Fibroids – A Far Too Common Problem
What are uterine fibroids?
Sometimes called leiomyoma or myomas, fibroids are benign tumours in the muscle tissue of the uterus and are a far too common problem. So although they don’t pose a malignant cancer concern, they certainly can be very impactful on one’s health. Fibroids are incredibly common. Found in 50-70% of females of reproductive age, and more commonly in black women (estimated at 80%). Although they may not cause any symptoms in many people, they are commonly associated with heavy periods, low back pain, constipation, pelvic pain, fertility concerns (recurrent pregnancy loss, early term labour, interference with implantation), and signs and symptoms of anemia.
Do fibroids need to be treated?
Although fibroids are often dismissed as normal and not of concern. When they present alongside some of the symptoms listed above, many folks are mystified by the lack of treatment options. For something so common and seemingly simple, conventional medicine often has little to say about fibroid treatment. Conventional treatments, such as surgical fibroid removal for uterine fibroids can be very effective for symptom management. It’s critical to know that there are many support options available. Naturopathic approaches to fibroid management are less invasive, and carry much less risk of adverse effects than conventional approaches. And using naturopathic medicine in no way limits what conventional treatment options you can also use and explore.
Fibroids can be very small, but have a big impact on quality of life, or be large and asymptomatic. They may be associated with more bulk-type symptoms (pelvic pain & pressure, bladder issues, constipation) when they grow towards the outer part of the uterus (subserosal). And more associated with heavy bleeding, clotting, and fertility challenges when they grow more toward the inner surface of the uterus (submucosal).
When fibroids are asymptomatic, they don’t require treatment but can be monitored for changes using routine ultrasound imaging. Fibroids that are symptomatic can be treated in a variety of ways, but one of the biggest challenges is balancing the side effects of treatment with the potential benefits.
Conventional treatment options for uterine fibroids / leiomyoma
Although hormonal birth control (oral contraceptive pill or IUD for example) may help manage symptoms and may even slow fibroid growth, they may not be effective for everyone, and they won’t reliably reduce fibroid size. Not all people are open to hormone therapy or may have other contraindications to these approaches.
Other treatments like Non-Steroidal Anti-Inflammatory drugs (NSAIDs, like ibuprofen or naproxen) carry less barriers than hormonal treatment, but don’t offer any support in reducing the size or growth of fibroids. They are primarily beneficial in reducing pain, and potentially reducing volume of bleeding (although I have not found this reduction to be clinically significant).
When it comes to reducing bleeding, tranexamic acid is even more effective than NSAIDs. But again, this doesn’t help to reduce growth or size of existing fibroids, and the benefits of the medication stop when you stop taking it. The medication can also draw out the duration of your period – even if it is lighter, you may bleed for longer when taking it.
GnRH agonists are a class of drug that essentially mimic menopause. This can be helpful in reducing symptoms, as well as reducing the size of fibroids. However, these drugs are not recommended long term due to the risk of reducing bone density. And again, typically growth and symptoms recur when the medications are stopped. Many folks don’t want to go through menopause before they need to, and needless to say this treatment is not compatible with pregnancy.
Surgical removal comes with all the inherent risks of surgery, as well as risks to fertility potential. And we also have still not addressed what is driving growth in the first place.
Naturopathic treatments for uterine fibroids / leiomyomas
There are a variety of naturopathic approaches to support improved quality of life with fibroids, and that may potentially support the slowing of growth of these tumours or even help to shrink them. Naturopathic approaches take into account the need to treat symptoms acutely such as pain or heavy bleeding, while also looking at what may be driving the growth of your fibroids so that we can reduce the symptoms in a more sustained way.
Natural therapies have been increasingly shown to safely and effectively reduce the adverse effects of fibroids. Vitamin D has been shown to improve symptoms and may have a role to play in stemming fibroid growth.
Green Tea extract (EGCG) can also reduce menstrual flow, and has a role to play in reducing pelvic inflammation. Proteolytic enzymes such as serratiopeptidase have several modes of action that can improve the impact of fibroids, including anti-inflammatory, analgesic and anti-edemic properties. They may even help to reduce the size of fibroids.
What we do naturopathically involves a multi-faceted and individualized approach to care. We will:
- Consider risk factors – what is / is not modifiable?
- Ex. things like exposure to endocrine disrupting chemicals (EDCs) may be broadly modificable
- Investigate the presence of growth factors
- think excess estrogen or insulin signalling issues
- Look for inflammatory triggers and moderate inflammatory responses to reduce the growth of fibroids and associated pain, heavy bleeding, clotting, swelling
Alongside these considerations, the types of remedies listed above and other lifestyle factors can change the experience of having fibroids quite drastically without surgical intervention in many cases.
Final Thoughts
Every case is different, and the pathophysiology of why fibroids develop in the first place is complicated and not fully understood. As such, not every treatment option may be effective for every patient. Speak to a qualified Naturopathic Doctor to figure out what treatment options are best suited to you.
If you, or someone you know, is struggling with the impacts of uterine fibroids – reach out! There’s so much more to offer than just hormonal birth control to manage your symptoms and support your uterine health and quality of life.
Visit Dr Kristen Mark’s website
References:
https://pubmed.ncbi.nlm.nih.gov/32379687/
https://pubmed.ncbi.nlm.nih.gov/32423112/