Uterine Fibroids natural treatment, vitamins, herbs, enzymes, supplements, diet and food by Ray Sahelian, M.D.

Up to 40% of women develop uterine fibroids, benign tumors that can cause pain, excessive bleeding, frequent urination, and infertility. Genetic studies hint that a woman's susceptibility to fibroids may be inherited from her father. Uterine myomas or leiomyomas are the most common gynecologic neoplasm in reproductive-age women. They are the leading cause of hysterectomy, or removal of the uterus, in the US. A Myoma is a solid tumor made of fibrous tissue, hence it is often called a fibroid tumor. They vary in size and number, are most often slow-growing and usually cause no symptoms. Those that do not produce symptoms do not need to be treated.

Cause of fibroids
It is clear that hormonal factors play a prominent role in fibroids, particularly estrogens. In addition to endogenous hormones, xenoestrogens in our environment (e.g., organochlorine pesticides, pharmacologic compounds) are of potential concern with regards to their impact on this disease. These environmental estrogens have been shown to promote the growth of leiomyoma.

Women with polycystic ovary syndrome are more likely to suffer from fibroids. PCOS is a hormone disorder that causes ovaries to develop multiple cysts, and is usually accompanied by lack of ovulation, weight gain and other problems. Perhaps those who follow the suggestions in the article on how to improve their PCOS condition may also find a reduction in their fibroid size.

Food, diet and fibroids risk
Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens. There appears to be a modest inverse association between lignan ingestion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. Eating an anti-inflammatory diet with lots of fresh vegetables, fruits, whole grains, legumes, beans, and fish while avoiding sweets and pastries could be of benefit.

Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata. Am J Clin Nutrition, December 2011.
We assessed the association of dietary intake of fruit, vegetables, carotenoids, folate, fiber, and vitamins A, C, and E with uterine leiomyomata in the Black Women's Health Study. We followed 22,583 premenopausal women. Fruit and vegetable intake was inversely associated with fibroids.
  
Alcohol intake
Reduce alcohol consumption since this may be a contributing factor. Br J Nutr. 2009. Association of intakes of fat, dietary fibre, soya isoflavones and alcohol with uterine fibroids in Japanese women. Department of Epidemiology and Preventive Medicine, Gifu University Graduate School of Medicine, Gifu, Japan.

Exercise and fibroids
Regular exercise reduces the severity of fibroids.

Natural herbs and supplements
In this study, we investigated the inhibitory effect of curcumin on leiomyoma cells proliferation. These experimental findings in vitro show that the inhibitory effect of curcumin on eiomyoma cell proliferation occurs through the activation of peroxisome proliferator-activated receptor-gamma. Curcumin may be useful as an alternative therapy for uterine leiomyoma. Inhibitory effect of curcumin on uterine leiomyoma cell proliferation. Center for Asian Traditional Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan. Gynecol Endocrinol. 2010.

EGCG found in green tea effectively inhibits proliferation and induces apoptosis in rat uterine leiomyoma cells in vitro and in vivo. Am J Obstet Gynecol. 2010. Green tea extract inhibits proliferation of uterine leiomyoma cells in vitro and in nude mice. Center for Women's Health Research, Department of Obstetrics and Gynecology, Meharry Medical College, Nashville, TN, USA.

Our experimental findings in vitro show that the repressive effect of genistein on E(2)-induced leiomyoma cell proliferation is through the activation of peroxisome proliferator-activated receptor-gamma. Genistein may be useful as an alternative therapy for leiomyoma. Gynecol Endocrinol. 2009 Jun;25(6):403-9.Repressive effect of the phytoestrogen genistein on estradiol-induced uterine leiomyoma cell proliferation.Miyake A, Takeda T, Isobe A, Wakabayashi A, Nishimoto F, Morishige K, Sakata M, Kimura T.Center for Asian Traditional Medicine, Tohoku University Graduate School of Medicine, Aoba, Sendai, Japan.

I am a great fan of Ray Sahelian, M.D.  and use several of the Physician Formulas products, including serrapeptase, which I personally believe will become important to deal with fibroids and tissue build-up in the next few years. It is currently dissolving an originally grapefruit-sized fibroid that I have which is down to an approx. golf ball size after 3 months. So thank you for making this amazing and natural supplement.
   This is quite interesting. We really hope that it does work and we await further reports from users to see whether serrapeptase really works or not.

Tripterygium plant, a Chinese herb, may be a therapeutic agent for leiomyomas. Tripterygium has a reversibly inhibitory effect on the ovary which may be one of the mechanisms of tripterygium in decreasing leiomyoma volume. Tripterygium is currently very difficult to find. If anyone comes across a source, let us know.

High blood sugar increases risks
Black women who tend to eat foods that increase blood sugar may have slightly greater risk. Uterine fibroids - noncancerous growths that often cause heavy menstrual bleeding and cramping during childbearing years - are 2 to 3 times more likely in black women than in other American women. Higher-carbohydrate diets can lead to higher insulin levels, which are in turn linked to levels of other hormones thought to encourage fibroid growth. American Journal of Clinical Nutrition, published online March 3, 2010.

Association with high blood pressure
Women with elevated blood pressure are at increased risk of developing fibroids. Hypertensive women were 24 percent more likely to develop clinically symptomatic fibroids than non-hypertensive women, and the risk increased with duration of hypertension. Fibroids are the most common gynecologic tumor and the second leading reason for hysterectomy in the US. In a study published in the American Journal of Epidemiology, Boynton-Jarrett and colleagues identified 7466 cases of fibroids over a 10-year period in more than 100,000 women participating in the Nurses' Health Study II. After factoring in age, race/ethnicity, weight, and reproductive history, the researchers found that for every 10-point increase in blood pressure, the risk of fibroids rose by 8 percent in those who did not take blood pressure-lowering medication and by 10 percent in those who did. The findings make it "reasonable" to look into novel approaches to treating fibroids, Boynton-Jarrett concluded, "and to explore whether enhanced control of blood pressure, or early detection and treatment for hypertension leads to reductions in the incidence of fibroids or complications associated with fibroids." American Journal of Epidemiology, April 1, 2005.

Medical treatment
Exogenous progestins can partially suppress estrogen stimulation of uterine fibroid growth. Danazol, an androgenic agonist, can suppress fibroid growth but has a high rate of adverse effects. GnRH agonists given by IM injection, subdermal pellet, or nasal spray are most helpful when given preoperatively to reduce fibroid and uterine volume.

Non-surgical management of leiomyoma: impact on fertility.
Olive DL.University of Wisconsin Medical School, Madison, Curr Opin Obstet Gynecol. 2004.
Important advances have occurred in the medical treatment of uterine fibroids. It was found, in a large randomized trial, that preoperative treatment with gonadotropin-releasing hormone analogue did not improve surgical results or decrease blood loss. However, important strides were made in understanding the molecular biology of the effect of the hormone analogue on fibroids. Other medical therapies investigated include danazol, raloxifene, mifepristone, aromatase inhibitors, and the levonorgestrel-containing intrauterine device. Most promising in terms of long-term usage for reduction of size and symptoms appears to be the combination of gonadotropin-releasing hormone analogue and raloxifene, although selective progesterone receptor modulators may also achieve this aim. However, none avoid producing an anovulatory state that inhibits fertility, and none have been shown to enhance fertility following discontinuation. Uterine artery embolization is another non-surgical technique under intense investigation. The year's literature suggests that while results are comparable with hysterectomy in terms of complication rate and patient satisfaction, there may be important issues for women who wish to undergo the procedure and retain future fertility. Specifically, there is a significant rate of premature ovarian failure, as well as occasional damage to the endometrial vasculature with resulting atrophy and adhesion formation. Improvements in technique, in particular the use of larger and more spherical microspheres for embolization, may reduce these unwanted effects.

Surgery
For a woman who undergoes hysterectomy for benign disease such as fibroids, leaving both ovaries in place has long-term survival benefits, at least if she is no older than 65 years and at average risk for ovarian cancer. Ovary removal through surgery is often recommended along with hysterectomy, on the thinking that it prevents the possibility of ovarian cancer developing. However, women who undergo ovary removal before age 55 are nearly 9 percent more likely to die before age 80. Those who have their ovaries removed before age 59 have a nearly 4 percent high risk. Gynecologists who have been looking at the issue of (ovary removal) have focused on one thing -- ovarian cancer. Women are living longer and the major killer of women is heart disease, taking 25 times more women's lives than ovarian cancer.

Three treatment options are available: hysterectomy; minimally invasive uterine artery embolization (UAE); and a noninvasive magnetic resonance-guided focused ultrasound (MRgFUS) procedure, which, unlike regular ultrasounds, uses high doses of focused ultrasound waves guided by MR images to destroy tissue -- in this case, uterine fibroids. Most women prefer the latter two options.

A minimally invasive procedure called uterine artery embolization (UAE) that shrinks fibroids by cutting off their blood supply is as effective as removing fibroids with an operation called myomectomy. But UAE offers the advantages of a speedier and less eventful recovery.

A minimally invasive procedure called uterine artery embolization is an increasingly popular treatment for fibroids, common benign growths in the uterus. However, new research suggests that this procedure may make future pregnancies more difficult by increasing the risk of preterm delivery. Typically, only fibroids that cause symptoms are treated. Such fibroids can be removed with an operation called myomectomy. The growths can also be "shrunk" with uterine artery embolization, which involves the injection of tiny particles to cut off the fibroid's blood supply. These days, myomectomy is often performed with "keyhole," or laparoscopic, surgery. Women seeking treatment for fibroids and who want to become pregnant at a later date should be counseled about the possible risks associated with uterine artery embolization.

Focused ultrasound treatment
For women with fibroids, treatment with focused ultrasound guided by magnetic resonance imaging (MRI) seems to relieve symptoms well. Investigators studied 109 women with symptomatic fibroids who underwent a single treatment session. The procedure involves imaging the uterus using MRI, then focusing high-energy ultrasound on the fibroids. This heats up the target tissue and kills it. After six months, 71 percent of the women achieved a 10-point reduction in the Uterine Fibroid Quality-of-Life scale, which measured 61 on average at the start of the study. Moreover, there was a much greater-than-expected average decrease of 23 in the score. After a year, in the 82 women evaluated, 51 percent met the goal of a 10-point improvement. The average score was 38, still significantly below that seen at the start of the study. Source: Fertility and Sterility, January 2006.

Endometriosis
What a woman eats can influence her risk. Endometriosis occurs when endometrial tissue, which normally lines the uterus, grows elsewhere in the pelvis. The new research indicates that women who eat the most green vegetables or fresh fruit have a reduction in risk for the condition, while those who eat the most beef or ham have an increased risk.. While endometriosis is relatively common, little is known about its cause, the authors explain in a report in the medical journal Human Reproduction. Dr. Fabio Parazzini from the University of Milan, Italy, and colleagues surveyed 504 women with endometriosis, and 504 age-matched "controls" regarding their dietary habits. The risk was significantly reduced among women with the highest intake of green vegetables (a 70-percent risk reduction) or fresh fruit (a 40-percent reduction), the researchers report, and significantly increased among women with the highest intake of beef and other red meat (a doubling of risk) and ham (a 1.8-fold increase).

Dysmenorrhea
The abdominal or low back pain that many women experience during their monthly menstrual periods may partly be due to stress. There is a significant association between stress and menstrual pain, which is called dysmenorrhea.

Emails
One out of four women have uterine fibroids, so I am sure this will be a question of interest to many. Is there any correlation to either increase or decrease in fibroid mass when one takes a creatine supplement for weight training / exercise enhancement. Is there any contra-indication with amino acids such as l-glutamine? I am 46 have known about my fibroids for about 10 years and my doctor says they have grown, which is typical. I have no menopausal symptoms yet, so I am told that they can continue to grow. I take creatine - about 3gms - three times a week prior to weight training. I also take l-glutamine - about 3 gms - every morning. My question is whether creatine has any effect on growth or decrease in the size of fibroids.
   This is an interesting question since fibroids are muscle tissue and creatine influences muscle size. However, most of the time creatine goes into skeletal muscle tissue that is being exercised. So, my guess would be that a creatine supplement does not have much of an influence on fibroids. It would be interesting to do a study on creatine supplementation and fibroids, that would be the best way to find out if there is a relationship. As to glutamine and fibroids, the answer would be similar to creatine.

Are fibromyalgia and fibroids related?
   Not directly, I don't think.