What are uterine fibroids?
Fibroids, also called leiomyoma, are benign but abnormal tissue growths that contribute to infertility by causing the inside of your uterus to be misshapen, impeding healthy implantation. Fibroids can protrude into the uterine cavity (submucosal), can be embedded in the wall of the uterus (intramural), or protrude into the abdominal cavity (subserosal). They are extremely common and occur in almost 70% of women of reproductive age.
What causes uterine fibroids?
The prevailing theory of fibroid etiology is that they result from a combination of inflammation-driven cell proliferation and hormonal imbalance. Traditionally, they have been thought to be the result of too much estrogen. More current thinking supports the notion that excess estrogen and/or progesterone may promote fibroid growth.
What are the symptoms of fibroids?
The symptoms of fibroids may include:
- A feeling of pressure in your lower abdomen
- On pressing on your abdomen, you may be able to feel a solid mass
- Heavy bleeding with your period
- Infertility
- Your abdomen may protrude or look pregnant
- A feeling of pressure on your bladder or urinary frequency
- Iron deficiency anemia due to heavy menstrual bleeding
What is the conventional fibroid treatment?
Depending on the individual patient, the following are fibroid treatments that your doctor may recommend:
- Surgery – myomectomy (removal of the fibroid(s)) or hysterectomy (removal of the uterus)
- Uterine artery blockage (embolization) – to shut down the blood supply to the fibroids
- Gonadotropin-releasing hormone analogue (GnRH-a) – for example, Lupron, to decrease estrogen-related fibroid growth
- Selective progesterone receptor modulators (SPRM) – for example, Fibristal, to moderate progesterone-related fibroid growth. Update: Fibristal, though effective, was removed from the market due to severe side effects.
These treatments can all be effective in easing fibroid symptoms. However, hysterectomy is obviously not the preferred method of treatment for women who wish to conceive. Embolization is only recommended in specific circumstances and is not a good choice for women who may wish to get pregnant afterward. GnRH-a works while taking it, but causes menopause-type symptoms, bone loss (osteopenia), and, while sometimes used prior to IVF, while you are taking it, it would lower your fertility. SPRMs have historically been used as emergency contraceptive pills. They are usually used prior to fibroid surgery. There have been reports of liver disease associated with SPRMs. Studies on the long-term use of these medications are ongoing.
What is the naturopathic treatment for fibroids?
The natural approach to fibroids involves addressing the two main factors contributing to them: inflammation and hormonal imbalance.
Inflammation:
These are significant contributors to inflammation: insulin, hormones, environmental pollutants, and food sensitivities. Correcting these through a healthy diet, exercise, vitamins, minerals, and herbs shrinks fibroids. Berberine is an effective agent for reducing estrogen- and progesterone-related cell proliferation in fibroids and also lowers insulin levels.
Hormone imbalance:
As a naturopathic doctor, I enhance estrogen clearance through supporting phase I and phase II liver detoxification with the appropriate vitamins, minerals, and amino acids in their active forms. I normalize estrogen production and activity through diet, exercise, and stress reduction. I can enhance progesterone production through supplementation with vitamin B6 and zinc, as well as herbs like Vitex. Herbs help to balance progesterone if it is excessive.
The benefits of my approach to fibroids are that it addresses the underlying imbalances. This provides a more lasting improvement, lowers recurrence rates, eliminates toxins, and enhances fertility simultaneously. The hormonal imbalances that contribute to fibroid formation are corrected to optimize fertility.
Medically Reviewed by Dr. Pamela Frank
References for Natural Treatment of Fibroids:
Park SB, Jee BC, Kim SH, Cho YJ, Han M. Cyclooxygenase-2 inhibitor, celecoxib, inhibits leiomyoma cell proliferation through the nuclear factor κB pathway. Reprod Sci. 2014 Sep;21(9):1187-95. doi: 10.1177/1933719114542010. Epub 2014 Jul 6.
Tsigkou A, Reis FM, Lee MH, Jiang B, Tosti C, Centini G, Shen FR, Chen YG, Petraglia F Increased progesterone receptor expression in uterine leiomyoma: correlation with age, number of leiomyomas, and clinical symptoms. Fertil Steril. 2015 May 22. pii: S0015-0282(15)00297-6. doi: 10.1016/j.fertnstert.2015.04.024. [Epub ahead of print]
Vilos GA, Allaire C, Laberge PY, Leyland N; Special Contributors, Vilos AG, Murji A, Chen I. The management of uterine leiomyomas. J Obstet Gynaecol Can. 2015 Feb;37(2):157-81.
Carranza-Mamane B, Havelock J, Hemmings R; Reproductive Endocrinology and Infertility Committee, Cheung A, Sierra S, Carranza-Mamane B, Case A, Dwyer C, Graham J, Havelock J, Hemmings R, Liu K, Murdock W, Vause T, Wong B; Special Contributor, Burnett M. The management of uterine fibroids in women with otherwise unexplained infertility. J Obstet Gynaecol Can. 2015 Mar;37(3):277-85.
Wu HL, Chuang TY, Al-Hendy A, Diamond MP, Azziz R, Chen YH. Berberine inhibits the proliferation of human uterine leiomyoma cells. Fertil Steril. 2015 Apr;103(4):1098-106. doi: 10.1016/j.fertnstert.2015.01.010. Epub 2015 Feb 14.
Teixeira D, Marques C, Pestana D, Faria A, Norberto S, Calhau C, Monteiro R. Effects of xenoestrogens in human M1 and M2 macrophage migration, cytokine release, and estrogen-related signaling pathways. Environ Toxicol. 2015 May 26. doi: 10.1002/tox.22154. [Epub ahead of print]