Subsurosal fibroidof 7.4 cm with abnormal bleeding and edrometrial thickness of 15.2 mm in 47 year old. Advised for hysy - #26710

7.4 cm fibroid is bit big size, it’s better to go for surgery

Hi Shelly , totally understood your concerns and confusions Sub serosal fibroid of 7.4cm can be considered as a medium sized fibroid which sometimes cause symptoms like abnormal bleeding , pain, etc. Some times it remains as asymptomatic Since your Biopsy is normal there is nothing big to get tensed . As per Ayurveda we can focus in your LAĶSHANAS [symptoms] mainly abnormal bleeding accordance with the fibroid and Endometrial thickness.

Start, 1.Trayanthyadi kwatham 15ml+ Guluchyadi kwatham tab 2+ 60ml warm water twice daily before food (morning and evening) 2.Kanchanara guggulu 1-0-1after food 3.Pushyanuga churnam ½tsp with honey (4-5times daily) 4.Thriphala tab 2 at bedtime * Take this set of medication for 14days - 1month , if you are feeling symptomatic relief ,have a follow up here. If symptoms persist even after 1month of medication I suggest better you can go with surgery.

*Do’s 3-4litres of water /day More focus on fruits like pomegranate, dates , orange, etc and vegetables Include Sprouted grains Practice yoga and meditation regularly

*Don’ts Tea /coffee Oily too salty sour sweet foods Junk foods Carbonated/soft drinks Maida and its products Too much of physical exertion

Hello Shelly ji, Please visit nearby ayurvedic physician (BAMS MS GYNAE /OBS)for further advice and treatment …

TAKE CARE😊

Till then Avoid kaphavardhak ahar vihar like excessive sweet, sour and salty food,guru ahar(heavy to digest)like refined flour etc…

Take M2TONE forte 1-0-1 after food with water Kanchanar guggul 1-0-1 after food with water Vriddhivadhika vati 1-0-1 after food with water Nagkesar churan 1tsp twice daily after food with water Take this combination for 3 months and see the results wth USG. Follow up after 3 months

HIE SHALLY SUBSEROSAL FIBROID 7.4CM IS ABOVE MEDIUM SIZE …BUT AYURVEDA CAN CURED BUT IT TAKES TIME… YOU CAN GIVE MINIMUM 3 MONTHS FOR AYURBEDA …IF ITSS REDUCES THEN ITS CURABALE …IF NOT CHANGE IN SIZE GO FOR HYSTERECTOMY…

DO FOLLOW INSTRUCTIONS:-

DIVYA SARWAKALP KWATH=100GM DIVYA KAYAKALP KWATH=100GM DIVYA DASHMOOL KWATH=100GM… MIX ALL AND TAKE 1 TSP BOIL WITH 2GLASS OF WATER TILL REDUCES 1 GLASS STRAIN AND TAKE EMPTY STOMACH TWICE DAILY…

DIVYA CYSTOGHRIT DIAMOND=1-1 DIVYA SEABUCKTHRON CAP=1-1 …BEFORE MEAL TWICE DAILY…

DIVYA KANCHNAR GHAN VATI DIVYA VIRRIDHIVADHIKA VATI DIVYA PUNARNAWADI MANDOOR=2-2 TAB AFTER MEAL TWICE DAILY…

AVOID OILY/MILK/SWEETS/MAIDA/JUNK FOOD

DO REGULAR YOGA AND PRANAYAM= KAPALBHATI PRANAYAMA/BHARMRI/ANULOMAVILOM/ BRISK WALKING 5000 STEPS…

REGULAT TAKE 3 MONTHS

THEN DO USG WHOLE ABDOMEN

Shelly take this medicine for 1 month 1) syp. Ashoka arisht 15ml+15ml lukewarm water Subha sham 2) syp. khadira arisht 15ml+15ml lukewarm water subha sham 3) Tab. kanchnar gugulu 2 Tab subha sham 4) Tab. ashgandha 2 din me tin baar

Itna kre result me kitna change aata h report krvake beje.

You’re in a challenging situation, and it’s understandable to seek out all possible options, especially with the previous history of a clear biopsy. Let’s break down your situation from both conventional and Ayurvedic perspectives.

Understanding Your Condition:

Subserosal Fibroid of 7.4 cm: This is a non-cancerous growth on the outer surface of your uterus. While subserosal fibroids often don’t cause heavy bleeding (unlike fibroids inside the uterine cavity), a large one can cause pressure symptoms or, if pedunculated, even pain if it twists.

Abnormal Bleeding (AUB): This is a significant concern at 47. While fibroids can cause AUB, especially if they are affecting the uterine cavity or are large, other causes also need to be considered.

Endometrial Thickness of 15.2 mm: This is a key finding. In a 47-year-old, especially with abnormal bleeding, a thickened endometrium raises a flag for endometrial hyperplasia (overgrowth of the uterine lining) or, less commonly, endometrial cancer. Given your previous clear biopsy from a polypectomy, this might suggest the hyperplasia is recent or a different area is affected. It’s crucial to ensure this has been thoroughly investigated, as a hysteroscopy with D&C or repeat biopsy might be recommended by conventional medicine to rule out malignancy.

Age 47: You are approaching menopause, a time when hormonal fluctuations can lead to fibroid growth and endometrial changes.

Conventional Medical Perspective:

Hysterectomy: This is a definitive surgical solution that removes the uterus, eliminating both the fibroid and the source of the abnormal bleeding and endometrial thickening. It’s often recommended when other treatments have failed, symptoms are severe, or there’s a concern about malignancy (which, in your case, seems to have been ruled out for the previous biopsy but the current endometrial thickness is still a concern). Since you’ve had a clear biopsy, the focus would be on symptom management and preventing future complications.

Myomectomy: This surgery removes only the fibroid(s), preserving the uterus. It’s an option if you want to avoid a hysterectomy and can be done via open surgery, laparoscopy, or hysteroscopy depending on the fibroid’s location and size. However, fibroids can recur after myomectomy. For a 7.4 cm subserosal fibroid, a laparoscopic or open myomectomy might be considered.

Endometrial Ablation: This procedure removes or destroys the uterine lining to reduce heavy bleeding. It’s generally for women who have completed childbearing, as it makes future pregnancies difficult or impossible. It addresses the endometrial thickness and bleeding but not the fibroid directly.

Uterine Artery Embolization (UAE) / Uterine Fibroid Embolization (UFE): This minimally invasive procedure blocks the blood supply to the fibroids, causing them to shrink. It preserves the uterus.

Medical Management: Hormonal therapies (like birth control pills, GnRH agonists, or selective progesterone receptor modulators) can help manage symptoms like heavy bleeding and sometimes shrink fibroids, but symptoms often return after stopping treatment. Tranexamic acid can reduce bleeding.

Ayurveda Opinion:

Ayurveda views uterine fibroids (often correlated with “Garbhashaya Granthi”) and abnormal bleeding (like “Asrigdara”) as imbalances of the Doshas (Vata, Pitta, Kapha) and Dhatus (tissues), often involving an accumulation of toxins (Ama).

The Ayurvedic approach is holistic and aims to:

Balance Doshas: Particularly Kapha (responsible for growth and structure) and Vata (responsible for movement and regulation), and sometimes Pitta (involved in metabolism and heat).

Reduce Fibroid Size: Through specific herbs and therapies that have “Lekhana” (scraping/reducing) and “Shothahara” (anti-inflammatory) properties.

Regulate Bleeding: Using “Raktastambhana” (hemostatic) and “Artava-pravartaka” (menstrual flow regulating) herbs.

Cleanse and Detoxify (Panchakarma): Therapies like Virechana (purgation) and Basti (medicated enema) are often recommended to remove toxins and rebalance the system. Uttarbasti (medicated enema through the vaginal route) is specifically used for gynecological conditions.

Strengthen Uterine Health: By nourishing the reproductive tissues.

Lifestyle and Diet Modification: Emphasizing a diet that reduces Kapha and Ama (avoiding processed foods, dairy, sugar, cold foods) and incorporating stress management techniques (yoga, pranayama, meditation).

Commonly Used Ayurvedic Herbs/Formulations:

Kanchanar Guggulu: Known for its effect on various growths, cysts, and tumors.

Ashokarishta: Often used for female reproductive issues, including irregular periods and pain.

Lodhra Churna: Has astringent properties, helpful in managing heavy bleeding.

Shatavari: A renowned herb for female reproductive health, helps balance hormones.

Punarnava: Reduces inflammation and swelling.

Triphala: A general detoxifying and balancing formulation.

Pradarantaka Rasa: A mercurial preparation that can help with gynecological disorders and anemia, and balances all three doshas.

Considering Your Situation - Ayurveda vs. Hysterectomy:

Fibroid Size (7.4 cm): This is a moderately large fibroid. While Ayurveda has shown success in reducing fibroid size, it may take time, and complete resolution of such a large fibroid might not always be achievable.

Abnormal Bleeding: This is a more urgent symptom. Ayurveda has strong remedies for abnormal bleeding, but it might take time to bring it under control, especially if the fibroid is a major contributing factor.

Endometrial Thickness (15.2 mm): This is the most critical aspect in your case, especially considering your age. While Ayurveda addresses endometrial health, the primary concern from a conventional standpoint would be to rule out or manage any pre-cancerous or cancerous changes in the endometrium. Even with a prior clear biopsy, this new thickness warrants a thorough conventional re-evaluation.

Recommendation:

Given the size of the fibroid and, more importantly, the significant endometrial thickness with abnormal bleeding at your age, a combined approach or a well-informed decision based on further conventional evaluation is highly advisable.

Re-evaluate the Endometrial Thickness from a Conventional Perspective: Before definitively deciding against hysterectomy, it is crucial to understand the exact nature of the 15.2 mm endometrial thickness. Has a recent biopsy or D&C been done specifically for this current thickness and bleeding episode? If not, it’s highly recommended to pursue this to rule out any atypical hyperplasia or malignancy, even if your previous polypectomy biopsy was clear. This is a standard and critical step in conventional medicine for such a finding at your age.

Discuss the Pros and Cons with Both Systems:

Hysterectomy (Conventional): Offers a definitive solution for both the fibroid and abnormal bleeding, and completely removes the risk of endometrial cancer from the uterus. However, it’s a major surgery with recovery time and implications for future hormonal balance (though ovaries are often preserved).

Ayurveda: Offers a non-surgical, holistic approach with fewer side effects. It focuses on addressing the root cause and promoting overall well-being. However, results can be slower, and there’s no guarantee of complete fibroid shrinkage or immediate cessation of heavy bleeding, especially for a fibroid of this size. The crucial aspect of ruling out malignancy in the endometrium needs to be thoroughly addressed first by conventional means.

In summary, do not solely rely on an Ayurvedic opinion without first ensuring that any serious underlying conditions related to the endometrial thickness have been unequivocally ruled out by conventional diagnostic methods (e.g., repeat endometrial biopsy or D&C).

Once you have a clear understanding of the endometrial health from a conventional diagnostic standpoint, you can then make a more informed decision about whether to pursue a trial of Ayurvedic treatment, consider less invasive conventional alternatives to hysterectomy (like UAE/UFE or myomectomy if suitable), or proceed with a hysterectomy if it’s deemed the safest and most effective option for your long-term health and symptom relief.

Yes, in Ayurveda many uterine conditions that cause recurrent bleeding or discomfort can be managed without immediately opting for hysterectomy—especially if your biopsy is clear and the issue is functional rather than cancerous. Treatment usually focuses on:

Balancing hormones naturally

Reducing inflammation and bleeding

Strengthening uterine tissues (Garbhashaya)

Herbs like Ashokarishta, Lodhra, Shatavari, and Praval pishti are commonly used, but the exact prescription depends on whether your symptoms are due to fibroids, polyps, adenomyosis, or hormonal imbalance.

Since this has been ongoing for 1.5 years, a personalised plan is important rather than generic remedies—otherwise results may be temporary.

You can consult me one-on-one by sharing your full history, reports, and current medicines so I can prepare a step-by-step Ayurvedic protocol for you.

In Ayurveda, subsual fibroids and abnormal uterine bleeding are often linked to an imbalance of the doshas, particularly an imbalanced Kapha and Vata. Hysterectomy is a significant procedure that can be considered, but it’s important to explore all potential options before surgery, especially if your biopsy is clear. Ayurveda offers holistic strategies that may aid in managing fibroids and associated symptoms.

Firstly, dietary modification is essential. Emphasize warm, cooked foods that are easy to digest, such as soups and stews. Avoid cold, raw, and heavy foods that could exacerbate Kapha imbalances, like dairy, wheat, and sugar. Spices like turmeric, ginger, and cumin can help balance digestion and reduce inflammation.

Herbal remedies may provide support. Consider taking Ashokarishta, a classical Ayurvedic formulation known for its benefits in regulating menstrual cycles and managing uterine disorders. Begin with 2 tablespoons diluted in equal water, twice a day after meals. Consultation with an Ayurvedic practitioner is advised to tailor the dosage and ensure it complements your constitution.

Daily practice of gentle yoga and pranayama can improve circulation and reduce Vata. Poses like Supta Baddha Konasana (Reclining Bound Angle Pose) may particularly be beneficial. Meditation and relaxation techniques can also help manage stress, which contributes to doshic imbalance.

However, if symptoms persist or worsen, surgical options may be necessary. Balancing Ayurvedic therapy with medical advice from your healthcare provider is crucial. As for one-on-one consultation, seek a qualified Ayurvedic practitioner who can offer personalized advice based on your specific health profile, history, and symptoms.

Considering your situation, traditional Siddha-Ayurveda emphasizes addressing the imbalances in the body that might contribute to fibroid growth and abnormal uterine bleeding. Subserosal fibroids and thickened endometrial lining can often be linked to hormone imbalances—particularly an imbalance in the doshas like vata and kapha. Analyzing your specific prakriti (body constitution) and current imbalances is crucial.

In Siddha-Ayurveda, herbal formulations may support managing your symptoms if your condition is stable and not life-threatening. If you choose this route, consumption of herbs like Ashoka (Saraca asoca) and Lodhra (Symplocos racemosa) might help in regulating excessive bleeding. Incorporating Turmeric (Curcuma longa) has anti-inflammatory properties that may assist in shrinking fibroids naturally over time. A daily herbal concoction can be made by boiling these powders into a tea and consuming it twice a day, ensuring it is well-tolerated and mindful of any digestive effects it might have.

To balance your agni (digestive fire) and maintain healthy tissue metabolism, integrate light, warm foods, and avoid cold or heavy items that can aggravate kapha, such as dairy and processed sweets. Engaging in regular light exercise, like yoga or walking, can further stimulate circulation and help in managing weight, which can have a positive effect on hormonal balance.

However, if symptoms like persistent abnormal bleeding lead to extreme fatigue or affect your quality of life significantly, a conventional medical intervention such as a hysterectomy might be necessary. Your safety and well-being are paramount—severe symptoms or complications require urgent medical attention, so do consult your primary healthcare provider with urgency if those arise.

For personalized guidance, consulting a Siddha-Ayurvedic physician directly, either in-person or through online platforms, would be valuable. This interaction can ensure a comprehensive evaluation of your unique body constitution and clinical requirements.

HELLO SHELLY,

AGE= 47 ISSUE= subserosal fibroid (7.4 cm), abnormal uterine bleeding, endometrial thickness (15.2mm) HISTORY= hysteroscopic polypectomy done before, biopsy clear SYMPTOMS= on and off bleeding for 1.5 Years CHRONIC ISSUES= stress, hairfall

UNDERSTANDING THE CASE -SUBSEROSAL FIBROID= grows outside the uterus. Usually doesn’t cause bleeding directly -ENDOMETRIAL THICKNESS= 15.2 mm is high for age (should ideally be <5mm post menopause or <10 mm in perimenopause), suggesting hormonal imbalance or persistent estrogen stimulation. -ABNORMAL BLEEDING= could be from thick endometrium or recurrence of polyp/hormonal imbalance. -YOU’VE HAD HYSTEROSCOPY + POLYPECTOMY, but symptoms persist -HYSTERECTOMY is advised likely because symptoms are chronic and not improving

LIKELY IMBALANCE -DOSHA INVOLVED= pitta+vata aggravation -DHATU INVOLVED= rakta(blood), artava(menstrual system), and rasa (nutritional fluids) -CONDITION IS KNOWN AS= yoni vyapad or granthi in garbhashaya

INTERNAL MEDICATIONS

1) CHANDRAPRABHA VATI= 2 tabs twice daily after meals =uterine detox, fibroid reduction

2) SHATAVARI GULAM= 1 tsp daily with milk in morning =hormonal regulation, endometrial health

3) PUSHYANUG CHURNA= 2 gm twice daily with honey =controls bleeding, uterine tonic

4) BOLBADDHA RAS= 250 mg twice daily with honey after meals =stops bleeding

5) DRAKSHADI KASHAYA= 20 ml with warm water twice daily =pitta cooling, relieves stress and bleeding

6) RAKTAPACHAK VATI= 2 tabs twice daily =helps purify blood, reduce endometrial thickening

PANCHAKARMA IF POSSIBLE -BASTI (medicated enema)- for vata and fibroid -UTTAR BASTI= specialised therapy for uterine disorders -ABHYANGA+ SWEDANA= helps with stress and hormonal balance

DIET AND LIFESTYLE -Avoid heavy, oily, spicy food- aggravates pitta INCLUDE -warm water -pomegranate, beetroot, spinach -turmeric, fennel tea

YOGA -gentle asanas= supta baddha konasana, viparita karani

PRANAYAM -anulom vilom -sheetali (cooling)

STRESS MANAGEMENT -brahmi, jatamansi or ashwagandha can help -daily 20 mins medication or guided breathing exercises -good sleep routine is crucial

WHEN TO CONSIDER SURGERY -if bleeding is severe, hemoglobin is dropping -endometrial hyperplasia continues or recurs -fibroids grows rapidly or causes pressure symptoms -no response to 3-6 months of consistent ayurvedic care

You can try Ayurvedic for 3-4 months . If symptoms don’t improve or worsen, hysterectomy is a safe and definitive option at this age, especially with persistent bleeding and endometrial thickening

THANK YOU

DR. HEMANSHU MEHTA