The traditional strategy for uterine fibroids (along with many other medical conditions) in this country is to “wait until it’s broke and then fix it.” But what about prevention? Currently, no one knows where fibroids come from which significantly limits prevention. However, while we can’t yet stop fibroids completely from forming inside a woman’s uterus, we can try to ease her symptoms so that medical or surgical therapy will not be necessary. We can also try to retard their presence and the rate of their growth, as we know that the larger and more numerous the fibroids are in the uterus, the more likely she will suffer with symptoms.
The best way to retard fibroid growth is to be as close to your ideal body weight as possible through healthy eating, exercise, and an adequate amount of sleep. While we don’t know where fibroids come from, we know they grow with hormonal (i.e. estrogen & progesterone) stimulation. Estrogen is stored in fat; therefore reducing excess body fat will improve your fibroid situation. Eating healthy including adequate amounts of colored fruits and vegetables is very important. These foods are rich in flavonoids which block estrogen production. While hormones are pervasive in the food (and water) supply, certain foods are hormone rich and should be limited. These include red meat, non-organic chicken, and dairy.
There are also natural products and supplements that can be very helpful in the treatment of symptomatic fibroids. There are others beyond this list, but I’ve included ones that I have had experience with. I broke these in to two rather arbitrary categories: symptom improvers and fibroid shrinkers, although there is crossover between these two groups.
Symptom improvers: can help with lightening the heavy menstrual flow and easing of the associated pelvic pain
- Red raspberry tea: is very safe and traditionally used to facilitate childbirth. It can help soothe the pelvic pain and decrease the heaviness of the periods associated with fibroids. It also can be given in drops (i.e. tincture of red raspberry).
- Yarrow (Achillea millefolium): A low dose in the form of a tea or drops alone or in combination with red raspberry can be used prior to the onset of menstruation to prevent heavy periods in women with fibroids.
- Shepherd’s purse (Capsella bursa-pastoris): can be used by itself at the start of the period if it’s heavy or in combination with red raspberry and yarrow (see below).
- Drops: 30 drops red raspberry & 30 drops of yarrow tinctures twice or three times a day 10-14 days prior to expected onset of the period. If period starts and is still heavy, 30 drops of Shepherd’s purse can be added.
- Tea: 2 parts dried Yarrow, 1 part dried Nettle leaf (adds iron), ½ part Hibiscus flower (improves iron absorption, adds flavor).
Place a small amount of the mixture into a quart sized jar. Fill with boiling water and cap. Steep for 30-40 minutes. Drink 3-4 cups a day 10-14 days prior to expected onset of the period. If period starts and is still heavy, can add 2 parts Shepherd’s Purse.
- Apple cider vinegar (ACV) & black strap molasses (BSM): can be used separately, but the molasses makes it taste better and provides much needed iron. 1 teaspoon ACV to a glass of water along with 1 tablespoon of BSM: the mechanism of ACV to improve symptoms is not well understood, but may be through loss of body fat (and therefore excess estrogen). The 1 tsp can be increased over time to as much as 2 tablespoons per glass.
- Castor oil pack: castor oil contains ricinoleic acid which has anti-inflammatory properties. It is reported to help with the pain associated with fibroids. A pack is made by saturating a piece of wool flannel in castor oil. Place directly on the pelvic area and cover with a plastic wrap. Place a heating pad or hot water bottle on it and cover with an old towel. Leave on for ~ 1hour and repeat several times per week.2.Fibroid shrinkers: Can decrease the size of fibroids.
- Chasteberry (vitex): it works by increasing luteinizing hormone (LH) production from the pituitary gland. This helps to increase progesterone levels (i.e. balance out estrogenic effects). 25-30 drops 2-4 x/day. Better at shrinking smaller than larger fibroids.
- Vitamin D: is one of the fat soluble vitamins (exs. A, E, and K). Vitamin D receptors are found all over the body including the uterus and also in fibroid tissue. Production of vitamin D in our bodies is mediated by absorption of sunlight in our skin. Therefore, where you live (geographic location), how much time you spend outdoors, use and level of sunscreens, and the pigment of your skin all have effects on your ability to absorb adequate vitamin D.
Studies have shown that 60-80% of African-American women have insufficient vitamin D levels versus 10-20% of their Caucasian age-matched counterparts. This is largely due to the difference in degree of pigmentation. Vitamin D deficiency is a risk factor for fibroids. In addition, vitamin D has strong anti-estrogenic and anti-progesteronic effects which inhibit fibroid growth.
There are a number of foods that are rich in vitamin D including: salmon, cod liver oil, herring, sardines, canned tuna, cow or soy milk, and some cereals.
Unlike water-soluble vitamins (ex. vitamin C) where excess amount is safely excreted in the urine, fat-soluble vitamins can have significant adverse effects if taken to excess. The recommend dose of vitamin D is 800 IU/day (vitamin D often sold in 1,000 or 2,000 IU doses). If you don’t get enough sunlight you need 1,000 IU/day and if you’re vitamin D deficient 2-4,000 IU/day. Over 5,000 IU/day is not recommended unless it is for a short period of time under direction by a medical professional.
A study in Epidemiology from 2013 entitled Vitamin D & the Role of Uterine Fibroids studied over 1,000 randomly selected women between the ages of 35-49. Those that got >1hr of sunlight/day and had adequate vitamin D levels had a significantly decreased risk for fibroids. It is likely that adequate vitamin D inhibits the initiation and the subsequent growth of fibroids.
Green tea extract (epigallocatechin gallate or EGCG): Green tea, like vitamin D has strong antioxidant properties due to high levels of polyphenols. EGCG is the most biologically active green tea. A small randomized trial published in the International Journal of Women’s Health in 2013 by Roshdy et al looked at a small group of women with fibroids who were randomized to 800mg/day of EGCG or placebo. The group was followed for 4 months by imaging and quality of life questionnaires. The placebo group saw a 24% increase in fibroid volume versus a 33% reduction for the EGCG group. The Q of L scores were also significantly better in the EGCG group.
For more information on fibroids, adenomyosis, and UFE (uterine fibroid embolization) please visit our website ATLii.com to make an appointment for a consultation with Dr. John Lipman, the leading fibroid expert in the United States, or call 770-953-2600.