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Fibroids

Introduction

What should I know about Fibroids?

Physicians refer to the benign tumors that can develop in a woman’s uterus as fibroids, or uterine leiomyomas. Benign uterine growths are the most common cause of abnormal vaginal bleeding. Indeed, fibroids account for one-third of abnormal vaginal bleeding cases. Such bleeding can occur between periods of menstruation, or during menstruation in the form of excessively heavy bleeding.

It is estimated that approximately 30 percent of women over the age of 35 have uterine fibroids. However, only certain types of uterine fibroids can lead to bleeding. As part of making a diagnosis, doctors will first rule out the presence of more dangerous malignant uterine tumors. This is especially the case for women who are nearing or experiencing menopause as they are at the highest risk for developing uterine cancer. At this point, doctors do not believe that benign fibroids can become malignant. However, in menopausal and postmenopausal women, rapidly growing fibroids can indicate that cancer is present in the uterus.

Fibroids may vary in size from small, barely visible nodules, to massive tumors that fill the pelvis. Whatever the size, a characteristic whorled pattern of smooth muscle bundles usually makes fibroids readily identifiable upon inspection by a physician.

Because fibroids can distort the shape of the uterus, they can cause many reproductive problems. These include recurrent miscarriage, infertility, premature and/or complicated labor, and birth defects. Women who wish to become pregnant and are known to have uterine fibroids may wish to have a pelvic exam before attempting pregnancy.

Fibroids may also disrupt the functions of the excretory system by compressing the bladder. This can cause an excessive need to urinate, as well as uncontrollable urination.

There seems to be an increased risk of fibroids in women of color, and in larger women. Conversely, the risk seems to decrease in women who have given birth and in women who smoke.

Statistic

The National Institute of Child Health and Human Development(NICHD), 1999.

    It has been estimated that up to 20 to 30 percent of women of reproductive age have fibroids, though not all have been diagnosed. Fibroids remain the number one reason for hysterectomy with 150,000 to 175,000 operations carried out each year.

Signs and Symptoms

The following list does not insure the presence of this health condition. Please see the text and your healthcare professional for more information.

Most women with fibroids show no symptoms and the growths can only be detected by a pelvic examination. The most common symptom is abnormal and/or heavy uterine bleeding. Because of the excessive blood loss, anemia can result. If pressure is placed on the bladder from large fibroids, discomfort and excessive urination may occur. Pain in the lower back or general pain in pelvic region may be present. Sterility and other reproductive problems can arise if the uterine cavity is distorted by the presence of fibroids.

General

  • Most fibroids cause few or no symptoms
  • The most common symptom is heavy bleeding during periods
  • Pain may occur in the abdomen or lower back resembling menstrual cramps
  • If fibroids grow large enough, they may be felt as hard lumps in the abdomen
  • If fibroids push against the bladder, they may cause an increased need to urinate
  • If they press against the ureters, they may cause a blockage of urine flow
  • Pressure on the rectum may cause constipation
  • Miscarriage or inability to become pregnant may occur if the locations of fibroids cause a distortion of the uterus

Treatment Options

Conventional

The primary therapy for patients with large or painful fibroids is surgery, with hysterectomy being the technique used most often. If, however, a woman wants to keep her ability to have children, doctors can do a surgical procedure to remove the fibroid growth. There is, however, significant risk of recurrent fibroids after such surgery. Meanwhile there are some pharmaceutical therapies available, mostly involving the use of medicines called GnRH agonists, which can help regulate the female body’s reproductive system. GnRH has been used to some success in shrinking the size of tumors, but tumors often return when the therapy is stopped. For this reason, GnRH therapy is often used just prior to surgical removal of fibroids.

Nutritional Suplementation

This category contains no therapies clinically applicable to this disease state.

Herbal Suplementation


Chasteberry

The chasteberry tree finds its origins in the Mediterranean. Its fruit is harvested and dried for medicinal purposes. It has a long folk history of use in women’s health, especially for mild to moderate complaints associated with menstruation and menopause.

Although chasteberry is considered safe for use, its function in the body isn’t fully understood. Studies suggest, however, that chasteberry has a progesterone-like effect, which may account for its use in the support of female health. (1) , (2) Because of this activity, chasteberry has been recommended for a variety of female complaints, such as PMS, menopausal symptoms, endometriosis, and other problems related with female hormonal imbalance. (3) , (4) , (5) Several clinical studies have also reported beneficial results with using chasteberry in treating women with certain types of infertility. (6)


Cat's Claw

This remedy hails from the South American rainforest. It has been used as a traditional medicine, possibly dating back as far as the Incan civilization. Scientists are now investigating cat’s claw for its disease fighting properties, as well as its potential for supporting gastrointestinal health. A standardized extract is derived from the bark of the root of the plant.

Because cat’s claw is an antioxidant, it has also been investigated to determine if it is useful for the treatment of cancer and the growth of other abnormal cells such as fibroids. (7) Antioxidants reduce the carcinogenic toxin buildup that stimulate abnormal cell development. Research indicates that cat’s claw may be able to target potential cancer cells and inhibit their development. (8)


Olive Leaf

Olive trees, widely cultivated throughout Mediterranean countries as a source of olives and olive oil, have been traditionally used not only in foods, but in health conditions including malaria, infections, cardiovascular diseases, and for general well-being. Olive contains an important antioxidant known as oleuropein that may be of benefit in the prevention of fibroids.


Grapefruit Seed

Grapefruit seed extract is used widely in the industrial, agricultural and cosmetic industries. Most of these uses center around grapefruit seed’s disinfectant properties. As a dietary supplement, grapefruit seed has been used as an antifungal and an antibacterial. It may also be useful for restoring the health of the gastrointestinal system. Its benefit in the treatment of fibroids may center on its ability to seek out unwanted cells and destroy them.

Diet & Lifestyle

Although scientific studies have not proven that elevated estrogen levels cause uterine fibroids, some physicians think this theory has merit. Therefore, it may be helpful for women to be aware of the following diet and lifestyle factors that can affect estrogen levels.

Dietary Fat: According to research, reducing the consumption of dietary fats may result in a significant lowering of estrogen levels. (9)

Dietary Fiber: A high fiber diet may act to decrease the amount of estrogen in a woman’s body. (10)

Exercise: Regular exercise lowers circulating levels of estrogen and reduces a woman’s risk of developing breast cancer. Indeed studies have indicated that regular physical exercise is one of the most important things a woman can do to lower estrogen levels and thereby lessen the risk of breast cancer. (11) , (12) Scientists think these benefits may also carry over to the prevention of fibroids.

Alcohol: A number of studies have also suggested that consumption of alcohol can increase estrogen levels and increase a woman’s risk of developing breast cancer. (13) , (14) Although these studies are reporting breast cancer risks, the elevated estrogen levels might also affect the risk of uterine fibroids.

Body fat: In postmenopausal women, after the ovaries have ceased to produce estrogen, body fat cells become the primary source of estrogen production. Obese women are known to have higher estrogen levels, which increases the risk of breast cancer. (15) Studies have also reported that obesity increases the risk of developing uterine fibroids. (16)

References

  1. View Abstract: Liu J, Burdette JE. Evaluation of estrogenic activity of plant extracts for the potential treatment of menopausal symptoms. J Agric Food Chem. May2001;49(5):2472-9.
  2. View Abstract: Makwana HG, et al. General Pharmacology of Vitex leucoxylon Linn Leaves. Indian J Physiol Pharmacol. 1994;38(2):95-100.
  3. Hillebrand H. The Treatment of Premenstrual Aphthous Ulcerative Stomatitis with Agnolyt. Z Allgemeinmed. 1964;40(36):1577.
  4. McGibbon D. Premenstrual Syndrome. CMAJ. 1989;141(11):1124-25.
  5. View Abstract: Jarry H, et al. In Vitro Prolactin But Not LH and FSH Release Is Inhibited by Compounds in Extracts of Agnus castus: Direct Evidence for a Dopaminergic Principle by the Dopamine Receptor Assay. Exp Clin Endocrinol. 1994;102(6):448-54.
  6. Propping D, et al. Diagnosis and Therapy of Corpus Luteum Deficiency in General Practice. Therapiewoche. 1988;38:2992-3001.
  7. View Abstract: Aquino R, et al. Plant Metabolites. Structure and in Vitro Antiviral Activity of Quinovic Acid Glycosides from Uncaria tomentosa and Guettarda platypoda. J Nat Prod. 1989;52(4):679-85.
  8. Wagner H, et al. The Alkaloids of Uncaria tomentosa and Their Phagocytosis-stimulating Action. Planta Med. 1995;5:419-23.
  9. View Abstract: Wu AH, et al. Meta-analysis: dietary fat intake, serum estrogen levels, and the risk of breast cancer. J Natl Cancer Inst. Mar1999;91(6):529-34.
  10. View Abstract: Goldin BR, et al. Estrogen excretion patterns and plasma levels in vegetarian and omnivorous women. N Engl J Med. Dec1982;307(25):1542-7.
  11. View Abstract: Bernstein L, et al. Physical exercise and reduced risk of breast cancer in young women. Journal of the National Cancer Institute. 1994;86(18):1403-1408.
  12. View Abstract: Frisch RE, et al. Lower prevalence of breast cancer and cancers of the reproductive system among former college athletes compared to non-athletes. British Journal of Cancer. 1985;52:885-891.
  13. View Abstract: Reichman ME, et al. Effects of alcohol consumption on plasma and urinary hormone concentrations in premenopausal women. Journal of the National Cancer Institute. 1993;85(9):722-27.
  14. View Abstract: Willett WC, et al. Moderate alcohol consumption and the risk of breast cancer. N Engl J Med. 1987;316:1174-80.
  15. View Abstract: Hershcopf RJ, Bradlow HL. Obesity, diet, endogenous estrogens, and the risk of hormone-sensitive cancer. Am J Clin Nutr. Jan1987;45(1 Suppl):283-9.
  16. View Abstract: Sato F, et al. Body fat distribution and uterine leiomyomas. J Epidemiol. Aug1998;8(3):176-80.