical experience point to several factors:

*Genetic alterations. Many fibroids contain alterations in genes that code for uterine muscle cells.

*Hormones. Estrogen and progesterone, two hormones that stimulate development of the uterine lining in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and estrogen receptors than do normal uterine muscle cells.

Other chemicals. Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.

Location
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 (subserosal or pedunculated), some towards the cavity (submucosal or intracavitary). Lesions affecting the cavity tend to bleed more and interfere with pregnancy. Secondary changes that may develop within fibroids are hemorrhage, necrosis, calcification, and cystic changes. Less frequently, leiomyomas may occur at the lower uterine segment, cervix, or uterine ligaments.

Risk factors
There are few known risk factors for uterine fibroids, other than being a woman of reproductive age. Other factors include:

*Heredity. If your mother or sister had fibroids, you’re at increased risk of also developing them.

*Race. Black women are more likely to have fibroids than are women of other racial groups. In addition, black women have fibroids at younger ages, and they’re also likely to have more or larger fibroids.
Inconclusive research

Research examining other potential risk factors has been inconclusive. Although some studies have suggested that obese women are at higher risk of fibroids, other studies have not shown a link.

In addition, limited studies once suggested that women who take oral contraceptives and athletic women may have a lower risk of fibroids, but later research failed to establish this connection. Researchers have also looked at whether pregnancy and giving birth may have a protective effect, but results remain unclear.

Diagnosis:
Uterine fibroids are frequently found incidentally during a routine pelvic exam. Your doctor may feel irregularities in the shape of your uterus through your abdomen, suggesting the presence of fibroids.

Ultrasound
If confirmation is needed, your doctor may obtain an ultrasound — a painless exam that uses sound waves to obtain a picture of your uterus — to confirm the diagnosis and to map and measure fibroids. A doctor or technician moves the ultrasound device (transducer) over your abdomen (transabdominal) or places it inside your vagina (transvaginal) to obtain images of your uterus.

Transvaginal ultrasound provides more detail because the probe is closer to the uterus. Transabdominal ultrasound visualizes a larger anatomic area. Sometimes, fibroids are discovered during an ultrasound conducted for a different purpose, such as during a prenatal ultrasound.

Other imaging tests
If traditional ultrasound doesn’t provide enough information, your doctor may order other imaging studies, such as:

*Hysterosonography. This ultrasound variation uses sterile saline to expand the uterine cavity, making it easier to obtain interior images of the uterus. This test may be useful if you have heavy menstrual bleeding despite normal results from traditional ultrasound….click to see

*Hysterosalpingography. This technique uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. Your doctor may recommend it if infertility is a concern. In addition to revealing fibroids, it can help your doctor determine if your fallopian tubes are open.  ...click to see

*Hysteroscopy. Your doctor inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus. The tube releases a gas or liquid to expand your uterus, allowing your doctor to examine the walls of your uterus and the openings of your fallopian tubes. A hysteroscopy can be performed in your doctor’s office.
Imaging techniques that may occasionally be necessary include computerized tomography (CT) and magnetic resonance imaging (MRI).

Other tests
If you’re experiencing abnormal vaginal bleeding, your doctor may want to conduct other tests to investigate potential causes. He or she may order a complete blood count (CBC) to determine if you have iron deficiency anemia because of chronic blood loss. Your doctor may also order blood tests to rule out bleeding disorders and to determine the levels of reproductive hormones produced by your ovaries.
Complications
Although uterine fibroids usually aren’t dangerous, they can cause discomfort and may lead to complications such as anemia from heavy blood loss. In rare instances, fibroid tumors can grow out of your uterus on a stalk-like projection. If the fibroid twists on this stalk, you may develop a sudden, sharp, severe pain in your lower abdomen. If so, seek medical care right away. You may need surgery.

Malignancy
Very few lesions are or become malignant. Signs that a fibroid may be malignant are rapid growth or growth after menopause. Such lesions are typically a leiomyosarcoma on histology. There is no consensus among pathologists regarding the transformation of Leiomyoma into a sarcoma. Most pathologists believe that a Leiomyosarcoma is a de novo disease.

Pregnancy and fibroids
Because uterine fibroids typically develop during the childbearing years, women with fibroids are often concerned about their chances of a successful pregnancy.

Fibroids usually don’t interfere with conception and pregnancy, but they can occasionally affect fertility. They may distort or block your fallopian tubes, or interfere with the passage of sperm from your cervix to your fallopian tubes. Submucosal fibroids may prevent implantation and growth of an embryo.

Research indicates that pregnant women with fibroids are at slightly increased risk of miscarriage, premature labor and delivery, abnormal fetal position, and separation of the placenta from the uterine wall. But not all studies confirm these associations. Furthermore, complications vary based on the number, size and location of fibroids. Multiple fibroids and large submucosal fibroids that distort the uterine cavity are the type most likely to cause problems. A more common complication of fibroids in pregnancy is localized pain, typically between the first and second trimesters. This is usually easily treated with pain relievers.

In most cases, fibroids don’t interfere with pregnancy and treatment isn’t necessary. It was once believed that fibroids grew faster during pregnancy, but multiple studies suggest otherwise. Most fibroids remain stable in size, although some increase or decrease slightly, usually in the first trimester.

If you have fibroids and you’ve experienced repeated pregnancy losses, your doctor may recommend removing one or more fibroids to improve your chances of carrying a baby to term, especially if no other causes of miscarriage can be found and your fibroids distort the shape of your uterine cavity.

Doctors usually don’t remove fibroids in conjunction with a Caesarean section because of the high risk of excessive bleeding.

Treatment & Modern Drugs
There’s no single best approach to uterine fibroid treatment. Many treatment options exist. In most cases, the best action to take after discovering fibroids is simply to be aware they are there.

Watchful waiting
If you’re like most women with uterine fibroids, you have no signs or symptoms. In your case, watchful waiting (expectant management) could be the best course. Fibroids aren’t cancerous. They rarely interfere with pregnancy. They usually grow slowly and tend to shrink after menopause when levels of reproductive hormones drop. This is the best treatment option for a large majority of women with uterine fibroids.

Medications
Medications for uterine fibroids target hormones that regulate your menstrual cycle, treating symptoms such as heavy menstrual bleeding and pelvic pressure. They don’t eliminate fibroids, but may shrink them. Medications include:

*Gonadotropin-releasing hormone (Gn-RH) agonists. To trigger a new menstrual cycle, a control center in your brain called the hypothalamus manufactures gonadotropin-releasing hormone (Gn-RH). The substance travels to your pituitary gland, a tiny gland also located at the base of your brain, and sets in motion events that stimulate your ovaries to produce estrogen and progesterone.

Medications called Gn-RH agonists (Lupron, Synarel, others) act at the same sites that Gn-RH does. But when taken as therapy, a Gn-RH agonist produces the opposite effect to that of your natural hormone. Estrogen and progesterone levels fall, menstruation stops, fibroids shrink and anemia often improves.

*Androgens. Your ovaries and your adrenal glands, located above your kidneys, produce androgens, the so-called male hormones. Given as medical therapy, androgens can relieve fibroid symptoms.

Danazol, a synthetic drug similar to testosterone, has been shown to shrink fibroid tumors, reduce uterine size, stop menstruation and correct anemia. However, occasional unpleasant side effects such as weight gain, dysphoria (feeling depressed, anxious or uneasy), acne, headaches, unwanted hair growth and a deeper voice, make many women reluctant to take this drug.

Other medications. Oral contraceptives or progestins can help control menstrual bleeding, but they don’t reduce fibroid size. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are not hormonal medications, are effective for heavy vaginal bleeding unrelated to fibroids, but they don’t reduce bleeding caused by fibroids.
Hysterectomy
This operation — the removal of the uterus — remains the only proven permanent solution for uterine fibroids. But hysterectomy is major surgery. It ends your ability to bear children, and if you elect to have your ovaries removed also, it brings on menopause and the question of whether you’ll take hormone replacement therapy.

Myomectomy
In this surgical procedure, your surgeon removes the fibroids, leaving the uterus in place. If you want to bear children, you might choose this option. With myomectomy, as opposed to a hysterectomy, there is a risk of fibroid recurrence. There are several ways a myomectomy can be done:

Abdominal myomectomy. If you have multiple fibroids, very large or very deep fibroids, your doctor may use an open abdominal surgical procedure to remove the fibroids.
Laparoscopic myomectomy. If the fibroids are small and few in number, you and your doctor may opt for a laparoscopic procedure, which uses slender instruments inserted through small incisions in your abdomen to remove the fibroids from your uterus. Your doctor views your abdominal area on a remote monitor via a small camera attached to one of the instruments.
Hysteroscopic myomectomy. This procedure may be an option if the fibroids are contained inside the uterus (submucosal). A long, slender scope (hysteroscope) is passed through your vagina and cervix and into your uterus. Your doctor can see and remove the fibroids through the scope. This procedure is best performed by a doctor experienced in this technique.
Variations of myomectomy — in which uterine fibroids are destroyed without actually removing them — include:

*Myolysis. In this laparoscopic procedure, an electric current destroys the fibroids and shrinks the blood vessels that feed them.
*Cryomyolysis. In a procedure similar to myolysis, cryomyolysis uses liquid nitrogen to freeze the fibroids.

The safety, effectiveness and associated risk of fibroid recurrence of myolysis and cryomyolysis have yet to be determined.

*Endometrial ablation. This treatment, performed with a hysteroscope, uses heat to destroy the lining of your uterus, either ending menstruation or reducing your menstrual flow. Endometrial ablation is effective in stopping abnormal bleeding, but doesn’t affect fibroids outside the interior lining of the uterus.
Uterine artery embolization
Small particles injected into the arteries supplying the uterus cut off blood flow to fibroids, causing them to shrink. This technique is proving effective in shrinking fibroids and relieving the symptoms they can cause. Advantages over surgery include:

*No incision
*Shorter recovery time
Complications may occur if the blood supply to your ovaries or other organs is compromised.

Focused ultrasound surgery.>..click to see

In focused ultrasound surgery, treatment is conducted within a specialized magnetic resonance imaging (MRI) scanner. High-frequency, high-energy sound waves are directed through a source (gel pad) to destroy uterine fibroids.
MRI-guided focused ultrasound surgery (FUS), approved by the Food and Drug Administration in October 2004, is a newer treatment option for women with fibroids. Unlike other fibroid treatment options, FUS is noninvasive and preserves your uterus.

This procedure is performed while you’re inside of a specially crafted MRI scanner that allows doctors to visualize your anatomy, and then locate and destroy (ablate) fibroids inside your uterus without making an incision. Focused high-frequency, high-energy sound waves are used to target and destroy the fibroids. A single treatment session is done in an on- and off-again fashion, sometimes spanning several hours. Initial results with this technology are promising, but its long-term effectiveness is not yet known.

Before you decide
Because fibroids aren’t cancerous and usually grow slowly, you have time to gather information before making a decision about if and how to proceed with treatment. The option that’s right for you depends on a number of factors, including the severity of your signs and symptoms, your plans for childbearing, how close you are to menopause, and your feelings about surgery.

Before making a decision, consider the pros and cons of all available treatment options in relation to your particular situation. Remember, most women don’t need any treatment for uterine fibroids.
Alternative medicine:
You may have seen on the Internet, or in books focusing on women’s health, alternative treatments, such as certain dietary recommendations or homeopathy, which combines stress reduction techniques and herbal preparations.

More research is necessary to determine whether dietary practices or other methods can help prevent or treat fibroids. So far, there’s no scientific evidence to support the effectiveness of these techniques.

Herbal Treatment:
YOU can fight benign lumps With these herbs:

Evening primrose, kelp, mullein, pau d’arco, echinacea, red clover.

You may click to see Homeopathic medications for Uterine fibroids>..(1)….(2)….(3)

Prevention
Although researchers continue to study the causes of fibroid tumors, little scientific advice is available on how to prevent them. Preventing uterine fibroids may not be possible, but you can take comfort in the fact that only a small percentage of these tumors require treatment.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.mayoclinic.com/health/uterine-fibroids/DS00078
http://en.wikipedia.org/wiki/Uterine_fibroids
http://www.nlm.nih.gov/medlineplus/uterinefibroids.html

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Does Thinking Make You Fatter?

A research team has demonstrated that intellectual work induces a substantial increase in appetite and calorie intake. This discovery could help to explain, in part, the current obesity epidemic.

The team measured the spontaneous food intake of 14 students after each of three tasks: relaxing in a sitting position, reading and summarizing a text, and completing a series of memory, attention, and vigilance tests on the computer.

Each session of intellectual work required only three calories more than the rest period. However, despite the low energy cost of mental work, the students spontaneously consumed 203 more calories after summarizing a text and 253 more calories after the computer tests than they did after relaxing.

Blood samples taken before, during, and after each session revealed that intellectual work caused bigger fluctuations in glucose and insulin levels — two critical components in the body’s regulatory and energy machinery — than rest periods.

Jean-Philippe Chaput, the lead author of the study, said that mental work “destabilizes” the levels of insulin and glucose, thus stimulating the appetite, apparently in response to a need to restore the body’s energy balance.
Sources:
ABC News September 10, 2008
Psychosomatic Medicine September 2008 70:797-804

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Will the Wii Keep You Fit?

Wii Fit,” which lets you use the game platform as an exercise tool, is already a runaway hit in Japan and Britain. It was recently released in the United States.

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The newest component of this game is a balance board — a motion-sensitive platform that looks like a double-wide bathroom scale. It can detect how much weight you place on each foot and which way you’re leaning.

Before you start playing, you create a profile, entering your height and age. The game then measures your weight, your body mass index and your “Wii Fit age.” Once you’ve been assessed, you then start your workout, which can include yoga, strength training, aerobics and balance games.
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Sources:

* ABC News May 19, 2008

Mapping the Face

New research into how the face stores fat could lead to more effective anti-aging strategies, better facial reconstruction techniques, and may even help doctors assess heart-disease risks.

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Compartmentalization: The face has a new map.

In the fight to protect our faces from the ravages of aging, gravity is one of our biggest enemies. As we get older, Newton’s favorite force pulls everything from our brows to our chins south, and despite the claims of the multibillion-dollar anti-aging industry there is only so much we can do to pull back. And new research indicates that the face is a much more complicated battlefield than previously thought.

Rather than being a single area, the face is made up of not one, but 16 anatomically distinct compartments that gain and lose fatty tissue independently of one another over time, scientists at the University of Texas Southwestern Medical Center announced in a recent issue of Plastic and Reconstructive Surgery. The discovery is upending previous assumptions about the face’s structure, and its implications may reach beyond better face-lifts to a new understanding of obesity.

“For the last 100 years or so, we thought that facial skin and fat were held up by a handful of ligaments, and that the visual effects of aging come as those ligaments break down and gravity takes over, says James Stuzin, a plastic surgeon in Coconut Grove, Fla., who was not involved in the study. œIt turns out we got that wrong.

One clue into the face’s complexity is the fact that it does not age uniformly. As your cheeks begin to sag, for example, the area around your eyes may remain young and sprightly looking. This led Rod Rohrich, a professor and plastic surgeon at the University of Texas Southwestern Medical Center and the study’s lead author, to speculate that something might be separating sections of the face from one another. To test this theory, he and his colleagues injected blue dye into the faces of 30 cadavers. Rather than disperse evenly, which is what you’d expect if the face were a single area, the dye only spread throughout a specific facial area, depending on where it was injected. In all, they found eight distinct compartments on each side of the face.

Human anatomy has been studied for over 500 years, says study coauthor Joel Pessa, an assistant professor and plastic surgeon at UT Southwestern.  œItâ’s pretty unusual to see something this new at the macroscopic, anatomical level.
This illustration shows how blue dye settled in two of the 16 distinct fat compartments in the face as documented by researchers.

The compartments themselves are created by membranes that carry blood vessels to the face. Ligaments, once thought to play a leading role, are really the posts along an intricate series of membrane fences, according to the research. Knowing where these membranes are located, and where they intersect, may aid in the design of more specific flaps—tears of skin that plastic surgeons move from one area of the body to another. This could improve facial reconstruction techniques for those who’ve been injured in accidents or combat.

As the face ages, not only do ligaments break down, empowering gravity, but each compartment gains or loses fat independently of its neighbors. While plastic surgeons have long understood that part of the aging equation involves facial fat loss (a process they refer to as deflation), they may have underestimated its role in shaping the appearance of older faces. “Some of what looks like sagging, is really just deflation in deeper compartments,” says Pessa. “Knowing this will allow us to approach facial rejuvenation in a much more precise and individualized way.”

Researchers are looking into whether the case is the same for the rest of the body. “It opens a whole new avenue of investigation,” says Stuzin. “Now we can look at fat storage in a very scientific manner.” Scientists already know that people who store fat in certain regions of the body face a greater risk for developing heart disease. But Rohrich and Pessa’s research shows that common terms like “intra-abdominal” may actually refer to several distinct compartments. And that may lead to better predictions of risk. “Rather than saying ‘you store fat in the abdomen,’ we’ll be able to say, ‘you store fat in the deep axillary fat compartment’.” says Pessa. “It will be a much more fine-tuned diagnosis—but that’s a few years down the road.”

Source:NEWSWEEK

Gifts From The Universe

Accepting Your Family
Families can contain a fascinating grouping of personalities. Despite the potential for so many to have similar traits, there are many different ways to express them. As people marry into families and have children, even more personalities enter the picture. There may be some people that we would not choose to be related to, but that’s what friends are for.

If we trust in a universe that has a higher purpose for everything, then we must believe that family members are in our lives for a good reason. These reasons may be easy to see and appreciate with some, but others may offer us a challenge. With those, we can look for something we can learn or perhaps teach. In the modern world where everyone seeks to be individuals, many move far away from their families in an attempt to escape them. But when we’ve successfully built a world around us that requires no one’s help, our families are the people who are still attached to us. We can still choose whether or not to honor the family ties, and how to treat each other, but the fact remains that we are energetically tied to our families.

Our families help us see where we have come from so that we may more clearly decide where we’d like to go. If we can learn to accept our families for who they are, then we go out into the world armed with the ability to deal with anyone. Some families are better than others at preparing us for the world. What we learn from our families, even if they are simply blank spots on our family trees, becomes the basis of our identities as individuals. Rather than denying our connections, we can choose to accept their presence in our lives. Acceptance does not mean we have to like them; we simply acknowledge that we are connected to them and honor that connection for like it or not, there is a reason. When we can embrace all that they bring into our experience, we may be grateful for all we have learned from them and have to learn, while we experience everything that comes with family fully and completely.
Source:Daily Om