UTERINE FIBROIDS
Uterine fibroids are benign tumors of the smooth muscle in the walls of the uterus. These are exceedingly common and are the most common reason for surgical removal of the uterus (hysterectomy). They are often asymptomatic and may be discovered upon routine pelvic exam. Symptoms may include pain, painful intercourse or excessive bleeding. In addition, large fibroids can press upon the bladder and cause urinary pressure and frequency of urination. Problems with becoming pregnant or carrying a successful pregnancy can occur. When a fibroid is suspected upon exam or by symptoms, a pelvic ultrasound is quite accurate at demonstrating the size and location of the tumor. These are almost never cancerous growths so treatment is based upon the degree of symptoms. Some fibroids will continue to grow rapidly and others may remain the same or even shrink.
Conventional medical treatment includes drugs and surgery. The growth of the tumor cells is dependant upon the female estrogen hormones. Fibroids typically shrink and may disappear at menopause so if a women is close to menopause, the best option may be to do nothing. The tumor growth can be stopped and size lessened by use of gonadotrophin-releasing hormone inhibitors. This type of drug causes menopause symptoms, is very expensive and is not a good long-term therapy. Use of synthetic or natural progesterone hormone may diminish the heavy menstrual bleeding. Use of low dose oral contraceptive pills does not seem to cause the fibroids to grow excessively.
The surgical removal of the uterus will decrease sex drive in about a quarter of women. Also, some women have menopause symptoms for a few months after surgery due to alterations in blood flow and hormone levels. Removal of only the fibroid tumor can be attempted in younger women who want to preserve fertility.
A primary alternative therapy is dietary modification. Diets high in saturated fats, refined carbohydrates and low in fiber promote high estrogen levels. Changing to a healthier diet can lower estrogen levels and may help shrink the tumor. Also helpful is adequate Vitamin B-complex from whole foods. Since the liver and gallbladder are intimately involved in hormone metabolism, a nutrition expert may be helpful in supporting the body to balance the estrogen and progesterone. Use of oral or topical progesterone can block the effects of excessive estrogen. This can reduce bleeding and cramping even if the tumor does not shrink.
Aerobic exercise, massage, Tai Chi, and acupuncture can all improve blood and energy flow to the pelvis. Castor oil packs applied three times a week may be helpful for some women. Becoming aware of underlying emotional issues can be crucial to the healing process. I particularly recommend the book by Christiane Northrup MD “Women’s Bodies, Women’s Wisdom” for an in-depth look at ways to explore healing on this level.
Daniel Blodgett MD