Uterine fibroids are considered mostly a kapha-accumulation disorder, but often involve pitta and vata displacements also, in which case the patient may be considered as precancerous. Therefore, treatment must be deep-acting to balance the tri-dosha and must be sufficiently sustained over time to eradicated slow-moving kapha. Remedial measures in Ahar (Food choices), Dinacharya (Right use of time), Asana (Postures), Marma Chikitsa (Energy point counseling) and Kaya Chikitsa (Internal medicines) are considered.
The uterus, ovaries, fallopian tubes, breasts, their contents, secretions and connective tissues all belong to artava vaha srotas, the channels carrying out female reproductive functions. The uterus has three main linings: innermost mucosal layer, middle muscular layer and a thicker outer wall, which interfaces with and differentiates from neighboring muscle structures. As artava vaha srotas act as one system, its components are all subject to fibrotic cellular changes, so if the uterus is removed and kapha accumulation remains unchecked, these kapha deposits tend to migrate to the remaining artava sites.
Within artava vaha srotas, Vata governs the functions of timing, communication and coordination with other psycho-biological cycles. Pitta governs the circulatory functions and blood Ph., and their functional interface with artava vaha srotas. Each lunar cycle between menarche and menopause, rich deposits of blood and mucous accumulate along the inner surface of the uterus in preparation for possible conception. Kapha governs the mucosal properties of thickness, viscosity and adherence affecting these three linings when uterine fibroid form.
Capillary function also involves three doshic influences of vata, pitta and kapha. Artava vaha srotas are intimately connected to the bhutagnis of the liver, which are also treated together with majja dhatu (endocrine system) cases of uterine fibroids for hormonal balance.
If the psycho-biological kapha qualities of cold, slow, heavy, etc. begin to accumulate in the generalized circulation and eventually into the artava vaha srotas, the woman may begin to notice a more sluggish onset of the menses, pre-menstrual bloating of the breasts, fingers and abdomen, and perhaps a tendency to weepiness. If this gradual accumulation continues, cystic changes may begin to come and go. The patient may report more lethargy or fatigue. She may report beginning signs of clotting and/or prolonged menses.
Once established in the uterine linings, endometrial thickening becomes a clinical manifestation of unprocessed, long-standing kapha deposits. Fibrotic changes represent the manifested stage of disease, which had gradually increased and accumulated under the causative influence of time. Fibroids may grow as much as to displace digestive, respiratory and eliminative organs and disrupt their functions. Fibroids may manifest as intra-mural, inter-mural, extra-mural or any combination of these, depending upon the duration of deposition and degree of trauma. Uterine fibroids represent a high risk factor for impending cancerous changes and tumor formations.
Nidana (Causative Factors)
Causes of kapha accumulation include sleeping between sunrise and sunset, eating kapha provoking foods and eating after 7pm. Other factors may include having sex during the menses, unresolved concerns about abortion, exposure to cold especially on menses, suppression of urination, defecation or flatulence, history of scarring from ‘dilatation and curettage’, and many more. Insufficient exercise, excess food intake, low thyroid function all may contribute to fibroid formations. The patient may harbor a hidden sense of grief and sadness associated with issues of maternity and conception. Retrograde apana vayu, chronic incomplete evacuation, can lead to accumulation of ama and later to doshic changes.
Manas (Psychological Factors)
Attachment of the soul and mind to life experiences occurs via the interplay of prana, tejas and ojas at the connective tissue cell level. We can tend to adhere to our emotional interpretations of life experiences, until the ‘flame of attention’ becomes focused enough to realize our previous disconnectedness and unconsciousness. Unresolved attachments may fester and one day sprout as endometrial changes and later as uterine fibroids. Kapha type of melancholic depression may precede manifestation of uterine fibroids. There may have been a sense of loss or trauma associated with pregnancy, perhaps a history of sexual abuse or a deep shock affecting mind-body harmony. Issues of intimacy and avoidance with oneself may indicate a need for medhya rasayana. The slowly developing condition of fibroids may have been ignored for some time.
Signs on the chin and at 6 o’clock of the irises help reveal the degree of kapha and/or pitta accumulation in the uterine tissue. Deep lines and discolorations here may suggest a deeper stress and dysfunction in the corresponding organs. The menstrual history will involve clotting, feeling of heaviness in the lower abdomen, excessive and/or irregular bleeding. Hairs may appear around the aereola, along the upper lip sideburn or chin areas, indicating thickening of the endometrium. Fibrous changes may be palpable and auscultable.
Nadi (Pulse Stream)
At the fifth level of the radial pulse, (if seven levels are considered as points of reference, with the seventh as the deepest), the artava pulse will confirm kapha qualities in all three digits throughout the fingertips. Uterine fibroids are felt as kapha impulses (slow, sluggish, impaired, heavy, thick) and must be noted at all three medial sites of the fingertips to be interpreted as uterine fibroids. Pitta dosha may also indicate complications perhaps involving profuse bleeding, iron-deficiency anemia and generalized weakness. This can be felt as a specific, regular impulse at the mid-curvature of all three fingers, and may feel weak due to low blood volume.
Ahar (Food Choices)
Food choices for the patient of uterine fibroids is according to the pulse reading, certainly kapha-soothing and perhaps also pitta-pacifying, depending upon the bleeding patterns. In the complications stage, the patient follows a tri-doshically balancing food program. Many such patients find they are truly only hungry twice daily, about 10-11am and about 4-5pm. Reducing food portions is helpful for reducing fibroids. Snacks can be doshically suitable fruits, such as pomegranate, and/or medicinal teas. Bitter, pungent and astringent foods are favored to support the metabolism in reducing its tendency to form fibrotic cellular changes from kapha ama.
Dinacharya (Right Use of Time)
To reduce kapha, one should be active before sunrise. The earlier the rising time, the quicker kapha can metabolize itself. Self-massage with a minimal quantity of a light oil such as sunflower oil can helps to invigorate the body. Exercise, beginning gradually and becoming more vigorous over a few months, before 10 am is best. Light sweating before10am, followed by a warm shower of plain water helps to burn kapha. A second exercise period at the end of the afternoon may be needed, depending upon the degree of kapha deposition into artava. Sleeping early enough to awaken early is a key to reducing kapha.
Give emphasis to yoga asanas that focus on the first and second chakras. Poses such as the Cobra, Bow, Boat, Mahamudra and Gentle Spinal Twists are helpful. Postures that focus on the cardio-pulmonary chakra, such as Cow, Lion and Child help remove the psycho-emotional root causes of uterine fibroids in the heart. Sun salutations bring positive activity to all chakras and may be useful if pitta is not elevated. These postures are best learned from an experienced yoga therapist versed in Ayurveda and Pranayama. Sufficient exercise to the point of light sweating is necessary to metabolize kapha deposits at the deepest tissue level of artava. Avoid sweating during menses and favor restorative poses. Avoid yoga practice on the first few days of flow.
Marma Therapy (Counselling Touch)
For effectively addressing the root causes of uterine fibroids in the astral and causal bodies, which interface through the nervous systems, Turiya Therapy may help transform the connective tissue memory into an individualized healing experience of selfrealization. The marmani, as surface doorways to the sub-conscious and unconscious, are gently contacted in a therapeutic sequence for treatment of the psycho-emotional causes of uterine fibroids. These points may include Gulpha, Shakti Urvi, Bhaga, Lohita, Unduka, Nabhi, Yakrut, Pleeha, Hridayam, Apastambha, Kanta, Ajnya and Adhipati. These and all vital marmani are not suitable sites for surgical incision.
Dravyas (Remedial Substances)
Plant substances of Kumari, Shud Guggulu, Neem, Ashok, Manjistha, may be prepared and administered orally to reduce the fibroids by drying, heating or catabolic actions via the gastro-intestinal tract. Various preparations such as churnas, asavas, aristhas, decoctions, etc. can be chosen Implants of oxygenating infusions such as 2 oz. warm barley juice can be used on an empty stomach if there is no spotting. Uttara basti (douche) with a decoction of 2 heaping tsps. each of ashok and neem can be cooked for 5 minutes, covered, cooled and strained. To administer, add 1/3 cup aloe gel. Warm castor oil packs applied to the lower abdomen will help to ‘melt’ the fibroids and retract the kapha via apana vayu.
For dosages and carrier substances, take into account the patient’s age, weight, ojas, tejas, prana, strength of the disease, strength of the mental commitment, scheduling limitations, etc. Individualized consultation is needed.
The patient of uterine fibroids is in the difficult to cure group, which calls for both knowledge of and commitment to her Ayurvedic self-healing program. She is likely to develop great forbearance, patience, spiritual surrender and a deep compassion for all, including herself through the process of palliation, cleansing and rejuvenation of artava vaha srotas.