Uterine Fibroids

Uterine fibroids affect 5.4%–77% of women, depending on the method of diagnosis.1 Fibroid tumors can be small and difficult to feel. These benign tumors have been known to grow to the size of a watermelon. Most gynecologists do not consider fibroid tumors to be a surgical problem until they are either exceedingly large or cause symptoms such as heavy or painful periods. Historically, hysterectomy (surgical excision of the uterus) has been the procedure of choice for patients with these issues. Approximately 300,000 hysterectomies are performed per year for these benign tumors. Conventional medicine has little else to offer other than a “watch and wait” attitude for women who suffer from small fibroids. However, if these small fibroids are approached from an integrative holistic perspective when they are initially diagnosed, much of the disability and invasive surgical procedures can be avoided.

The exact cause of fibroids is not well understood. The incidence of fibroids seems to be higher in African-American, obese, nonsmoking, and perimenopausal women. Fibroids are associated with high estrogen levels or estrogen dominance. Fibroids are just one condition associated with estrogen dominance. Others are as follows:

    • Autoimmune diseases: Hashimoto thyroiditis, systemic lupus erythematosus, rheumatoid arthritis, multiple sclerosis, ulcerative colitis, scleroderma, Sjögren syndrome
    • Fibrocystic breast problems
    • Gallbladder disease
    • Cervical dysplasias and other hormone-dependent cancers (breast, uterine, and ovarian)
    • Endometriosis
    • Infertility
    • Menstrual irregularities of all kinds
    • Polycystic ovary syndrome
    • Premenstrual syndrome

In addition to estrogen dominance, studies have supported a connection between systemic inflammation and fibroid growth.2 A prominent culprit in the cause of systemic inflammation is the concept of “leaky gut.” This is when instead of normal protein digestion into amino acids that are then transported THROUGH the intestinal cells, large peptides and proteins are absorbed intact IN BETWEEN cells in the intestinal wall. This malabsorption produces inflammatory mediators which surrounds the pelvis where estradiol is also at work stimulating the growth of atypical cells which may go on to develop into fibroids. Intestinal dysbiosis can also contribute to estrogen dominance through several mechanisms, including reabsorption of estradiol that would have otherwise been excreted from the body. The result is an elevation of total body estrogen, resulting in more stress on the liver and its detoxification capacities. Additionally, pathogens can produce toxins that have strong estrogenic effects of their own. Intestinal dysbiosis can be brought on by antacid abuse, antibiotics, chronic stress, eating practices that do not enhance digestion and absorption (“eating on the run”), intestinal infection, and birth control pills.

At RMRM, most of our discussions start with a client’s diet and the changes that can be implemented to improve gut health. We also have a very experienced nutritionist who would love to review your history in this regard and offer invaluable input.

Acidic and inflammatory foods, such as commercial red meats, poultry, and dairy products, are sources of arachidonic acid, which increases inflammatory prostaglandins and other inflammatory mediators that help to support fibroid growth. Avoiding commercial meat products also reduces exposure to added hormones and pesticide residues in these products.3 Small amounts of organic grass–fed meats can be added back as inflammation subsides.

Sweets and other foods with a high glycemic index are potentially stressful and can increase insulin resistance, increase estrogen dominance, and support fibroid growth.

Gluten grains, especially wheat, rye, and barley, contain genetically engineered gluten that is much stronger than that found in the more ancient gluten grains such as spelt. These newer grains can increase estrogens by inhibition of the cytochrome P450 3A4 enzyme system and can also affect thyroid hormones. Because all the wheat in this country is now genetically modified to be glyphosate ready (Roundup) and all the corn and soy in this country are now genetically modified to be 2,4-D-ready (a component of Agent Orange), it would be best to avoid these when trying to lower inflammation.4

Alcohol is not a problem if it is consumed in moderation. Studies show that women consuming more than five alcoholic drinks per week have a higher risk for breast cancer. This increase probably results from the effect of alcohol on the detoxification of estrogens. Organic coffee in moderation (1–2 cups per day) is also safe. Artificial ingredients, colorings, flavorings, and preservatives should be eliminated. Margarines and other sources of trans-fatty acids and hydrogenated oils are also unhealthy and must be avoided.

Foods That Reduce Estrogen Dominance:

Deep sea, cold-water fish, such as wild Pacific salmon, sardines, mackerel, and cod, have large quantities of omega-3 oils (eicosapentaenoic acid [EPA] and docosahexaenoic acid [DHA]).5 Because heavy metals, such as mercury, contribute to estrogen dominance, favor fish-species with lower levels of mercury. These are fish at the lower end of the food chain. The larger game fish, such as swordfish, tuna, and bass, concentrate the contaminants from eating smaller fish. Krill, small crustaceans, are a good source of noncontaminated EPA and DHA. Algae sources of DHA are also available.

Seeds and nuts, especially flaxseed, hemp seed, and chia seed, contain isoflavones.6 These are hormone-balancing. Consume 2–4 tablespoons per day added to a yellow pea-rice protein powder shake first thing in the morning. Coconut oil (1 tbsp) would be another good addition to this morning shake.

Other seeds and nuts, such as pumpkin seeds, sunflower seeds, and walnuts, are also good sources of omega-3 oils.7

Cooked cruciferous vegetables, such as broccoli, Brussels sprouts, cabbage, and cauliflower, support healthy estrogen metabolism. Legumes, such as adzuki beans, peas, lentils, and edamame, all have hormone-modulating flavonoids and can safely be eaten.8

Aerobic exercise consumes oxygen and helps “burn” carbohydrates (glucose). Oxygen-consuming exercises are exemplified by running, fast walking, and swimming. Because carbohydrates are consumed during aerobic exercise, this form of exercise is associated with improvements in insulin resistance and sugar use.

Anaerobic exercise classically uses fats (triglycerides) as an energy source. Weight trainers consume medium-chain triglycerides during their workouts to enhance energy and “fat burning.” Weight training also helps stabilize hormones such as growth hormone and testosterone. Because fat cells (adipocytes) are hormone factories that produce inflammatory mediators and estrone, limiting adipose tissue also reduces estrogen dominance. A regimen of 30 minutes of regular exercise three times per week has also been shown to lower the incidences of breast and colon cancer.

Botanical therapies can be very useful in reducing fibroid growth and decreasing fibroid symptoms.9 Recent studies indicate that curcumin from the spice turmeric and green tea extracts are effective in reducing angiogenesis by supporting peroxisome proliferator–activated receptor (PPAR) activation.10

Specific botanicals can reduce inflammation. Botanicals are often found in combination products, such as those containing Boswellia (400 mg), ginger (200 mg), turmeric (300 mg), and cayenne (50 mg) in every two tablets.

    1. A. Lethaby, B. Vollerhover: Fibroids (uterine myomatosis, leiomyomas). Clin Evid.11:490-493 2004
    2. L.A. Wise, J.R. Palmer, E.A. Stewart, et al.: Polycystic ovary syndrome and risk of leiomyomata. Fertil Steril. 87:1108-1115 2007
    3. L. Hilakivi-Clarke, J.E. Andrade, W. Helferich: Is soy consumption good or bad for the breast?. J Nutr. 140:2326S-2334S 2010
    4. J. Crago, K. Tran, A. Budicin, et al.: Exploring the impacts of two separate mixtures of pesticide and surfactants on estrogenic activity in male fathead minnows and rainbow trout. Arch Environ Contam Toxicol. 68:362-370 2015
    5. Z. Harel, F.M. Biro, R.K. Kottenhahn, et al.: Supplementation with omega-3 polyunsaturated fatty acids in the management of dysmenorrhea in adolescents. Am J Obstet Gynecol. 174:1335-1338 1996
    6. R.H. Lehrman: The macrobiotic diet in chronic disease. Nutr Clin Pract. 25:621-6262010
    7. C. Nagata: Decreased serum estradiol concentration associated with high dietary intake of soy products in premenopausal Japanese women. Nutr Cancer. 138:863-8701997
    8. A.B. Moore, L. Castro, X. Zheng, et al.: Stimulatory and inhibitory effects of genistein on human uterine leiomyoma cell proliferation are influenced by the concentration.Hum Reprod. 22:2623-2631 2007
    9. C. Cabrera: Holistic treatment of fibroids. Med Herbalism. 5:2-4 1993
    10. M. Malik, M. Mendoza, M. Payson, et al.: Curcumin, a nutritional supplement with antineoplastic activity, enhances leiomyoma cell apoptosis and decreases fibronectin expression. Fertil Steril. 91:2177-2184 2009