FIBROIDS

FIBROIDS AKA MYOMAS / LEIOMYOMAS

Fibroids are benign uterine tumours deriving from a single cell from the myometrium (muscle of the uterus/womb). Fibroids are common, impacting 20-50% of women of reproductive age, and up to 80% of women over 50.

Symptoms of fibroids can include:

• Heavy periods (menorrhagia)

• Menstrual flooding

• Menstrual clotting

• Abdominal pain

• Bloating

• Increased urination

• Leg numbness (if nerve impingements)

• Iron deficiency (due to heavy blood loss)

• Infertility (<3%) due to physical obstruction of the egg

  • Via altering the shape of the uterus

  • Altering myometrium (uterine) contraction and creating inflammation

  • An increase in HOX gene expression can positively alter the endometrium to allow implantation to occur. However women who are infertile with fibroids may show down regulation of HOXA gene expression; subsequently low or negative levels can negatively influence implantation

• There also may be no symptoms!

Fibroids can be:

• Submucosal – within the uterus – 10% of fibroids are submucosal

  • Most commonly causing heavy bleeding

  • Most commonly associated with infertility

• Intramural – within the myometrium (muscle of the uterus)

  • Can create more inflammation within the muscle wall and pain

  • Can be misinterpreted as adenomyosis

• External to the uterus

  • Can put extra pressure on bladder and bowel so create an increased risk of IBS and bladder issues

  • Rarely involved in heavy bleeding or subfertility

Potential causes of fibroids may include:

• Oestrogen

  • Therefore there is an increased incidence of fibroids in people with endometriosis, adenomyosis, early oral contraceptive pill use, uterine polyps, uterine hyperplasia, PCOS, high prolactin, high alcohol use, and obesity (as fat cells produce oestrogen).

• Endocrine disrupting chemicals (EDC’s)

  • This class of chemicals mimic hormones, binding to oestrogen receptors and altering natural hormone levels

  • EDC’s are ubiquitous and are particularly found in phthalates and bisphenol-A (plastic and conventional beauty/skin care products)

• Genetics can play a role – e.g. COMT gene, HOXA gene

DIET considerations:

• Avoid caffeine – it may increase prolactin which may increase fibroid and myometrium cell growth, may increase oestrogen in the follicular phase (first half of menstrual cycle), may impair iron absorption

• HYDRATION! To flush hormones and toxins, and regulate hunger/weight

• Weight management – reducing adipose (fat) issue reduces oestrone (oestrogen) levels

• Cruciferous vegetables – broccoli, kale, cauliflower, Brussels sprouts, bok choy, pak choy, etc

• Anti-inflammatory foods – such as turmeric and ginger

• Prebiotic foods – garlic, onion, leeks, asparagus, Jerusalem artichokes, chicory root, apples

• Green tea

SUPPLEMENT considerations:

• Fibre such as PHGG to regulate oestrogen clearance via the gut microbiome

• Vitamin D – deficiency is associated with increased fibroids and size of fibroids

• Vitamin E – may decrease fibroids during pregnancy

• Iodine – iodine can down regulate oestrogen receptors; however I discourage self prescribing iodine as it is not suitable for all people (e.g. if thyroid antibodies are present)

• Antioxidants such as resveratrol, luteolin and quercetin – these can induce apoptosis (cell death) and reduce fibroid growth

• Calcium-d-glucarate – supports oestrogen metabolism and detoxification

• Herbal medicine – to regulate hormones, reduce inflammation and pain, support liver detoxification of oestrogen, support the lymphatic system, etc. Speak to your naturopath or herbalist for a prescription bespoke to you.

Ultimately there is a lot that can be done to support the hormones, nutrients and inflammation associated with fibroids, a holistic approach is essential! Reach out to us at hello@bridgetbnaturopathy.com for a naturopathic consult to support you on your journey with fibroids.