What are fibroids?
Fibroids (also called myomas) are non-cancerous growths found in or around the wall of the womb (myometrium). They vary in size (between a pea and a melon) and are composed of muscle and fibrous tissue. Fibroids are almost always benign with 1 in 1000 being malignant.
It is possible for a woman to be unaware they have fibroids as often there are no symptoms. However, 1 in 3 woman do have symptoms (70-80% of woman before the age of 50). Fibroids are more common in woman of African-Caribbean origin, and in overweight individuals due to the associated increase in oestrogen. Woman who have had children have a lower risk of fibroids, and the more children the lower the risk. If fibroids are suspected then usually an ultrasound scan is recommended for confirmation.
What are the symptoms of fibroids?
- Heavy and/or painful periods - fibroids can make the womb bigger, increasing surface area, and increasing the amount of blood
- Excess bleeding can cause anaemia - symptoms of Anaemia include exhaustion, shortness of breath, dizziness, sore tongue, headaches
- Abdominal pain, from fibroid pressure
- Lower back pain, from fibroid pressure
- Frequent urination, from fibroid pressure
- Constipation, from fibroid pressure
- Pain/discomfort during intercourse
- Trouble conceiving (infertility)
- Abdominal swelling
- Pedunculated fibroids can twist causing pain
What are the different types of fibroids?
Intramural fibroids - develop in muscle wall of the womb, most common.
Subserosal fibroids - develop outside the wall of the womb into the pelvis, and can grow quite large.
Pedunculated fibroids - when subserosal tumours develop a stem.
Submucosal fibroids - develop in the muscle layer beneath the womb’s inner lining and grow into the womb cavity.
What are the potential causes of fibroids?
Fibroids are linked to the hormone oestrogen. Oestrogen is a reproductive hormone produced by the ovaries. Oestrogen levels are at there highest between the ages of 16 and 50 (when woman are able to reproduce). It has been shown that during the menopause, when oestrogen levels decrease, so too do the size of the fibroids. Taking HRT can increase oestrogen levels.
During times of emotional stress it is possible to have a cycle without ovulation, were oestrogen is produced without the hormone progesterone to counter balance it like it would normally, causing oestrogen dominance.
Often fibroids do not need to be treated and will shrink and disappear on their own, especially after the menopause. Medication to shrink the fibroids is usually the first course of action.
Heavy bleeding treatment is the same medication used for heavy periods (mefenamic acid and tranexamic acid).
GnRH analogues can be used as they bring on temporary menopause, which will decrease oestrogen and subsequently shrink the fibroids. Progesterone can be used to help to balance oestrogen and also can be used to help control heavy bleeding.
The next approach is surgery. Some doctors would recommend a hysterectomy while other more specialised doctors would perform a myomectomy (to remove the fibroids).
Follow a hormone balancing diet - see our article on hormone balance for further information.
Decrease foods that increase oestrogen- alcohol, animal fat, cheese, milk, cream, ice-cream, chocolate and most meat
Avoid tea & coffee - as caffeine increases menstrual flow.
Avoid saturated fats - mainly from meat and dairy products as these can contribute to weight gain, which will increase oestrogen. Saturated fats will compete with the essential fats for absorption, which are important to reduce fibroids. Saturated fats also can inhibit liver function which is essential for excess hormone removal.
Avoid alcohol - some alcohol can be oestrogenic which will inevitably increase oestrogen levels. Secondly, alcohol puts a lot of extra load on the liver, inhibiting its ability to detoxify and remove excess hormones. Alcohol also contains sugar, which in turn increases fat storage, subsequently increasing oestrogen levels. It also inhibits certain important nutrients and disrupts fat metabolism. Essential fats are important for proper hormone balance.
Eat fibre - this will aid the liver with toxic and oestrogen removal (whole grains, fresh fruit, and vegetables).
Increase phytoestrogens - these are adaptogenic naturally occurring oestrogens in foods (soya, lentils, garlic, chickpeas). They bind to oestrogen receptors including those in the womb and breasts blocking the bodies own more potent oestrogens, reducing the oestrogenic effect. They have also been shown to stimulate the production of SHBG (protein produced by liver that binds to sex hormones), that binds to and therefore reduces the effect of oestrogen.
Reduce xenoestrogens - these are from environmental sources (pesticides, herbicides, insecticides, fungicides, plastics and household cleaning products can have a hormone-disrupting effect, increasing oestrogen exposure). To minimise exposure as far as possible eat organically produced food.
Increase essential fatty acids - EFA’s are needed to produce prostaglandins, which can increase blood flow. The drug mefenamic helps control heavy bleeding by controlling prostaglandins. Arachidonic acid (from dairy and meat) produces PGE2 (prostaglandins that increase blood flow and clotting), resulting in heavy periods.
Eat plenty of fats from fish, nuts and seeds - this helps to increase the beneficial prostaglandins that reduce clotting. These prostaglandins help balance hormones by increasing cell receptor sensitivity to hormones.
Increase fermented soya-based foods - such as tempeh, as they have a regulating effect on oestrogen levels.
Eat flaxseeds - these contain lignans, which help balance hormones naturally.
Eat foods high in vitamin E - such as avocados, wheat germ and hazelnuts. Vitamin E is a really important fat-soluble antioxidant and helps to alleviate menstrual pain.
Eat foods high in carotenes - such as Cantaloupe melon, sweet potato, spring greens and carrots. Carotenes are known to be important for female reproductive function.
Supplements - for those that suffer with heavy periods it can be helpful to take a supplement that specifically supports that.
Herbs - Agnus castus is a female hormone balancer, Milk thistle is important for liver support and encouraging detoxification while Peony helps to balance oestrogen levels. When taking herbal supplements we recommend consulting a qualified Medical herbalist, particularly if you're taking any prescribed medication.
- Keep weight under control
- Support your liver - see our article on the liver for more detail
- If there are no changes to lifestyle or diet then fibroids can grow back.