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Fibroids
 

Fibroid Introduction

Uterine fibroids are also called leiomyomas, myomas, and fibromyomas. They are benign tumors of uterine smooth muscle. There are three types of fibroids; submucosal, intramural, and subserosal; depending on where the fibroid is located. Fibroids can be any size from 2 cm to 8cm in diameter. They usually present with more than one, though single fibroids do exist.

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The exact cause of fibroids is not fully understood. They do respond to hormone production, namely estrogen. This is evident by the fact that they tend to get larger during the reproductive years when estrogen is high and can spontaneously regress after menopause when estrogen production begins to decline.

Women of childbearing age are most likely to be diagnosed with fibroids. They can be found in children who have not menstruated, though it is rare. African-American women are more likely to be affected by fibroids than Caucasian women. Being overweight or obese also increases ones risk for developing fibroids. Having children, usually decreases one’s risk. [1]

Fibroid Symptoms

Persons with Fibroids may be asymptomatic for many years, and will not even know they have them. However, once symptoms begin to appear the fibroids can be quite large. The most common symptom is menorrhagia, or excessive bleeding. The bleeding can occur any time during a woman’s normal menstrual cycle, but most often it is excessive menstruation.

Other symptoms that may be prominent are sense of fullness or pressure in the pelvic region due to the fibroid encroaching on other tissues. Women may develop problems with incontinence, frequency and urgency of urination, as well as constipation.

Pain is usually not a symptom of fibroids until the degeneration phase occurs. The pain is caused by the excessive cramping of the uterus trying to expel the fibroid. Pain can also be due to the inflammatory process of breaking down the fibroid.

Fibroids can cause infertility in some women. This is mainly due to an increased risk of early miscarriage, and not due to a difficulty conceiving. Once pregnancy is established, the fibroids do not seem to disrupt the pregnancy, though they could potentially cause preterm labor and malpresentation. [2]

Women with fibroids may suffer from iron deficiency anemia, caused by excessive blood loss. They may have symptoms associated with anemia such as fatigue, pallor, and shortness of breath.

Fibroid Statistics

  • 25-27% of women in the US have clinically symptomatic fibroids.
  • It is estimated that as many as 77% of women of childbearing age have fibroids, mostly asymptomatic.
  • Each year there are an estimated 200,000 hysterectomies due to fibroids.
  • African American women have a 3-5 times the risk of white women. [3]

Fibroids Treatment

To treat fibroids is difficult, because the cause is not fully understood. Conventional medicine is still looking for better treatment options that can be successful for the majority of women before suggesting surgery. Surgery is still the most widely used treatment for symptomatic fibroids.

There are two different types of surgeries that are used for fibroids:

  • Hysterectomies remove the whole uterus, and hence the fibroids. This surgery is reserved for extremely difficult cases or women who are not planning on having any more children.
  • A myomectomy is a surgical removal of the fibroids, and is most useful for submucosal fibroids. It is an option for women who are trying to conceive, and may be a useful treatment for infertility when no other cause is known.

Drug therapies that are being developed are the use of Gonadotropin releasing hormone agonists, progestin, and androgen hormones. [4]

There are also few alternatives when it comes to natural treatment of fibroids. Most alternative practitioners will agree that very few treatments can be counted on to yield similar results in all patients. Finding methods to shrink or regress the fibroids is difficult and the majority of alternative therapies are focused on treating the symptoms of fibroids, mainly the excessive bleeding.

Supplements for Fibroids

Lipotropic factors

Lipotropic factors such as choline and inositol assist the liver. They help mobilize fat in the liver as well as assist the liver in detoxifying the blood. The liver is responsible for the breakdown of hormones, like estrogen, in the body. Because estrogen is implicated as a possible cause of fibroids, assisting its breakdown by the liver may be beneficial. [5]

Vitamin C

Vitamin C is useful for the treatment of menorrhagia, which often accompanies uterine fibroids. Vitamin C has been shown to prevent excessive bleeding by providing stability to the capillaries and arteries in the uterine endometrium. [6]

Bioflavonoids

Like Vitamin C, bioflavonoids can be useful for treating the main symptom of fibroids, menorrhagia. They have been found to improve capillary stability and prevent excessive bleeding. Bioflavonoids are also believed to reduce the effect of estrogen on fibroids by binding to the same receptos on the cell membrane of uterine smooth muscle cells. [7]

Vitamin A

Vitamin A is another nutrient useful for excessive bleeding, commonly associated with fibroids. In one particular study, it was found that vitamin A was deficient in women with fibroids. Vitamin A supplementation also resulted in decreased bleeding in women with fibroids, with the majority of women having complete resolution of their menorrhagia. [8]

Iron

The excessive bleeding associated with fibroids can lead to a deficiency of iron. Low iron can cause iron deficiency anemia. The stores of iron can also become depleted in the body. Women with fibroids who have anemia need to be treated with oral iron supplementation. [9]

Botanical Medicine

Botanical medicine may be useful for treating the symptoms of fibroids. The most easily treated symptom, again, is excessive bleeding. Herbs such as Capsella bursa-pastoris or Shepard’s Purse, and Achillea millefolium or Yarrow, are well known anti-hemorrhagic herbs that can help decrease the bleeding. Vitex agnus-castus or Chaste Tree Berry is also a useful herb. It has been shown to increase progesterone production and to possibly decrease the effect of estrogen upon the growth of the fibroid. [10] These herbs can be taken separately or together, in synergistic combinations.

References

[1] Beers M, Berkow R. Uterine Fibroids. The Merck Manual: 17th Ed. 1999. Pages 1959-1960.

[2] Beers M, Berkow R. Uterine Fibroids. The Merck Manual: 17th Ed. 1999. Pages 1959-1960.

[3] http://www.pdrhealth.com/drug_info/nmdrugprofiles/herbaldrugs/101840.shtml The National Institute of Child Health and Human Development. November 2004.

[4] Beers M, Berkow R. Uterine Fibroids. The Merck Manual: 17th Ed. 1999. Pages 1959-1960.

[5] Hudson, T. Uterine Fibroids. The Women’s Encyclopedia of Natural Medicine; Keats Publishing, 1999. Pages: 265-276.

[6] Cohen JD, Rubin HW. Functional menorrhagia: treatment with bioflavonoids and vitamin C. Curr Ther Res Clin Exp. 1960 Nov; 2: 539-542.

[7] Cohen JD, Rubin HW. Functional menorrhagia: treatment with bioflavonoids and vitamin C. Curr Ther Res Clin Exp. 1960 Nov; 2: 539-542.

[8] Lithgow DM, Politzer WM. Vitamin A in the treatment of menorrhagia. S Afr Med J. 1977 Feb 12; 51(7): 191-193.

[9] Hope S. 10-minute consultation: menorrhagia. BMJ. 2000 Oct 14; 321: 935.

[10] Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill Livingstone; London: 2000. Pages 238-243.