can lignans shrink fibroids?

Do Fibroids shrink - Dr Dhwarga

Uterine Fibroids: Mechanisms, Treatment Challenges and the Power of Embracing a Functional Approach

You are here:HomeFunctional Medicine for ProfessionalsUterine Fibroids: Mechanisms, Treatment Challenges…

Woman having painful stomach ache during working from home,Female suffering from abdominal pain,Period cramps,Hands squeezing belly,Stomach pain

Dear Colleagues:

Uterine fibroids are a huge, underappreciated issue. They are the most common gynecological disorder, affecting nearly half of women younger than 40 years old, and far more (>70%) for those older. Frankly, I don’t think we are doing enough to help these patients. Fibroids are the leading indication for hysterectomy in the US, accounting for 39% of all hysterectomies each year, and while some are asymptomatic, symptoms include heavy and prolonged periods, difficulty with intercourse, bowel dysfunction, non-cyclic pelvic pain, low back pain, urinary frequency and urgency, and constipation. Because not all fibroids cause heavy bleeding, their impact can be missed, think: refractory constipation or incontinence.

Beyond hysterectomy, conventional treatments include pharmacotherapy, myomectomy, and uterine artery embolization, however, these treatments leave much to be desired. Oral contraceptives or aromatase inhibitors may be used to manage bleeding (with potentially severe side effects in the latter), and even after myomectomy, fibroids often recur and 10% of women will undergo hysterectomy within 5 – 10 years.

It’s our time. Functional medicine is ideal to analyze the underlying, contributing causes and target treatments accordingly for each unique patient.

In this month’s blog, learn underlying mechanisms and practical treatment takeaways – and, really interesting to me (and something I’ve seen in practice) the role that progesterone plays in increasing fibroid size in some women. I suspect that our fibroid treatment failure in some cases has to do with prescribing progesterone to the wrong patient. With comprehensive treatment of hormones, diet, lifestyle, nutrition, and stress, functional medicine management of uterine fibroids can improve our female patients’ quality of life, and minimize the need for drug therapy and surgical interventions. Read on to find out how, and be sure to leave a comment, share to let us know what you think!

~DrKF

Uterine Fibroids: Mechanisms, Treatment Challenges and the Power of Embracing a Functional Approach

Uterine fibroids (leiomyomata) are surprisingly common: by the age of 50, around 80% of African-American women and at least 70% of white women develop fibroids, according to the National Institutes of Health. This means that a large majority of women in America will develop them. They are even more common than being overweight. Fibroids are challenging to treat, and conventional approaches consist mainly of surgical procedures for management of symptoms. Additionally, a few medications are being used to reduce symptoms pre-surgically, such as gonadotropin-releasing hormone agonists, SERMs (selective estrogen receptor modulators) and aromatase inhibitors.

To begin to understand fibroids, it is important to recognize that they are growths; technically, they are benign (not cancerous) tumors of uterine muscle tissue. Yet their growth is abnormal, begging the question “What makes them grow, and how can we reduce those risk factors?” While the answer isn’t known for certain, the high (and rising) prevalence of fibroids clearly indicates that contributing factors are quite common. Fibroids aren’t always symptomatic, but can result in chronic pain, abnormal bleeding, scarring, reduced fertility, and lower quality of life for women. Consequently, regular screening is advisable and there is much we can do with our Functional Toolkit.

A Finely-Tuned Environment

When considering the potential reasons for the development of uterine fibroids, it’s helpful to think about the total environment in which they develop. Within the uterus, a dynamic equilibrium among chemical mediators of growth and transformation constantly remodel the uterine environment. Eating and living habits can feed these mediators, which can serve as a trigger for fibroids, as we discuss later.

The uterus must perform an enormous metabolic undertaking. In women of reproductive age, it takes an intricate yet ever-changing balance among numerous growth hormones and related messengers to maintain fertility, regulate the maturation and release of eggs, and prepare a viable uterine environment for a healthy fetus. And all this must be accomplished on a monthly basis. If and when an egg is fertilized, this biochemical symphony must rapidly transition to keeping the fetus healthy. A mother’s blood circulation must be redirected, billions of precision cell divisions in a fetus must be supported, and specialized tissues needed to nourish the fetus’ rapid growth must be created. Mammary and central nervous functions are prepared in order to protect and nurture the new life.

In order to accomplish its primary function, the uterus is constantly undergoing an extraordinary amount of executive coordination between various hormones and messengers that help hormones do their jobs effectively. Specifically, there must be executive coordination among levels of the following hormones and enzymes:

Rise and fall in multiple forms of estrogen (endogenous estradiol, estrone, and estriol as well as environmental xenoestrogens and dietary phytoestrogens) and estrogen receptors

Rise and fall in progesterone and progesterone receptors

Rise and fall in follicle-stimulating and luteinizing hormones (FSH and LH)

Cortisol and other stress hormones, which can affect overall hormone balance

Aromatase, COMT (catechol-O-methyltransferase), and other key sex hormone-metabolizing enzymes. COMT degrades catechol estrogens so they can be cleared from the body and polymorphisms of the enzyme are associated with an increased risk of fibroids. Aromatase is an enzyme that converts androgens into estrogens.

Insulin-like growth factor (IGF), prolactin, sex hormone-binding globulin (SHBG), DHEA (dehydroepiandrosterone), testosterone, and thyroid hormones must also be optimized. For example, fibroids may have elevated IGF expression and may accompany metabolic disorders. Therefore, it is crucial to evaluate and address inputs that impact glucose and insulin responses. Furthermore, fibroids are often associated with a high prolactin level, which is linked to infertility.

Balancing hormones can reduce the risk of developing fibroids. Since they are also fundamentally important in energy metabolism, immune balance, and gastrointestinal function, optimizing hormones in women with fibroids may additionally improve inflammation, gut dysbiosis, sleep, and overall quality of life.

Fibroids Hear Growth Signals Loud and Clear

It’s long been noted that fibroids grow more rapidly during pregnancy and tend to regress after menopause, though perimenopausal hormonal fluctuations can provide growth impetus. We now know that not only do fibroids possess receptors for both estrogen and progesterone, but that a highly-estrogenized milieu may upregulate the genetic expression of progesterone receptors. Both estrogen and progesterone should be viewed as “growth hormones” for fibroids; it’s just that they promote different aspects of ovarian and uterine tissue function at different times of women’s reproductive cycles.

Thus, while optimizing balance among pro-estrogenic influences is a central focus in approaching fibroids, it is also important to consider how progesterone and the function of its receptors may be contributing to their growth. The 2016 Study of Women’s Health Across the Nation (SWAN) study additionally pointed out an interesting association between high testosterone levels and incidence of fibroids, especially if estradiol levels were also high. The study noted that receptors for androgens are highly expressed in fibroids. It also detected a doubled risk for fibroids with the use of exogenous hormone therapies, and an inverse relationship between FSH level and fibroid development.

An interesting question is: why do fibroids seem so “hungry” for growth hormone messages? While we don’t purport to completely answer this huge issue, part of the explanation may be that vitamin D, one of the body’s chief controllers of hormonal and immune responses, regulates sex steroid receptor expression in uterine fibroids. Vitamin D deficiency is relatively common, and through the above mechanism, this could play a key role in the development of fibroids.

Progesterone, Not Just Estrogen, Can Increase Fibroid Size

Traditionally, in treating fibroids, a greater focus was placed on estrogen’s role. SERMS (selective estrogen receptor modulators) are often used to treat fibroids. However, it has only recently become appreciated that progesterone also plays a key role in fibroid growth. Progesterone receptors (PRs) have two isoforms: A and B. Fibroids have heightened expression of both of these progesterone receptor isoforms. Additionally, high estrogen levels can signal an uptick in PR expression. Recognizing the likely role that progesterone plays in fibroids and the ability of estrogen to boost progesterone receptor expression, research is now focusing on SPRMs (selective progesterone receptor modulators), sometimes referred to as “antiprogestins,” that alter PR function—and thus cellular responsivity to progesterone. One SPRM, Ulipristal, has been proven to effectively treat fibroids long-term, although rare liver complications have been reported.

SPRMs serve as synthetic steroidal signals for PRs. They may act as agonists, antagonists, or both at various binding sites within PRs. SPRMs essentially recode PRs’ genetic programs for transcription. They also change a cell’s life-and-death cycle and alter immune signaling. Through these actions, they can induce programmed cell death (apoptosis) and suppress collagen formation within fibroids to limit their growth.

Lingering questions we have about SPRMs, include:

Especially since SPRMs are given continuously rather than mimicking the natural up-and-down cycle of progesterone, what are their long-term effects?

Since SPRMs affect basic cell programming in hormone-sensitive tissues (not just the uterus) and are known to change endometrial architecture in novel ways, are they associated with an increased risk for cancer

SPRMs are now being administered in Europe, so we’ll be paying close attention to outcomes there.

Given the apparent treatment benefit of interfering with progesterone receptors, it begs the question if progesterone supplementation, which is commonly used to balance estrogen, is beneficial for all women with fibroids. Perhaps progesterone should be carefully administered in these women or clinicians could stratify risk for using progesterone in women with fibroids. Monitoring response to therapy by tracking fibroid size with pelvic and/or transvaginal ultrasound is useful- just be consistent with timing, as fibroids change with cycle hormone ratios. Further, those with larger, palpable fibroids will likely know if an intervention is effective or not themselves.

Lifestyle and Dietary Factors Affecting Fibroids

Detoxification of steroid hormones in the liver and intestines can reduce circulating levels of hormones, and thus influence fibroid growth. Therefore, it’s necessary to address dietary factors to enhance healthy clearance of hormones. Prime examples include limiting intakes of caffeine and alcohol (which interfere with liver detox of estrogen), increasing dietary fiber intakes (to limit intestinal deconjugation of excreted estrogen metabolites), and increasing consumption of phytoestrogens. A few examples of phytoestrogens include flaxseed lignans, resveratrol, hops flavonoids, black cohosh, and isoflavones from red clover, soy, or kudzu. However, it’s good to keep in mind that different women respond differently to phytoestrogens.

Fibroids generally have high COMT and aromatase expression, which is involved in the breakdown of androgens into estrogens. Therefore, optimizing estrogen levels is crucial. More importantly, improving the balance between the formation of weaker 2-OH-estrones and the more potent  4-OH-estrones and 16α-OH-estrones is a focal point of fibroid treatment. 2-OH-estrones are estrogen metabolites that, when converted to their methoxy counterparts, block cancer growth. On the other hand, 16α-OH-estrones and 4-OH-estrones are estrogen metabolites that may promote cancer development in women. Suggestions for optimizing the balance between these two metabolites can include supporting healthy methylation function, encouraging regular sweat-inducing activity, regularly eating Brassica vegetables, and/or supplementation with DIM (diindolylmethane, a stable metabolite of sulforaphane), plus glutathione. These encourage formation of the more beneficial 2-OH-estrones, improve healthy estrogen metabolism, and help increase SHBG levels while discouraging formation of the more genotoxic estrogens.

Addressing Other Critical Risk Factors

Another risk factor for fibroids is visceral adiposity. A recent Chinese study found a remarkably strong link between visceral adiposity and risk for fibroids. In this population:

Higher waist-to-hip ratio increased risk up to 7.7-fold (especially peri-menopausally)

Greater body fat percentage, waist-height ratio, or visceral fat area each increased risk around 4-fold

Higher body mass index (BMI) or waist circumference, each, increased risk almost 3-fold

Because obesity is associated with significant changes in immunometabolic and hormonal parameters, it seems likely that the strength of these findings will be confirmed in other populations. Consequently, these central obesity-related measures may present a simple and low-cost method of screening for fibroid risk.

Exposure to factors that can influence sex hormone levels, such as xenoestrogens, endocrine disruptors, and persistent organic pollutants may also play a role in fibroid development. Therefore, eliminating environmental exposure to these toxins may be beneficial.

Other research has shown that:

Women with fibroids given 800 mg/day of a decaffeinated, EGCG-rich green tea extract showed significant reductions in fibroid volume and symptom severity, along with less bleeding and better quality of life. (Comparable to Lupron)

Smoking, longer menstrual cycle or menstrual bleeding, and nulliparity can increase risk.

Intakes of vitamin A, fruit, and vegetables relate inversely to fibroid risk; having citrus fruits at least 3 times weekly showed an especially strong protective association.

African-American adults tend to have lower intakes of fruits, vegetables, vitamins A and C, carotenoids, and fiber, and are also less likely to take vitamin/mineral supplements—all of which may help explain African-American women’s particular susceptibility to developing fibroids.

Weight gain during adulthood may heighten risk, even if weight remains normal.

Though not confirmed in women, melatonin may selectively trigger apoptosis and autophagy in fibroid cells while sparing normal uterine muscle, according to preclinical research. Melatonin is also antiestrogenic and antioxidant.

In an animal model, a flavonoid from licorice herb called isoliquiritigenin interfered with estrogen-induced fibroid growth and triggered apoptosis and autophagy in affected cells.

Resveratrol also showed the ability to stimulate apoptosis and autophagy in fibroid cells, in a preclinical study.

The seaweed polysaccharide fucoidan inhibited fibroid cell proliferation and encouraged apoptosis.

Beyond the EGCG paper cited above, it’s worth noting that in general flavonoids stand out as a way to address fibroids. An interesting 2017 study looking at the flavonoid kaempferol (in kale, spinach, dill, tarragon)  showed a potent inhibitory effect on both mRNA levels and protein levels of estrogen receptor, IGF-1. Additionally, impaired glucose metabolism and excessive glycation are linked to fibroid development, and flavonoids improve these two metabolic processes. Flavonoids have other actions that block fibroids including prebiotic effects, optimizing life-and-death cell cycle regulation, and improving overall redox and immune balance. Pair these “side benefits” with a paucity of adverse effects and flavonoids are an ideal choice.

How Genetics Influence Fibroid Growth

A 2015 study looked into genomic features that distinguish metabolic subtypes of fibroids, and discovered that genetic expression of insulin-like growth factor, prolactin, and Wnt/β-catenin proteins (involved in normal as well as abnormal cell proliferation) may characterize fibroids with different response patterns. It also identified several polymorphisms that play into fibroid development, including several that affect oncogenesis, immune factors, cell metabolism and migration, collagen formation, and endogenous antioxidant systems like Nrf2. Metabolomic profiling of fibroids reveals that some may have altered metabolism in relation to amino acids, heme, vitamin A, and antioxidants. Another project examines how -omics can distinguish between benign fibroids and those disposed to malignant transformation. While this avenue of research is in the early days, it will undoubtedly help clarify which treatments are best suited to each woman’s genetically unique fibroids.

Suggested Takeaways

Optimize hormone levels and hormone messengers, including estrogen, progesterone, cortisol, IGF, prolactin, SHBG, DHEA, testosterone, and thyroid hormones.

Evaluate and address inputs that impact glucose and insulin responses.

Reduce visceral fat by optimizing glucose metabolism, hormones, and stress.

Caution should be used when treating with progesterone. In some women, it likely promotes, rather than diminishes, fibroids.

Thoroughly evaluate and address factors that can influence sex hormone levels, such as exposures to xenoestrogens, endocrine disruptors, and persistent organic pollutants. Eliminate sources of these pollutants by avoiding products that contain BPA, parabens, and phthalates.

To better target particular treatments, consider testing for genetic variants relating to estrogen and progesterone receptors, aromatase, and COMT.

Recommend that patients reduce intake of caffeine and alcohol (and animal products, too) to facilitate liver detox of estrogen while increasing dietary fiber intakes to block intestinal deconjugation of excreted estrogen metabolites. Increased intake of vegetables and fruits (especially citrus fruit) may also be helpful.

Consider supplementation with phytoestrogens such as flaxseed lignans, resveratrol, hops flavonoids, black cohosh, and isoflavones from red clover, soy, or kudzu.

Optimize levels of the estrogen metabolites 2-OH-estrones and 16α-OH-estrones by supporting healthy methylation function, encouraging regular sweat-inducing activity, regularly eating Brassica vegetables, and/or supplementation with DIM (diindolylmethane).

Begin a supplementation protocol that includes EGCG-rich green tea extract, resveratrol, melatonin, fucoidan, and kaempferol.

Optimize vitamin D levels.

Appreciate how stress can devastate overall hormone balance. Consider nutritional support of adrenal function and cortisol levels and mind-body practices, careful exercise prescription, and the use of herbs like licorice.

Uterine fibroids can cause severe pain and discomfort for many people. Food certainly isn't the ​only​ factor that contributes to fibroids, but experts say it does play a part in the condition.

How to prevent the growth of Uterine Fibroids? | Dr. Hansaji Yogendra

VIDEO OF THE DAY

"While we don't fully understand the causes of fibroids, studies have shown that dietary patterns and foods may be associated with higher or lower risk for developing fibroids," says Melissa Groves, RD, LD, an integrative and functional medicine dietitian specializing in women's health and hormones, and the founder of The Hormone Dietitian.

First, What Are Fibroids?

Fibroids, also known as myomas or leiomyomas, are uterine tumors made of smooth muscle and connective tissue, per UCLA Health. While the word "tumors" may sound terrifying, fibroids are typically benign. In fact, fibroid statistics estimate that up to 80 percent of all people with uteruses will develop fibroids at some point in their lives, with Black people being three to four times more likely to have fibroids than other groups, according to the U.S. National Library of Medicine.

Fibroids also become more common with age up until menopause, when myomas rarely develop or tend to shrink if they're already present.

While some people never even realize they have fibroids, others have painful symptoms, including heavy or elongated periods, pelvic pain, increased urination, constipation and backaches, per the Mayo Clinic.

"Staying at a healthy weight by eating a balanced diet that includes plenty of fresh fruits, vegetables, lean proteins and healthy fats can be helpful to decrease or prevent fibroid growth."

The Connection Between Diet and Fibroids

Diet choices alone can't prevent or treat fibroids, but research suggests the foods we eat may influence fibroid risk and growth.

"Elevated levels of hormones like estrogen may make you more likely to get fibroids," says Cory Ruth, RD, a registered dietitian who specializes in PCOS and hormone imbalance, and founder of The Women's Dietitian.

How does that relate to our diet? "Fat cells make more estrogen, which can increase your risk for fibroids or make them worse," Ruth explains. "Staying at a healthy weight by eating a balanced diet that includes plenty of fresh fruits, vegetables, lean proteins and healthy fats can be helpful to decrease or prevent fibroid growth."

In other words, instead of following a low-estrogen diet specifically, aim to eat a variety of whole foods that support your overall health.

The Best Foods for Fibroids

No single food will cure your fibroids, but certain nutrients are associated with improvements in symptoms and a reduction in myoma growth. Read on for five foods that may help shrink your fibroids naturally.

1. Vitamin-D Rich Foods

Sandwich with avocado and poached egg, as an example of food good for fibroids

Eggs are a good choice when you have fibroids because they're rich in vitamin D.

Image Credit: zeleno/iStock/GettyImages

As if we needed another reason to love vitamin D. Too-low levels of the fat-soluble vitamin are associated with an increased risk of fibroids, per a July 2018 review in the ​International​ ​Journal of Molecular Sciences​​.​

Vitamin D likely affects fibroid risk and growth thanks to its role in gene expression. That is, by stopping certain cells from multiplying, the vitamin can block the growth of myomas. But vitamin D levels must be sufficient in order for this to work. That may be part of the reason why studies have repeatedly found that people with uterine fibroids (UF) have lower levels of vitamin D compared to people without UFs.

Vitamin D isn't the easiest nutrient to find in your diet, but the following foods are good sources:

Fatty fish like salmon and tuna (these also pack anti-inflammatory omega-3 fatty acids)

Egg yolks

Certain fortified foods (think: milks, yogurts and breakfast cereals)

Ruth recommends prioritizing seafood if you're looking to add more D to your diet: "Aim for three to four servings per week of fatty fish like salmon, herring, tuna and mackerel for maximum omega-3 benefits. If you're not enjoying these types of fish that often, you can take a supplement with at least 500 milligrams of EPA and DHA."

2. Flaxseeds

flax seed in a jute bag

There's no research on how long it may take flaxseeds to shrink fibroids, but it's worth making these seeds a staple in your diet to reap the long-term health benefits.

Image Credit: panco971/iStock/GettyImages

Fibroids or not, we should all befriend flaxseeds. Not only do they deliver plant-based omega-3s (also known as ALA), but flaxseeds are also a great source of fiber, which is important for people with fibroids, especially if they struggle with constipation.

Why? When we're constipated there's more time for estrogen to become reactivated in and reabsorbed from the gut, Groves explains, potentially resulting in elevated levels of estrogen in the body — a risk factor for uterine fibroid development. It makes sense, then, that "studies have shown that a diet high in fiber has been linked to lower estrogen levels," Groves says.

Flaxseeds also contain compounds called lignans that act as phytoestrogens, per the Memorial Sloan Kettering Cancer Center. When eaten in moderation, phytoestrogens may modestly block the effects of excess, ​true​ estrogen in the body, hindering its ability to promote fibroid growth.

Always opt for ​ground​ flaxseeds unless you're blending them into a smoothie. The whole seeds are tough for the body to break down, but grinding them helps us better digest them and reap their health benefits.

What About Soy?

You may have heard that phytoestrogens are a no-no for women’s hormones. But soy can actually serve as an "anti-estrogen," per a February 2021 review in the ​International Journal of Environmental Research and Public Health​​. ​In other words, just like flax, soy can help dampen the effects of true estrogen in the body.

Also good to know: “Soy contains phytoestrogens that are very different from xenoestrogens [found in plastics and pesticides], which may be harmful to both our hormones and overall health,” Ruth explains. “Research demonstrates that soy is fairly neutral and even has protective benefits against certain cancers. [People with fibroids] can absolutely enjoy whole, unprocessed soy products in moderation.”

These include:

Edamame

Roasted soybeans or soy nuts

Talk to your doctor about a safe level of soy intake for you if you have a personal or family history of estrogen receptor-positive breast cancer.

3. Citrus

close view of a person cutting up citrus fruits, as an example of food good for fibroids

All fruits may help shrink fibroids, but citrus is an especially smart choice.

Image Credit: NemanjaMiscevic/iStock/GettyImages

While eating plenty of produce is recommended for those with fibroids, research suggests citrus fruits like grapefruit and oranges are among the most important plants for myoma prevention.

People who ate three or more servings of citrus per week were significantly less likely to have UFs compared to people who ate citrus less than once a month, according to a December 2011 study from ​The American Journal of Clinical Nutrition​​.​

Tip

Opt for the whole fruit instead of juice for less sugar and more fiber.

4. Gut-Friendly Foods

Golden onions on rustic wooden background, as an example of food good for fibroids

Gut-supportive onions are used to flavor dishes in many different cuisines.

Image Credit: ehaurylik/iStock/GettyImages

"Anything that supports gut health is going to support healthy hormones by default," Groves tells LIVESTRONG.com. That's because bacteria in the gut (sometimes referred to as the "estrobolome") are involved in the detoxification and elimination of excess estrogens, per research from the journal ​Maturitas​​.​

Groves recommends combining probiotics found in fermented foods with prebiotics, the fibers that feed our good gut bacteria.

Gut-friendly fermented foods include:

Yogurt

Kefir

Sauerkraut

Kombucha

Kimchi

Tempeh

Foods high in prebiotics include:

Alliums (leeks, garlic, onions)

Asparagus

Bananas

Honey

Whole grains (oats, whole wheat, barley)

Lifestyle strategies are also important for gut health (and, by extension, hormone health), Grove adds. "[Remember to] slow down and eat mindfully, chew food thoroughly and manage stress."

What About Green Tea?

A small August 2013 study from the ​International Journal of Women's Health ​reported that daily supplementation with green tea extract significantly reduced the size of study participants' uterine fibroids. But of course, taking green tea extract in supplement form isn't the same as drinking a cup of green tea. Not only are supplements unregulated, but their contents are much more concentrated than whole foods (or in this case, drinks). It's always a good idea to talk to your doctor before starting any new supplements.

It's also worth noting that although some other teas are marketed as "fibroid-shrinking teas," there's no research to support drinking tea as a way to manage fibroids.

5. Potassium-Rich Foods

top view of a bowl of oatmeal with banana and walnuts, as an example of food good for fibroids

Bananas are rich in potassium and support good gut health, both of which may help with fibroids.

Image Credit: wmaster890/iStock/GettyImages

People with fibroids are more likely to also have high blood pressure, or hypertension, according to early (but still cited) research in the ​Journal of Reproductive Medicine​​.​ Friendly reminder: A high-potassium diet is helpful for driving down blood pressure because it counteracts the effects of sodium in the body.

That's one reason why potassium-rich foods like bananas are recommended for people with fibroids. Other healthy, high-potassium foods include:

Avocados

Collard greens

Lentils

Okra

Potatoes

Tomatoes

Yogurt

What About Celery Juice?

Some people claim that celery juice can shrink fibroids. While the drink does contain some potassium and other vitamins and minerals, it's not especially high in the nutrient, and there's no evidence connecting celery juice to a lower risk of fibroids.

The Worst Foods (and Drinks) for Fibroids

We may not know for sure which foods cause fibroids to grow, but based on research, people with fibroids are better off limiting the following:

1. Red Meat (Including Pork)

Eating a lot of animal proteins like beef, pork and lamb may raise your risk of developing fibroids, per research in ​Obstetrics & Gynecology​​.​ (The study is from 1999, but it's still cited often.) It's important to note, though, that this research only found an association — it didn't establish a cause-and-effect relationship between meat and fibroids.

That said, it's a good idea to practice moderation with red and processed meats. "You don't need to avoid these proteins completely," Ruth says. "Opt for three to four servings per week."

Turn to other nutrient-dense sources of protein like fatty fish, nuts and potassium-rich beans to fill in any gaps.

Tip

A serving size of red meat is 3 to 4 ounces, or about the size of a deck of cards.

2. Alcohol

Sad but true: Alcohol is a hormone disruptor, meaning it can exacerbate estrogen imbalances in the body.

How? "Since alcohol is a toxin, the liver prioritizes detoxing that toxin over any of its usual jobs, such as metabolizing hormones, balancing blood sugar and eliminating other toxins," Groves says. What's more: "A higher consumption of alcohol has been linked to fibroid development and fibroid pain." Ouch.

If banning booze altogether is out of the question, focus on reducing how much you drink.

"Up to one alcoholic beverage a day is considered 'moderate drinking,'" Groves says. "Some people may find that even one serving a day worsens pain [associated with fibroids], so listen to your body and tune in to how you feel after a drink."

What About Caffeine?

No research has conclusively shown that coffee or caffeine increases the risk of fibroids or causes fibroids to grow.

What About Dairy?

"Research on dairy and fibroids is conflicting," Ruth admits. While some point to dairy products as solid sources of potassium and protein, others highlight the fact that modern cow's milk contains high levels of estrogen, which is less than ideal for those with uterine fibroids.

"To err on the side of caution, it may be wise to enjoy dairy products in moderation and opt for low-fat products," Ruth says.

Because endocrine-disrupting chemicals can accumulate in animal fat, a full-fat milk or yogurt may be more harmful than a lower-fat alternative. That said, more research is needed before we can declare a 'yay' or 'nay' on dairy for those with fibroids.

The Bottom Line

Eating certain foods won't heal your fibroids, but following hormone-healthy dietary patterns may help reduce your risk of myomas and their growth.

"The best foods to consume for fibroids are those that are high in fiber, like fruits, vegetables and whole grains; anti-inflammatory foods like fatty fish, nuts and seeds; and fermented foods, like yogurt and kefir," Groves says. "It's also a good idea to eat foods that are supportive of liver health to support estrogen metabolism, like cruciferous vegetables, citrus, berries, flaxseed and artichokes."

Avoiding inflammatory foods like those with excess added sugars, alcohol, processed meats, refined carbohydrates and vegetable oils high in pro-inflammatory omega-6 fatty acids is also encouraged.

Looking for more guidance on the best diet for uterine fibroids? Work with a registered dietitian to find the best balance of nutritious foods for you.

BACKGROUND: Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens.

Uterine fibroids patients find hope in plant-based diet

OBJECTIVE: The objective of this case-control study was to evaluate the relation between uterine fibroid risk and phytoestrogen exposure.

DESIGN: Two overnight urine collections (48 h apart) from 170 uterine fibroid cases and 173 controls were analyzed for isoflavonoids (ie, daidzein, genistein, equol, and O-desmethylangolensin) and lignans (enterodiol and enterolactone). Logistic regression was used to determine associations between the mean excretion of the 2 collections and the risk of uterine fibroids.

RESULTS: Unadjusted isoflavone excretion did not differ significantly between cases and controls (2.33 +/- 5.82 and 2.60 +/- 5.90 nmol/mg Cr, respectively; P = 0.68), but cases excreted significantly less lignans than did controls (2.86 +/- 3.45 and 4.57 +/- 6.67 nmol/mg Cr, respectively; P < 0.01). The trend for a reduced risk of uterine fibroids with increasing quartiles of lignan excretion was significant (odds ratio for highest versus lowest quartile = 0.31; 95% CI: 0.17, 0.58; P for trend < 0.01). When adjusted for age, BMI, race, family history of uterine fibroids, and isoflavone excretion, this trend remained but was attenuated (P = 0.07).

CONCLUSIONS: Our findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. No association was found between isoflavone excretion and uterine fibroids; however, the intake of soy foods, the primary source of isoflavones, was low in this population.

If you’re struggling with abdominal pain, heavy, painful periods, and fatigue , you might be one of the millions of women diagnosed with uterine fibroids each year. The most common neoplasm affecting women (non-cancerous growths, also called leiomyomas) occur in 70 percent of pre-menopausal women . A quarter of all women seek treatment for fibroids. Conventional treatment typically involves hormonal birth control , medication, or surgery—but doesn’t address the root of the issue. Following a myomectomy (surgical removal), up to a third of fibroids recur and roughly 10 percent of women will have a hysterectomy within ten years.

Lifestyle and holistic changes, on the other hand, target the underlying causes of uterine fibroids and can result in lasting improvement. According to Jessie Wei, MD , a functional medicine physician at Parsley Health, for many women, the best long-term treatment involves modifying your nutrition, sleep habits, and stress management strategies. Holistic strategies can be employed to combat uterine fibroids through natural treatment.

Causes of uterine fibroids

In healthy women, estrogen and progesterone interact to maintain a delicate balance. For women who seek treatment for uterine fibroids, however, that balance tips toward estrogen dominance , a major culprit behind the condition. “It’s what happens when estrogen, which is our main sexual hormone, is either too high in the body,” says Danielle DeSimone , a health coach at Parsley Health. “Or estrogen might be a completely normal level, but it’s going unchecked by too little progesterone.”

One metastudy noted that while uterine fibroids are associated with many variables, estrogen’s role is especially concerning; there are no documented prepubertal cases and the condition recedes after menopause—the phase of life when estrogen is naturally low. According to the National Institute of Health , other risk factors include older age, race (Black women are at higher risk), obesity, a family history of fibroids, high blood pressure, no history of pregnancy, Vitamin D deficiency, and the consumption of food additives and soy milk.

Uterine fibroids natural treatment methods

Whether you’re hoping to prevent a recurrence of uterine fibroids after surgery, you want to ease fibroid symptoms, or slow the development of fibroids, the below uterine fibroids natural treatments can help.

Make your diet (and your hormones) work for you.

To understand the role diet plays in supporting the fine balance between estrogen and progesterone, you first need to understand the relationship between estrogen, the liver, and gut. Normally, your body uses estrogen and eliminates it, first sending it to the liver. From there, estrogen metabolites (byproducts of estrogen metabolism) enter the gut and exit via the stool. But imbalanced gut bacteria can interfere with that process by cutting off the signal for the estrogen to be excreted. This process is called enterohepatic circulation, and causes estrogen to instead be “recycled right back into the body,” setting the stage for estrogen dominance, says Dr. Wei.

According to DeSimone, you can support the part of the gut that processes estrogen metabolism, the estrobolome, through diet. Research shows that changes in the estrobolome can propel estrogen-mediated conditions including uterine fibroids and that gut microbiome changes can decrease estrogen circulation. These foods can help:

Fermented foods, rich in probiotics , are an excellent choice. Kimchi, sauerkraut, and plant-based yogurt, “can be really helpful just for getting a better balance of those ‘good guys,’” says DeSimone.

Fiber -rich foods are also key. Fiber feeds the probiotics and helps them flourish, explains DeSimone. She suggests filling your plate with four to five cups of non-starchy vegetables (measured raw) each day.

Dark, leafy greens like spinach, kale, arugula, collards, and baby greens are great for “general liver detox,” according to DeSimone. An Evidence-Based Complementary and Alternative Medicine study found kale and collards support liver health.

Cruciferous vegetables like broccoli, cauliflower, Brussels sprouts, and cabbage, hold a compound known as DIM (Diindolylmethane). According to DeSimone, DIM binds to excess estrogen in the bloodstream and flushes it out. One study found that women with diets higher in cruciferous vegetables were less likely to experience uterine fibroids.

Flaxseeds also help clear excess estrogen. They’re rich in lignans, a weak phytoestrogen that “hangs out in the cell,” explains DeSimone, “blocking our own estrogens from being used, which means they have to get flushed out.” One study found an inverse association between lignan excretion and uterine fibroid risk. DeSimone suggests two tablespoons of ground flaxseed per day.

Anti-inflammatory herbs and spices like parsley, garlic, cilantro, and turmeric also support healthy liver function. Gut inflammation can weaken the intestinal lining, which promotes dysbiosis, which occurs when too many “bad bacteria” crowd out “good bacteria.”According to one study , many herbs and spices (including turmeric, basil, bay leaves, cinnamon, garlic, and ginger) have anti-inflammatory properties.

Avoid inflammatory foods and those that tax your liver. Reducing or eliminating alcohol, excess sugar, gluten , and dairy also fosters a healthy gut microbiome. A Journal of Obstetrics & Gynaecology study found that women who consumed food additives in processed, sweetened, or preserved foods were more than three times as likely to experience uterine fibroids versus women who did not.

Keep in mind, you don’t necessarily need to give up your favorite foods or follow strict rules to see results. Particularly for women with a history of disordered eating, it’s important to avoid black and white thinking, says Dr. Wei. Instead, she suggests focusing on a plant-based diet eating a rich variety of foods. In addition to getting plenty of greens, opt for foods of all colors of the rainbow. Parsley health coaches work with members to develop a personalized nutrition plan that meets their goals. Intentional nutrition changes can be an easy step for uterine fibroids natural treatment.

Prioritize quality sleep.

“Sleep is the foundation of everything,” says DeSimone. Insufficient sleep drives up cortisol , your major stress hormone, and in turn, causes insulin to spike, which sets you up for an array of chronic conditions—including uterine fibroids. One study , which examined the relationship between stress and uterine fibroids, suggested that the activation of the hypothalamic-pituitary-adrenal axis and the consequent release of cortisol may play a role in the fluctuating estrogen and progesterone levels, setting the stage for uterine fibroids.

In general, you should aim for seven to eight hours of sleep a night, but there is some evidence women may need on the higher end of that, says DeSimone. She finds many of the women she works with need eight to nine hours of sleep. While minimal, one study found women tend to sleep an average of 11 minutes longer than men. Research suggests hormones are largely responsible for the ways in which female sleep needs differ from males over their lifespan.

Even if you can’t get enough sleep, says DeSimone, you can still benefit from quality sleep . Parsley’s health coaches offer strategies to optimize your sleep environment and how to create an optimal bedtime routine for restful sleep. Avoiding activities like scrolling social media and checking the news before bed can help, as these stressors can interfere with your natural sleep cycles.

Find a mindful outlet.

Stress management is foundational to health and hormonal balance , says Dr. Wei. “If the body thinks it’s in trouble, it’s going to prioritize cortisol secretion,” which, as noted above, can lead to estrogen dominance.

According to one study , this relationship may be bidirectional; researchers found that menopausal women who received estrogen replacement therapy experienced higher cortisol levels than those who did not. If you release cortisol in response to stress, and that drives your estrogen up, the estrogen spike may then drive your cortisol up further. According to a Medical Hypotheses study, this estrogen-cortisol feedback loop is present in cats, and may also be present in humans.

While there’s no one-size-fits-all approach to stress relief, there are myriad strategies you can try. Here are a few:

Find joy. According to DeSimone, you might find joy in a creative outlet like dancing, or art. But you don’t need to carve out time for a new hobby to feel better; Dr. Wei emphasizes the importance of simply slowing down enough to appreciate the small, beautiful moments you might otherwise miss.

Be mindful.Dr. Wei recommends some form of mindfulness to all her patients. While guided meditations and apps work for some, taking a walk and appreciating nature is her personal go-to.

Exercise frequently. Exercise can not only lower blood pressure (another risk factor for fibroids), it’s also an excellent stress reliever . DeSimone notes that her exercise recommendations vary from client to client so, in general, it’s important to find a form of movement you enjoy.

Manage environmental risk factors.

Man-made estrogens, or endocrine disruptors , found in many common health, cleaning, and beauty products can contribute to estrogen dominance. To minimize environmental risk factors, substituting items like non-stick cookware and conventional cosmetics with clean alternatives is a great starting point, says Dr. Wei. According to the literature , even fetal exposure to synthetic estrogens increases the risk of developing uterine fibroids. DeSimone suggests visiting the Environmental Working Group website to find out where endocrine disruptors are lurking and identify healthier alternatives.

The takeaway:

A holistic approach to fibroid treatment might sound overwhelming but it doesn’t need to be. With Parsley physician and health coach support , you’ll co-create a personalized, sustainable treatment plan that meets you where you are. If you and your doctor determine surgery may be an appropriate option for you, they can also guide you through recovery and help you prevent future recurrences of uterine fibroids.

If you have been diagnosed with fibroids, I know that you’re already aware of what you should be avoiding (dairy, red meat, all the white stuff). You probably know that the birth control pill can only manage your symptoms and might make them worse when you come off. You want to get a handle on the pain, discomfort and heavy bleeding long term and you want to see some positive change soon. Maybe you also want to try for a baby or maybe you’re just looking to get your old self back again.

If you already know what to avoid as a fibroid sufferer, then you’re already tapped into the idea of food as potential medicine. Some foods make hormonally-sourced conditions worse, and some make them better. Food can alleviate symptoms and even shrink those fibroids back to manageable size. If you think of dairy, red meat, all the white stuff as stimulating and inflaming the fibroids, then these foods and supplements I’ll list here do the opposite – they will calm your internal eco-system and create the right environment for your body to balance itself.

My choices of foods and supplements for you are based on my knowledge and understanding of the root cause of fibroids. According to Western medicine, no one knows for sure what causes fibroids, and you may have heard this from your doctor. However we do know this one very important fact – they are affected by excess estrogen in the body which makes them grow and they will often decrease in size after menopause (when overall body estrogen is lower). So you need an approach to your diet and health that supports your body to process and eliminate this excess estrogen as efficiently and rapidly as possible. You need to create a low estrogen environment in your body. This is why you may have heard that women with fibroids should specifically avoid meat and dairy products from animals treated with synthetic hormones – these are unnecessary and powerful estrogens that can create estrogen dominance and make fibroids grow.  

The 5 foods you should eat if you have fibroids

Flax seeds –  These are part of a food group called “selective estrogen receptor modulators.” This means they affect the effect estrogen has on different parts of the body. Flax seeds inhibit estrogen sensitivity in the uterus, which is beneficial when you have fibroids. They are also a fantastic source of fiber which you need to move excess estrogen out of your bowel as quickly as possible to eliminate it from your body. Finally, flax seeds are a great source of omega-3 fatty acids (which reduce the insulin resistance that can suppress liver function) and lignans (which bind to estrogen receptors and prevent absorption of excess estrogen).

Soy – For those of you who know my work, I’m not a big fan of soy for women in their reproductive years.  But in the case of fibroids, certain forms of soy can be beneficial. Specifically seek out non-processed, organic soy in the form of tempeh and miso to add to your diet.  This kind of soy has an anti-estrogenic affect on the uterus. Avoid all processed soy like soy cheese, soy meat and other meat and dairy replacements. Moderation is key here and I wouldn’t recommend having soy every day, but unprocessed and organic soy is a useful dietary tool for managing fibroids.

Beans – Legumes are an excellent source of fiber and protein, plus they have a low glycemic impact which reduces the kind inflammation that can increase fibroid growth. You should focus on kidney beans, lentils, and mung beans. As many fibroid sufferers know to reduce their intake of meat, beans and legumes can be a healthy protein replacement.

Whole grains – If you know to stay away from the white processed stuff like bread, pasta, and noodles then you’ll sure be looking for a way to replace these in your diet. Whole grains help with insulin stabilization.  High insulin levels from white starchy stuff (which acts like sugar in the body) is a factor in making fibroids grow. Whole grains are also a great source of fiber and will help to speed up the process and elimination of excess estrogen.

Pears and apples – These are liver-supporting foods. A well-functioning liver is key to preventing estrogen dominance developing in your body, and its symptoms like fibroids. Pears and apples contain a flavonoid named phloretin which impairs tumor growth, along with lots of fiber. This flavonoid actual blocks the production of estrogen.

The 3 supplements you should take if you have fibroids

Milk thistle – for detoxification and protection of your liver, allowing for more efficient processing and elimination of excess estrogen

Maitaki and shiitake mushroom extract – to boost your immune system and slow fibroid growth

Chlorophyll – fibroids cause heavy periods and this, coupled with a low meat intake, can leave some women anemic. Chlorophyll is almost molecularly identical to hemoglobin, the difference being magnesium versus iron, but it does help replace what is lost with bleeding and so help with your fatigue and immunity.

Always remember, that once you have the right information about how your body really works, you can start making health choices that finally start to work for you! You can do this – the science of your body is on your side!

to your FLO,

Alisa

Good things come in threes:

I want to hear from you!

First, do you have fibroids?

Second, do you already avoid meat, dairy and the white stuff?

Third, everyone you know is hormonal – spread a little good ovary karma and share this article on social 😉

Need more Hormone Help?

If you’re needing some health upgrading, it’s time you started you looking into what’s going on with your hormones.

Massive Fibroid Tumors Journey | My Symptoms, Diagnosis, and Pre-Op Myomectomy/C-Section

I’ve designed a 4 day hormone detox and evaluation to help you understand exactly what’s out of whack and how you can start getting back to balance so that your hormones no longer have to suffer.

Click here to get your FREE detox and evaluation!

MONTHLY FLO:

Ready to Reclaim Your Health?

You don’t need to solve your symptoms all by yourself. I designed MonthlyFLO to help you understand the science of your cycle and fast track your healing. Thousands of women around the world have taken my virtual health program, MonthlyFLO and reclaimed their health from conditions like severe PMS, PCOS, Fibroids, Endo, Cysts and more!  If you’re ready to feel better, check out

Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens. The objective of this case-control study was to evaluate the relation between uterine fibroid risk and phytoestrogen exposure. Two overnight urine collections (48 h apart) from 170 uterine fibroid cases and 173 controls were analyzed for isoflavonoids (ie, daidzein, genistein, equol, and O-desmethylangolensin) and lignans (enterodiol and enterolactone). Logistic regression was used to determine associations between the mean excretion of the 2 collections and the risk of uterine fibroids. Unadjusted isoflavone excretion did not differ significantly between cases and controls (2.33 +/- 5.82 and 2.60 +/- 5.90 nmol/mg Cr, respectively; P = 0.68), but cases excreted significantly less lignans than did controls (2.86 +/- 3.45 and 4.57 +/- 6.67 nmol/mg Cr, respectively; P < 0.01). The trend for a reduced risk of uterine fibroids with increasing quartiles of lignan excretion was significant (odds ratio for highest versus lowest quartile = 0.31; 95% CI: 0.17, 0.58; P for trend < 0.01). When adjusted for age, BMI, race, family history of uterine fibroids, and isoflavone excretion, this trend remained but was attenuated (P = 0.07). Our findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. No association was found between isoflavone excretion and uterine fibroids; however, the intake of soy foods, the primary source of isoflavones, was low in this population.

LOCARNO, SWITZERLAND & EASTON, PA – October 20, 2006 – A new study published in the American Journal of Clinical Nutrition (2006; v84, 587-93), has demonstrated a possible relationship between lignans and risk of uterine fibroids.

According to the study authors, uterine fibroids are hormonally responsive. Growth of fibroids is initiated by estradiol and progesterone, and fibroids shrink through gonadotrophin-releasing hormone agonists. The researchers analyzed 170 uterine fibroid cases and 173 controls for isoflavonoids (i.e. genistein, daidzein, equol) and lignans (enterolactone and enterodiol). Researchers collected two overnight urine samples (48 hours apart). Logistic regression was used to determine associations between excretion and the risk of uterine fibroids. The findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. When considering two human lignans measured, this association was most notable for enterolactone. No association was found between isoflavone excretion and uterine fibroids, yet the researchers noted that soy intake was low in this study population.

WERBUNG

“This study is good news for lignans and their potential for supporting women’s health,” said Robin Ward, Vice President of Marketing, Linnea Inc.

“Specifically, 7-hydroxymatairesinol, found in most potent and economically viable concentrations in Norway spruce, has been shown to directly raise enterolactone levels. Although these new data on uterine fibroids are preliminary in nature, it may be sensible to consider that 7-hydroxymatairesinol a useful dietary supplement for women who are concerned about uterine fibroids.”

Derived from Norway spruce (Picea abies), HMRlignan™ is a direct enterolactone precursor dietary supplement. It is a proprietary and patent-protected product manufactured and marketed worldwide by Linnea, Switzerland.

About Linnea

From its headquarters and manufacturing facility in Locarno, Switzerland, Linnea specializes in the manufacture of botanical extracts and phytochemicals, and is a leading supplier to the pharmaceutical, dietary supplement and cosmetic industries. HMRlignan™ is a proprietary, patent protected, product manufactured by Linnea SA. The company’s U.S. office, Linnea Inc., is located in Easton, Pennsylvania. For more information about HMRlignan™,

What does fibroid discharge look like?

LOCARNO, Switzerland—In a study published in the American Journal of Clinical Nutrition (84:587-93, 2006), a possible relationship was found between dietary lignans and risk of uterine fibroids. Researchers analyzed 170 uterine fibroid cases and 173 controls for isoflavonoids (i.e. genistein, daidzein, equol) and lignans (enterolactone and enterodiol). Researchers collected two overnight urine samples (48 hours apart); logistic regression was used to determine associations between excretion and the risk of uterine fibroids. Findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. When considering two human lignans measured, this association was most notable for enterolactone. No association was found between isoflavone excretion and uterine fibroids, yet the researchers noted that soy intake was low in this study population.

“Although these new data on uterine fibroids are preliminary in nature, it may be sensible to consider that 7-hydroxymatairesinol a useful dietary supplement for women who are concerned about uterine fibroids,” said Robin Ward, vice president of marketing for Linnea, the supplier of HMRlignan™.

In addition, 7-hydroxymatairesinol was found to be the dominating lignan in wheat, triticale, barley, corn, amaranth, and millet and oat bran. Researchers at the Abo Akedemi University, Department of Biochemistry and Pharmacy, analyzed 24 plant lignans through HPLC-MS/MS in bran extracts of 16 cereal species, four nut species and oilseeds (sesame and linseeds). Of these 24 lignans, 18 were previously unidentified in these sources; 16 of the lignans were identified in analyzed samples. According to study authors, the proportion of new lignans of the total lignan content exceeds 50 percent—i.e., the new lignans are dominant in wheat, barley, corn, and quinoa bran and in amaranth. Further, in triticale bran, the proportion is nearly 50 percent, and in rye, oats, buckwheat, millet, and dhurra bran, the proportion is between 26 and 44 percent. In spelt wheat and all rice species, the proportion is between 3 and 16 percent. Ward added, “With its abundance in grains and other foods, it is clear that 7-hydroxymatairesinol is a significant source of dietary lignans as part of a healthy diet regimen. The new research validates HMRlignan as an exceptional choice for inclusion in dietary supplements and functional foods.”

What does it feel like to expel a fibroid?

Fibroid expulsion is the term used when uterine fibroids are passed out of the body. A small percentage of women experience symptomatic fibroid expulsion after undergoing uterine fibroid embolization (UFE) for their fibroids. Here’s what you should know.

What causes fibroid expulsion?

The UFE procedure cuts off blood supply to fibroids in the uterus to shrink the fibroids and help alleviate their symptoms. In some cases, the blood-starved fibroid passes out of the body. This event is unusual and rarely causes serious problems, and can lead to drastically reduced symptoms and uterine size.

According to Richard Shlansky-Goldberg, MD, Interventional Radiologist and Professor of Radiology, Obstetrics & Gynecology, and Surgery at the Hospital of the University of Pennsylvania in Philadelphia, PA, as well as the leader of the study, the process can occur anywhere from weeks to years after UFE.

How often does fibroid expulsion occur?

A study published in the Journal of Vascular and Interventional Radiology sought to better understand fibroid expulsion and its impacts on patients’ health. The study examined the histories of 759 women who had undergone UFE between July 1999 and June 2009.

The study found that almost 4.9 percent of the UFE patients experienced fibroid expulsion within 3.5 months of the procedure. Of those 37 women, only 5 percent had any symptoms to go along with the expulsion. Symptoms include cramping and vaginal discharge.

It’s significant to note that the determining factor in whether or not a woman had symptoms during fibroid expulsion was whether or not it was a “bulk expulsion.” During a bulk expulsion, large pieces of the fibroid (or even the entire fibroid), passed from the body. In total, eighty-nine percent of the women who had symptomatic fibroid expulsion experienced bulk expulsion.

“Fibroids that have a higher likelihood of expulsion include the pedunculated and submucosal types of fibroids,” Dr. Shlansky-Goldberg says.

Does fibroid expulsion require medical intervention?

Importantly, fibroid expulsion often safely occurs without medical intervention. Almost half of all cases studied occurred at home or in the doctor’s office with a minimally invasive transvaginal procedure. Women who have had children tend to have greater success with fibroid expulsion than those who have not.

That said, there are times when further medical intervention becomes necessary. For example, fibroids that are only partially expelled may need to be removed with gynecological treatment.

Fibroid Expulsion

In the study, 27 percent of women who experienced a fibroid expulsion required an operative transvaginal myomectomy. A further eight percent required a hysteroscopic fibroid resection, in which a scope is used to guide the removal of the fibroid.

Hysterectomy

Fibroid expulsion only poses a risk to a woman if the fibroid does not completely leave the body through the vagina, either naturally or through surgical means. In that rare case, there can be a risk of infection that may require a hysterectomy.

In the study, only 4 women (11 percent) out of the 37 who experienced fibroid expulsion required an urgent hysterectomy, and only 2 women (4 percent) elected to have a hysterectomy in order to alleviate symptoms such as chronic vaginal discharge.

Discharge & Cramping

Most of the time, the discharge and cramping that occur with fibroid expulsion only lasts for weeks or months, according to Dr. Shlansky-Goldberg. Notably, he reports that many women are delighted to have the fibroid out, because the removal of the fibroid can lead to a smaller or normal sized uterus.

What should I do if I think I’m experiencing fibroid expulsion?

Patients who think they are experiencing fibroid expulsion should first contact the interventional radiologist who performed the UFE. According to Dr. Shlansky-Goldberg, that doctor will order an MRI to confirm. Then, the doctors can work with the patient to come up with a plan of care.

Communication is Key

Of course, successfully managing any medical condition requires collaboration among the patient and doctors. Communication between interventional radiologists and the gynecologists is especially important if the patient has a history of fibroid expulsion.

At Viva Eve, we’re experts at treating uterine fibroids. Viva Eve we provide high-quality, personalized care for every patient and we’ll partner with you to determine your best treatment options.

What makes fibroids grow fast?

Each year, large number of women in the world including India undergo uterine fibroids treatment. Uterine Fibroids are most common among women who have never been pregnant, who had history of fibroids in their families, and who are overweight or obese.

Medical researchers are still working on the reasons which cause uterine fibroids including the reasons of fibroid’s rapid growth. Here for the purpose of creating awareness I am explaining about the symptoms of fibroids, fibroid’s size and how to slow down uterine fibroid’s growth.

Uterine Fibroid Symptoms

Uterine fibroids are abnormal growth and non-cancerous tumors that develop in woman’s uterus wall. Sometimes these uterine fibroids become too large and cause severe abdominal pain and heavy periods. Uterine fibroids can be very small also, difficult to be detected by the human eye.

Uterine fibroid symptoms can include:

Heavy menstrual bleeding

Periods that are painful

A bloated feeling in your pelvic region

Lower back pain

Painful intercourse

More frequent urination

What May Cause Fibroids to Grow Rapidly?

Genes responsible for growth of uterine muscle and other abnormalities in uterine blood vessels may be fibroids growth reason.

As per medical research, estrogen and possibly progesterone is also a factor that contribute towards the growth of uterine fibroid.

Fibroids can’t grow without these natural female hormones, which is why symptoms often stop once a woman enters menopause.

Size of Uterine Fibroid

It’s difficult to predict how big a fibroid will grow or what causes a fibroid to grow rapidly. Fibroids can be of different sizes and can grow at a different speed in each women. Sometimes, uterine fibroids vanish on their own and even without any treatment.

Uterine Fibroid Size can range from smaller than a pea to larger than a melon. It is seen that most women who had uterine fibroids, have enlarged uterus. In fact, a very large fibroid can expand the uterus to the size of a second-trimester pregnancy and press against the bowel or bladder, causing constipation or frequent urination.

Very large fibroids may cause the abdomen to swell to the point that it’s difficult for a doctor to conduct a thorough pelvic exam.

Left unattended, very large fibroids can begin to degenerate or burst, even if they aren’t causing any symptoms. Uterine fibroids start degenerating occurs when the fibroid does not get enough blood supply, causing the cells of the fibroid to die. This typically causes abrupt, severe pain and tenderness.

Uterine Fibroids Treatment

Uterine fibroids prevention is not known, but some precautionary measures can be taken that may slow down uterine fibroid growth or minimize symptoms, such as adopting a fibroid-friendly diet.

A study showed that women who consumed milk, cheese, ice cream, or other dairy products at least once a day were less likely to develop fibroids than women who consumed dairy less frequently.

Another study showed that compounds from green tea inhibit the growth of fibroid cells and eventually increased the death rate of these cells. Artificial hormones, that can be used in birth control pills, tend to decrease the growth of uterine fibroid.

If you’ve been diagnosed with fibroids, there are treatment options available depending on a number of factors, including the size, location and number of fibroids. Minimal invasive treatment procedures like uterine fibroid embolization is a very good and effective technique to treat uterine fibroid and its success rate is very high.

Uterine fibroid embolization has the longest track record and has a significantly lower rate of major complications compared with surgery.

Is Almond good for fibroids?

Living with fibroids often means living with pain and anxiety. It makes sense to explore ways that might prevent this condition or at least lessen its symptoms. While no diet can guarantee fibroid prevention, altering the food you eat may help slow fibroid growth. An even better plan? Take control of the problem while fibroids are still small. Research all your treatment options. Be in the driver’s seat when it comes to your body.

Below is a complete guide on how fibroids and your diet may interact and what changes you can make that might help with a fibroid issue. While there is little medical data that supports foods shrinking fibroids, there is evidence that changing your diet may help soften or suppress fibroid symptoms.

As with all dietary-based approaches, the hard part is sticking to the program. Many women prefer to shrink fibroids with a non-surgical, non-invasive procedure called Uterine Fibroid Embolization (UFE). UFE alleviates fibroid symptoms by reversing the fibroid growth process.

What Does a Fibroids Diet Look Like? Does It Help?

Studies have yet to provide complete evidence as to why fibroids occur. Many scientists suspect estrogen levels play a significant role in fibroid development. Some fibroid treatments focus on methods to reduce a woman’s estrogen levels. Generally, this involves estrogen suppressant therapy. Most physicians will only recommend this kind of treatment for a short time. The adverse elements to interrupting a body’s natural hormone levels and/or artificially supplementing the body with suppression or stimulation of hormones have significant risks in the long term.

But what if the diet is an important factor in hormones that stimulate fibroid growth? What if you are getting estrogen ‘boosts’ from foods you eat regularly?

How Do Diet Increase Estrogen Levels?

You already know that many modern food products are treated with environmental estrogens. Industrial-agro fruits and vegetables are often sprayed with xenoestrogens to stimulate quicker growth. Farmed fish are treated with estradiol for the same reason.

Many of the things we eat have been treated with hormones. Switching to organic-based products can help lower the amount of estrogen in your diet. You can also try eating foods that help lower the estrogen that you, yourself, are producing. And you can avoid foods that are naturally high in estrogen.

The warning signs of uterine fibroids

Combine all these efforts, and you decrease the amount of estrogen intake from food. This can work toward slowing fibroid growth and lessening your symptoms.

Foods that support liver function are also very important. By keeping the liver healthy, you help the body rid of excess toxins, which boost your immune system.

Best Food Candidates for a Fibroids Diet

There are no foods proven to shrink fibroids. However, consider adding these foods to your diet plan in order to decrease estrogen levels.

Cruciferous Vegetables

These veggies are crucial for helping your liver detox. We recommend you don’t overcook them, or they lose a lot of nutrients.

Broccoli

Cabbage

Bok choy

Kale

Turnips

Watercress

Radish

Arugula

Detox Agents

Explore foods that boost the body’s detox ability.

Garlic

Beets

Ginger

Turmeric

Plenty of water

Polyphenol (Antioxidant)

An antioxidant called polyphenol, which is found in green tea, can help counteract estrogen. Incorporating green tea into the diet daily may help curb estrogen levels.

Carotenes

A good amount of carotenes supports overall health.

Apricots

Cantaloupe

Carrots

Pumpkin

Spinach

High Vitamin E Foods

Vitamin E, Vitamin B, magnesium, and omega-3 fatty acids may help reduce fibroid symptoms. Foods with plenty of Vitamin E include:

Almonds

Wheat germ

Hazelnuts

Cod liver oil

Anti-Inflammatories Are Your Friends

You may have heard about pineapple and fibroids. Pineapple is one of the major anti-inflammatory foods. Fresh rosemary also helps decrease inflammation.

Multivitamins Daily

Vitamin balance in the body contributes to overall health. While we prefer getting vitamins directly from natural foods, an adult multivitamin is often the default setting for many women. Look for multivitamins that include 100% Daily Value amounts of:

B1 (thiamin)

B2 (riboflavin)

B3 (niacin)

B12

B6

Vitamins C, D, E

Folic acid

Max of 15,000 IUs of beta-carotene (Vitamin A).

Worst Foods For Fibroids

While no single food has been linked to causing fibroids, certain foods could put you at greater risk for fibroid occurrence. Why? They contain and elevated estrogen. Eliminating them may help you better regulate your estrogen levels.

Foods that Increase Estrogen

Red meat

Alcohol

Animal fats

Cheese

Cream

Butter

Ice cream

Chocolate

Soy and soy products

Be sure to trim fat from turkey and chicken, as it could boost estrogen levels as well.

Type of Milk

Whole milk might be delicious, but low-fat is a better option. Better still? Switch to non-dairy. Oat or almond milk is less likely to aggravate a fibroid condition. Be aware that soy milk is not a wise choice. Soy products are estrogen elevators. (see below)

Soy Products

Prolonged consumption of soy products has been linked to higher estrogen levels. While the occasional bite of tofu or a soy latte won’t cause too much harm, the overall pattern for soy-rich foods is pretty clear. Soy and soy products are estrogen rich. And the prevalence of soy and soy-based products across our modern diet makes removing them a challenge.

Sweetener Types

Watch out for artificial sweeteners. While they aren’t estrogen rich, there is evidence they affect gut bacteria and hormone balance. Eating natural sugar isn’t a good idea either. High insulin (caused by an elevated sugar intake) lowers the sex hormone-binding globulin (SHBG), which dumps estrogen in your system and can contribute to symptoms like sore breasts, fibroids, and heavy menses. Eliminating sweeteners from your diet is doable but difficult.

Plastic Containers

While durable and convenient, plastic containers can influence estrogen levels in the body. BPA, a chemical found in many plastic containers, mimics estrogen. Studies show that food often absorbs small amounts of plastic from plastic containers. Consider storing edibles in glass, paper, or ceramic containers.

Speak With Your Doctor About a Fibroid Diet

An estrogen suppressive diet doesn’t guarantee you will stop fibroid growth or eliminate symptoms. But it may be worth the work. Positive dietary changes are attainable (and you don’t need medical insurance to reap their benefits). You might see positive results from a diet that lowers estrogen and raises your immune system.

The reality is that dietary changes alone are unlikely to end a fibroid problem. Diet can’t address the root cause. As long as your body produces estrogen (which is natural, if you’re not well into menopause), as long as fibroids have a blood supply (which allows them to grow and thrive), you are likely to be stuck in a symptom cycle.

Know all your treatment options

Think about treatment earlier versus later. Think less invasive versus surgical. You’re the boss of your body. Research all your choices.

Some women will move from symptomatic to asymptomatic with a strict dietary change. Others will get minimal or zero relief. Lowering estrogen levels and boosting antioxidants might help. But it won’t cure. The most important thing in a treatment journey? Address fibroids before they have a chance to change your life, your body, your freedom. You will save months, or years, or even decades of ill-health, restriction, and regret.

To learn more about treating uterine fibroids non-surgically by blocking fibroid blood supply, please contact us. You may find relief with dietary changes. If you don’t, we’re here with a proven and highly successful non-surgical alternative. Find out about Uterine Fibroid Embolization.

What can I eat to shrink my fibroids?

Sometimes, the only way to treat uterine fibroids is with medicine or surgery. But some people may improve their symptoms simply by making changes in their diet, exercise, and stress management routines.

Even if you need medical treatment, natural approaches like acupuncture, lifestyle changes, and supplements may help you feel better.

By understanding all of your options, you might be able to reduce, or even get rid of, pain and other symptoms you have from fibroids. Here are some easy do’s and don’ts you can follow that may make a difference in helping you feel better.

Do’s …

Load up on fresh fruits and vegetables. A recent study found that eating plenty of fruits like apples and tomatoes, and cruciferous vegetables like broccoli and cabbage, could lower the risk of developing fibroids. And, eating healthier choices like organic fruits and vegetables and whole-grain foods could help improve your symptoms.

Keep an eye on your blood pressure. Researchers have shown a strong link between fibroids and high blood pressure. Talk to your doctor about how to manage your blood pressure, either with diet, lifestyle, or medication.

Manage your stress level. While researchers are still examining the impact of stress on fibroids, some studies suggest the two may be linked. Try relaxation techniques like yoga, massage, and tai chi to help manage your stress. Some women find that alternative therapies like acupuncture can help relieve their period pain, too.

Make yourself comfortable. If you’re having painful periods because of your fibroids, try lying down and elevating your legs with a pillow. Or lie on your side and bring your knees into your chest to take the pressure off your back.

Talk to your doctor before trying any supplements. There is some research that suggests supplements like vitamin D could be helpful in lowering your risk for fibroids.

While some alternative medicine practitioners recommend supplements like raspberry leaf tea to support pregnancy and treat issues like PMS, it’s not recommended for fibroids. That’s because the tea can have an estrogen-like effect on the body and make your problem worse. That’s why it’s always important to discuss all medications and supplements -- even if they’re natural -- with your doctor. They could have side effects you’re not aware of.

SUGGESTED

Don’ts …

Don’t eat a diet full of processed foods, red meats, and high-fat dairy. Studies show that eating these foods can make your fibroids worse. The same goes for alcohol and caffeine.

Don’t skip your workouts. One study found that women who exercised the most (about 7 hours per week of activities like running, dancing, or walking) had the lowest chance of developing fibroids. Exercise can also help keep your blood pressure down.

Don’t overdo it on the sugar. A study found that eating a high-sugar diet could be linked to a higher risk of fibroids.

Don’t smoke. Experts believe that smoking can increase your period pain because it reduces the amount of oxygen that gets to your pelvic region.

Which fruit can shrink fibroid?

Here at the Midwest Institute for Non-Surgical Therapy (MINT), we’re often asked the question “Can fibroids shrink with diet?” In truth, diet alone cannot cure fibroids, however, a well-balanced diet can and does help to ease many of the symptoms and complications associated with fibroid growth.

So what exactly are fibroids and how do they occur?

Uterine fibroids are non-cancerous growths that form in and around the walls of the uterus. While they are not life-threatening, they do affect somewhere between 70% – 80% of all women at some point during their lifetime. Consisting of a combination of muscle and other tissue, they can be as small as a seed or as large as a watermelon. Women can also develop multiple fibroids.

Unfortunately, doctors cannot universally agree on what causes fibroids. However, it’s thought that being overweight can trigger them, as can having low levels of certain nutrients.

While only around 20-50% of women develop physical symptoms such as:

Pain

Anemia

Constipation

Heavy menstrual bleeding

Difficulty in becoming pregnant &

Miscarriages

it’s suggested that certain foods and balanced diets may play a role in reducing any risk or easing possible symptoms.

So, in answer to the question “Can fibroids shrink with diet alone?” the foods you eat may contribute towards alleviating some of the symptoms. More importantly, the right foods can assist in balancing hormones that may or may not trigger fibroid growth in the first place.

So, what foods should you consider and why?

A Mediterranean diet

This is not so much of a food type but a lifestyle change. It’s well-documented that a Mediterranean diet can reduce the risk of strokes, heart attacks, type II diabetes and of course, weight gain. In addition, some studies found that Vitamin D contained in many foods that typically make up a Mediterranean diet, including sardines, may help to prevent fibroid cells from producing fibrous tissue.

As such, you may want to eat more:

Uterine Fibroid Embolization | Cheryl Hoffman, MD | UCLAMDChat

Fresh vegetables – including, broccoli, asparagus, spinach, and the healthiest vegetable of all – kale. These are all great for your iron intake and therefore can help to tackle anemia, so often a bi-symptom of fibroids – but also, kale is high in Indole 3 Carbinol which is thought to help prevent the development of estrogen-driven fibroid production.

Fruits – such as tomatoes, apples, grapes, figs, melons, peaches and avocado can also help to lower the risk of fibroids. Pears and apples particularly contain a flavonoid known as phloretin which is an estrogen blocker. In some cases, this can also help to impair fibroid growth.

Wholegrains such as nuts and seeds – some of these food varieties are part of a group known as ‘selective estrogen receptor modulators’ – Flax seeds, in particular, can inhibit estrogen sensitivity in the uterus. Nuts and seeds are also a great source of fiber.

Oily fish – like sardines, mackerel, salmon, and tuna, are rich in vitamin D but also contain essential fatty acids which have anti-inflammatory properties. Seafood like shrimp, clams, and mussels are rich in vitamin B12 which can help to alleviate the symptoms of anemia – often a condition of fibroids.

Olive oil – a Mediterranean diet wouldn’t be complete without olive oil. Olive oil – particularly extra virgin varieties – contain high levels of polyphenol oleocanthal. This is thought to inhibit the production of prostaglandin – an inflammatory molecule – and may, therefore, help to prevent or ease fibroid inflammation in some cases.

The key takeaway – Can fibroids shrink with diet?

Eating a balanced diet – particularly a Mediterranean diet, is great for shedding those extra pounds and can play a part in maintaining your overall health. So while fibroids may not always be prevented, adopting significant lifestyle changes along with a healthy diet are some of the first steps you should take in treating fibroids and alleviating any symptoms or conditions.

The next step if a patient is experiencing conditions like those listed earlier, is to undergo treatment.

Here at the Midwest Institute for Non-Surgical Therapy (MINT), we carry out a process known as Uterine Fibroid Embolization. UFE is a revolutionary non-surgical treatment that allows patients to undergo a pinhole incision to remove troublesome fibroids while still retaining the uterus. Recovery takes just 1-2 days and no stay in hospital is needed. The main advantage apart from a speedy recovery is that because the uterus remains intact, women are still able to conceive naturally if they wish.

Does vitamin D shrink fibroids?

We often get asked if Vitamin D is good for fibroids and if Vitamin D can help shrink fibroids. We have looked at the research and although it is not definitive, there is growing evidence to suggest that oral Vitamin D supplementation can help stop fibroid growth and may even help to shrink fibroids. We review the evidence here and answer common questions about Vitamin D and its effects on uterine fibroids.

Does Vitamin D Shrink Fibroids?Does Vitamin D Shrink Fibroids?

In this Article

The relationship between vitamin D deficiency and uterine fibroids

Do vitamin D supplements stop fibroids from growing?

Do vitamin D supplements shrink fibroids?

Research on other vitamins in uterine fibroids

Frequently asked questions about vitamin D and uterine fibroids

 

What is Vitamin D?

Vitamin D is a fat-soluble vitamin that helps your body use calcium, magnesium, and phosphate. Vitamin D is also classified as a hormone due to its effects on the reproductive system.

Types of Vitamin D

Vitamin D comes in several forms—vitamin D1, vitamin D2, and vitamin D3. Vitamin D1 (calciferol) is found in fish oils. Vitamin D2 (ergocalciferol) is found in plants. Vitamin D3 (cholecalciferol) is produced by the body when UV light from the sun interacts with cholesterol in the skin. The most active form of vitamin D is called 25-hydroxyvitamin D3. It has activity in almost every tissue of our bodies [12].

Studies on Vitamin D and Fibroids

Vitamin D Deficiency and Uterine Fibroids

Studies have shown that low vitamin D levels in the blood are more commonly associated with the presence of uterine fibroids [4-6]. Women with sufficient vitamin D levels were estimated to lower their odds of uterine fibroid occurrence by 32 percent as compared with patients who had vitamin D deficiency [4]. 

Do Vitamin D Supplements Stop Fibroids from Growing?

The first research study conducted to understand vitamin D’s effect on uterine fibroid growth was done in 2009 by Blauer et al [7]. The results showed that when uterine fibroid cells obtained from women who had undergone hysterectomy were treated with vitamin 25-hydroxyvitamin D3, uterine fibroid growth slowed down. In fact, greater vitamin D concentrations led to greater inhibited fibroid growth. In another study by Sharan et al., 25-hydroxyvitamin D3 was shown to inhibit the proliferation of immortal uterine fibroid cells [8]. 

A 2016 study conducted by Ciavattini et al. examined 108 women who received vitamin D supplementation and who had “small burden” uterine fibroids. Participants had less than 4 fibroids each, and each fibroid measured less than 5 cm in diameter. The study found that women who did not take vitamin D supplements experienced an average fibroid volume growth of 40% in one year of follow-up, whereas women that regularly took vitamin D supplements experienced no fibroid growth during the same timeframe [3]. 

A recent 2020 study by Arjeh et al analyzing the effects of vitamin D on uterine fibroids showed similar results. Vitamin D deficient women with less than 4 uterine fibroids (largest one less than 10 cm in diameter) who received weekly oral high dose vitamin D saw inhibited fibroid growth by the end of the 12-week long study. Meanwhile, women who received the placebo saw uterine fibroid volume increase [9].

Do Vitamin D Supplements Shrink Fibroids?

A 2019 research study done in Iran by Hajhashemi et al. showed that Vitamin D supplementation decreased uterine fibroid size [1]. Sixty-nine vitamin D deficient participants with 1 to 2 uterine fibroids 2 to 8 cm in size completed the study. Participants were randomly assigned to receive a 50,000 IUs dosage of vitamin D every 2 weeks for 10 weeks (35 women) or a placebo tablet at the same frequency (34 women). Uterine fibroid size was measured in all women before the start of the study and again 6 months after. The results indicated that uterine fibroid size significantly decreased in the group that used vitamin D as compared to the placebo group [1]. 

What Other Vitamins Help Shrink Fibroids?

There is also some medical science indicating the potential therapeutic effects of vitamin A. One study showed that women with a greater dietary intake of fruit and preformed vitamin A obtained from animal sources had a lower risk of developing uterine fibroids [11]. In another study, human uterine fibroid smooth muscle cells responded to treatment with a potent natural derivative of vitamin A called all-trans retinoic acid (ATRA). Increased doses of ATRA led to an increased anti-proliferating effect on fibroid cells. When proliferation was inhibited by ATRA, changes in smooth muscle cell morphology also occurred. Inhibition in proliferation and altered morphology were reversible when ATRA treatment was discontinued [10].

It is unclear if Vitamin C and Vitamin E are good for uterine fibroids because they have not been as widely studied [2]. Therefore, it is difficult to conclude their beneficial effects, if any exist.

FAQ

Is Vitamin D Good for Fibroids?

Vitamin D has been shown to help stop or decrease fibroid growth. It is unclear if vitamin D can shrink fibroids in volume. 

Can Vitamin D Help with Fibroids?

Multiple studies have demonstrated that vitamin D deficient women with existing uterine fibroids who take oral vitamin D supplementation experience inhibited fibroid growth. Though promising, these results are not conclusive. Always consult your doctor before adding a new supplement or vitamin to your diet.

Does Low Vitamin D Cause Fibroids?

Low vitamin D levels are associated with the presence of uterine fibroids, however, many other factors contribute to the development of uterine fibroids. 

How Much Vitamin D Should I take to Shrink Fibroids?

7,000 international units (IU) of oral vitamin D per day or 50,000 IU/week can help treat vitamin D deficiency, which may help inhibit fibroid growth. Always consult your doctor before adding a new supplement or vitamin to your diet.

Other Fibroid Shrinking Blog Articles

Non-Surgical, Vitamins, Medications, & Supplements Used To Shrink Fibroids

Shrink Fibroids with Apple Cider Vinegar: Does it Really Work? 

Dr. Michael Lalezarian fibroid specialistDr. Michael Lalezarian fibroid specialist

About the Author

Dr. Michael Lalezarian is a practicing interventional radiologist with the Fibroid Specialists of University Vascular in Los Angeles, CA. In addition to patient care, Dr. Lalezarian teaches and supervises medical students, residents, and fellows as a full time teaching Professor in the Department of Radiology at UCLA. He is regarded as an expert in uterine fibroid embolization. You can view Dr. Lalezarian's full bio here.

Can vitamin C shrink fibroids?

Background: Uterine fibroids significantly affect the quality of life of reproductive-age women. The socioeconomic cost and psychological strain on patients cannot be overemphasized. The role of diet and micronutrients on the onset and development of uterine fibroids has come under review in recent times. This study assessed the levels of some micronutrients and trace elements in the serum of women with uterine fibroids.

Methods: Eighty-eight women were recruited from the Gynecology Outpatient Clinic of Lagos University Teaching Hospital, 44 with uterine fibroids and 44 women without uterine fibroids. Blood samples were obtained and analyzed for serum levels of selected micronutrients (vitamins A, C, D, and E) and trace elements (calcium, magnesium, and phosphorus). Pelvic ultrasonography was performed on all study participants.

Results: Women with uterine fibroids had statistically significant lower serum levels of vitamin C (1.20 ± 0.59 vs 1.62 ± 1.75 mg/dl; p = 0.01), vitamin D (34.23 ±10.67 vs 37.06 ±11.46 ng/ml; p = 0.04), and calcium (2.27 ± 0.19 vs 2.32 ± 0.09 mmol/L; p = 0.02) compared with women without uterine fibroids. There was no significant difference in the serum levels of vitamins A (39.63 ± 15.71 vs 40.09 ±15.26 μ/dl; p = 0.91), vitamin E (5.44 ± 4.65 vs 5.26 ± 4.62 µg/mL; p = 0.87), magnesium (0.89 ± 0.09 vs 0.89 ± 0.08 mmol/L; p = 0.78), and phosphorus (1.29 ± 0.38 vs 1.19 ± 0.17 mmol/L; p = 0.14) in women with uterine fibroids compared to those without uterine fibroids.

Conclusion: This study showed lower serum levels of vitamin C, vitamin D, and calcium in women with uterine fibroids when compared to women without uterine fibroids. It is possible that these micronutrients and trace elements may play a role in the etiopathogenesis, progression, and/or proliferation of uterine fibroids. However, whether the findings of low serum levels of these elements are a cause or an effect of uterine fibroid, is yet to be determined.

Introduction

Uterine fibroids are benign gynecological tumors seen in reproductive-age women and the most common indication for hysterectomy globally [1]. Women with symptomatic uterine fibroids present with a history of heavy menstrual bleeding, abnormal uterine bleeding, pelvic pressure symptoms like urinary frequency, incontinence, constipation, and tenesmus and pelvic pain. It is indeed a disease of public health importance as its impact on the quality of life, loss of work hours, short-term disability, absenteeism and psychological strain on patients cannot be overemphasized. In fact, a study by Cardozo et al. found the annual societal cost of uterine fibroid in the United States to be more than that for breast, colon, or ovarian cancer, and nearly one-fifth the cost of diabetes [2].

The importance of micronutrients is expressed in the characteristic deficiency states that arise when these nutrients are deficient in the human body. Most notable are scurvy from vitamin C deficiency, rickets from vitamin D deficiency, megaloblastic anaemia from B12 deficiency, osteoporosis from calcium deficiency, etc. Research into the role of micronutrients in the prevention or treatment of disease as well as optimizing health has been on the increase as more people seek natural alternatives and scientists better understand the biochemistry of these substances. Some epidemiological studies suggest a potential association between diet and hormone-modulated diseases [3,4]. Vitamins and minerals, collectively known as micronutrients play very important roles in metabolism and tissue maintenance, with most of them functioning as cofactors, coenzymes, gene control, and antioxidants. As cofactors, they modulate the activity of enzymes or are an integral part of the enzyme prosthetic group; as coenzymes, they play an active role in the complexing of biochemical reactions, in gene control they regulate transcription of receptors, and as antioxidants, they act as scavengers of free radicals [5]. Vitamins are available either as water-soluble (vitamins B and C) or fat-soluble (vitamins A, D, E, and K) while minerals are available as microminerals (iron, copper, iodine, zinc, and fluoride) or trace elements (calcium, magnesium, phosphorus, sodium, and potassium). Micronutrients are not produced by the body and must therefore be obtained from dietary sources.

Although the etiopathogenesis of uterine fibroids is not well understood, it is known, that proliferation of smooth muscle cells and excessive extracellular matrix deposition are the main features of uterine fibroids development and that oestrogen and progesterone play a prominent role in the initiation and promotion of uterine fibroids [6-8]. The relationship between breast cancer (a disease modulated by oestrogen) and micronutrients suggests that women who ate diets rich in micronutrients had a reduced risk of developing breast cancer [9,10]. Islam et al. suggested that certain dietary or alternative treatments may be effective for uterine fibroids [11]. Several observational studies also suggest that increased consumption of fruits, vegetables, and dairy may reduce the risk of developing uterine fibroids [12,13].

Dr. David Samadi - Can Birth Control Pills Treat Fibroids?

Micronutrients have certain properties that may reduce the risk of uterine fibroids in women, for example, carotenoids. Vitamins C and E have antioxidant properties that stabilize cell membranes and prevent DNA damage and consequent mutations as a result of oxidative stress. Magnesium, calcium, and phosphorus function as co-factors in the synthesis and repair of DNA and regulation of hormones [14]. Ciebiera et al. found elevated levels of alpha-tocopherol in women with uterine fibroid and concluded that vitamin E as a phytoestrogen may modulate estrogen receptors and increase oestrogen levels, thereby increasing the odds of developing uterine fibroids [15]. The few studies that have evaluated the role of micronutrients in the pathogenesis of uterine fibroids have been inconsistent and carried out mostly in the Caucasian and African-American populations as against African women in whom the disease burden is greater. This study, therefore, seeks to compare the pre-operative serum levels of some micronutrients (vitamins A, C, D, and E) and trace elements (calcium, magnesium, and phosphorus) in women with and without uterine fibroids in Lagos.

Materials & Methods

This was a cross-sectional study carried out at the Gynaecology Outpatient Clinic of Lagos University Teaching Hospital from July 1, 2019, to January 31, 2020. Eighty-eight women aged 20-45 years who met the eligibility criteria and gave a written informed consent were recruited into the study. A structured proforma was used to get information by face-to-face interview. Data collected included: socio-demographic parameters, medical, drug and obstetric history, menstrual history, history of dysmenorrhea, deep dyspareunia, non-cyclical chronic pelvic pain, gastrointestinal and lower urinary tract symptoms, and history of uterine fibroids in first degree relatives. Anthropometry was assessed and body mass index (BMI) was calculated.

Women who were pregnant, lactating, smokers, currently using vitamin supplements were excluded from the study to reduce confounders.

At enrolment, study participants were screened using a portable 2D ultrasound unit Sonostar 15 SS-10 (Sonostar Technologies Co., Ltd., Guangdong, China) with a 5 MHz probe at the Gynaecology Outpatient Clinic by a single investigator (ASH). Eligible participants were then referred to the Department of Radiodiagnosis LUTH for a pelvic ultrasonography with Doppler studies by an experienced sonologist (ATA). The pelvic ultrasonography was performed using a 3D ultrasound unit TUS-X100S (Toshiba Diagnostic Ultrasound Systems Ltd., Japan) with a transabdominal (5.0 MHz) and/or transvaginal (7.0 MHz) ultrasound probes as appropriate. Pelvic scan was interpreted in real-time and images stored in soft and hard copies. Each fibroid was measured in sagittal and axial views and the maximum diameter was taken for the study. Women with ultrasound diagnosis of uterine fibroids were assigned to the fibroid group (n=44) and those without uterine fibroids were age matched within (±2 years) to those with uterine fibroids and assigned to the no fibroid group (n=44).

Sample collection and laboratory methods

A plain vacutainer and an ethylenediaminetetraacetic acid (EDTA) vacutainer were labelled with the unique identification number of each woman. Ten milliliters of venous blood was obtained from the antecubital vein, using a peripheral venous catheter, 5 ml was placed in a plain vacutainer and 5 ml into an EDTA vacutainer. The samples were allowed to clot for two hours at room temperature, centrifuged using Eppendorf 5415C centrifuge (Eppendorf AG, Germany) at 3000 rpm for 15 minutes, the serum supernatant removed with a sterile Pasteur pipette, and equal volumes were aliquoted into two cryogenic vials and frozen at −80 °C at the Central Research Laboratory in LUTH. The serum samples were allowed to thaw on the workbench and all assays performed at room temperature as one batch. 

Assay of Vitamin A

Determination of vitamin A was performed using human vitamin A Elisa Kit, CSB-E07889h (Cusabio Technology LLC, Houston, TX, USA), following the manufacturer’s instruction.

Assay of Vitamin C

Determination of Vitamin C was performed using human vitamin C Elisa Kit, MBS726748 (MyBioSource, Inc. San Diego, CA, USA), following the manufacturer’s instruction.

Assay of Vitamin D

Determination of Vitamin D was performed using human 25 (OH) vitamin D Elisa Kit, VD220B (Calbiotech, Inc., El Cajon, CA, USA), following the manufacturer’s instruction.

Assay of Vitamin E

Determination of Vitamin E was performed using human vitamin E Elisa Kit, CSB-E07893h (Cusabio Technology LLC, Houston, TX, USA), following the manufacturer’s instruction.

The optical density of each micronutrient was determined using a microplate reader MR-96A-Mindray (China) set to 450 nm.

Assay of Calcium, Magnesium, and Phosphorus

Serum calcium, magnesium, and phosphorus levels were analysed using a fully automated chemistry analyzer, COBAS INTEGRA 400 (Roche Diagnostics International AG, Rotkreuz, Switzerland) plus by using system compatible packs.

Statistical analysis

Analysis was done using the IBM Statistical Package for Social Sciences (SPSS) Statistics for Windows, Version 25.0 (Armonk, NY: IBM Corp). Data were presented as tables. Shapiro-Wilk test was used to test for normality. Normally distributed continuous variables were presented as mean ± standard deviation, while non-parametric variables were presented as median ± interquartile range. Student’s T-test and Chi square test were used to compare normally distributed continuous variables and categorical variables, respectively. P-value less than 0.05 was considered statistically significant.

Ethical considerations

Ethical approval was obtained from the HREC of LUTH, and all included study participants gave voluntary and informed consent. The Helsinki declaration ethical principles were observed throughout the conduct of the study.

Results

All 88 women, 44 with uterine fibroids and 44 without uterine fibroids were included in the statistical analysis.

Sociodemographic parameters of participants

Table 1 shows the sociodemographic parameters of the two groups. There was no statistically significant difference in the sociodemographic parameters between the two groups.

Variables Fibroid (N = 44) No fibroid (N = 44) χ2 p-value

Mean (SD) Mean (SD)

Age 38.3 (6.5) 35.9 (7.5) t = 1.55 0.132*

Parity 0.93 (1.5) 0.77 (1.3) t = 0.54 0.592*

BMI (kg/m2) 26.88 (5.18) 26.14 (4.38) t = 0.76 0.470*

  n (%) n (%)  

Ethnicity

   Igbo 11 (25) 22 (50) 7.94 0.064

   Yoruba 22 (50) 18 (40.9)  

   Others 11 (25) 4 (9.1)  

Level of education

   Primary 1 (2.3) 1 (2.3) 0.00 1.000

   Secondary 7 (15.9) 7 (15.9)  

   Tertiary 36 (81.8) 36 (81.8)  

Employment status

   Employed 36 (81.8) 32 (72.7) 2.92 0.234

   Unemployed 8 (18.2) 12 (27.3)  

Marital status

   Married 26 (59.1) 26 (59.1) 0.00 1.000

   Single 18 (40.9) 18 (40.9)  

Socioeconomic status

   Semi-skilled 15 (34.1) 20 (45.5) 1.41 0.493

   Skilled professional 24 (54.5) 21 (47.7)  

   Unskilled 5 (11.4) 3 (6.8)  

Table 1: Sociodemographic characteristics of participants

*Independent t-test; SD: standard deviation.

Baseline characteristics of participants

Table 2 shows the baseline characteristics of the participants. More women with uterine fibroids reported dysmenorrhea (84.1% vs 47.7%; p < 0.001), heavy menstrual bleeding (72.7% vs 40.9%; p = 0.003), urinary frequency (63.6% vs 18.2%; p < 0.001), use of analgesics (70.5% vs 31.8%; p < 0.001), and presence of fibroids in their first-degree relatives (38.6% vs 18.2%; p = 0.034) when compared with women without uterine fibroids.

Variables Fibroid (n = 44) No fibroid (n = 44) χ2 p-value

n (%) n (%)

Heavy menstrual bleeding

   Yes 32 (72.7) 18 (40.9) 9.08 0.003

   No 12 (27.3) 26 (59.1)  

Dysmenorrhoea

   Yes 37 (84.1) 21 (47.7) 12.95 < 0.001

   No 7 (15.9) 23 (52.3)  

Dyspareunia

   Yes 9 (20.5) 10 (22.7) 0.07 0.802

   No 35 (79.5) 34 (77.3)  

Analgesic use

   Yes 31 (70.5) 14 (31.8) 13.14 < 0.001

   No 13 (29.5) 30 (68.2)  

Recent blood transfusion

   Yes 9 (20.5) 3 (6.8) 3.47 0.064

   No 35 (79.5) 41 (93.2)  

Urinary frequency

   Yes 28 (63.6) 8 (18.2) 18.80 < 0.001

   No 16 (36.4) 36 (81.8)  

Fibroid in the first-degree relative

   Yes 17 (38.6) 8 (18.2) 4.53 0.034

   No 27 (61.4) 36 (81.8)  

Table 2: Baseline characteristics of participants

Ultrasonographic parameters of uterine fibroids

Table 3 shows the ultrasonographic findings among participants with uterine fibroids. About half (47.7%) of the participants had uterine fibroids less than 20 weeks’ gestational size. Half of the fibroids were intramural in position.

Parameters N=44

n (%)

Uterine size in weeks∞

   <20 weeks 29 (65.9)

   >20 weeks 15 (34.1)

Location of fibroids

   Type 1 (sub-mucous) 8 (18.2)

   Type 2–5 (intramural) 22 (50)

   Type 6 (sub-serous) 7 (15.9)

   Hybrid 7 (15.9)

Number of fibroids

   Solitary 13 (29.5)

   Multiple 31 (70.5)

Maximum diameter of largest fibroids

   <50 mm 9 (20.5)

   50–100 mm 21 (47.7)

   >100 mm 14 (31.8)

Table 3: Ultrasonographic parameters of uterine fibroids

∞Abdominal examination in comparison with single intrauterine gestation

Biochemical characteristics of participants

Table 4 shows the biochemical characteristics of participants in both groups. Women with uterine fibroids had statistically significantly lower serum levels of vitamin C, vitamin D, and calcium when compared with women without uterine fibroids. There was no significant difference in the serum levels of vitamins A, vitamin E, magnesium, and phosphorus in women with uterine fibroids when compared with those without uterine fibroids.

Variables Fibroid (n=44) M (SD) No fibroid (n=44) M (SD) t p-value Normal range

Serum vitamin A (μ/dl) 39.63 (15.71) 40.09 (15.26) 0.20 0.91 20–60

Serum vitamin C (mg/dl) 1.20 (0.59) 1.62 (1.75) −1.07 0.01 0.4–2

Serum vitamin D (ng/ml) 34.23 (10.67) 37.06 (11.46) −1.20 0.04 25–80

Serum vitamin E (µg/ml) 5.44 (4.65) 5.26 (4.62) 0.23 0.87 5.5–17 µg/mL

Serum phosphorus (mmol/L) 1.29 (0.38) 1.19 (0.17) 1.48 0.14 0.97–1.45 mmol/L

Serum calcium (mmol/L) 2.27(0.19) 2.32 (0.09) −1.53 0.02 2.25–2.62 mmol/L

Serum magnesium (mmol/L) 0.89(0.09) 0.89 (0.08) 0.11 0.78 0.85–1.10

Table 4: Biochemical characteristics of participants

Discussion

This study aimed to measure and compare serum levels of some micronutrients (vitamin A, vitamin C, vitamin D, vitamin E, calcium, magnesium, and phosphorus) in women with and without uterine fibroids.

In this study, we did not find any significant difference in the sociodemographic and baseline characteristics between the two groups of women. This study found a statistically significant difference in the serum levels of vitamin C, vitamin D, and calcium between the two groups of women. Women with uterine fibroids had lower levels of vitamin C, vitamin D, and calcium when compared with women without uterine fibroids. On the other hand, there was no significant difference in the serum levels of vitamins A, vitamin E, magnesium, and phosphate between women with uterine fibroids and those without. Interestingly, most women in both study groups had the recommended levels or the reference range of all analyzed micronutrients [16].

The finding of lower vitamin C levels in women with uterine fibroids is consistent with the study of Oyeyemi et al. [17]. This may be due to the similarity in the racial population of the study participants. Vitamin C is well known for its antioxidant properties and some recent epidemiological studies suggest a reduction in levels of antioxidants in uterine fibroids [18,19].

The lower level of vitamin C in women with uterine fibroids may be a cause or an effect relationship. Heinonen et al. in their study concluded that the depletion of vitamin C metabolites may be linked to the large quantity of extracellular matrix in uterine fibroids since vitamin C has been shown to be a cofactor in the synthesis of collagen [20]. But in contrast to the findings of Wise et al. who assessed the association of the dietary intake of fruit, vegetables, and different vitamins including vitamin C, and did not find any significant relationships between vitamin C and uterine fibroids [12].

We also found reduced levels of calcium in women with uterine fibroids, compared to those without fibroid. This is consistent with the findings of Dheeraj and Singh in coastal Odisha, India, but contradicts the findings of Oyeyemi et al. in South-West Nigeria where they found higher levels of calcium in women with uterine fibroids [17,21]. This may be due to the difference in the demographics of the study population.

In addition, our study found lower levels of vitamin D in women with uterine fibroids. This is consistent with several studies that have identified vitamin D deficiency/insufficiency as a risk factor for uterine fibroids [22-24].

Strengths of the study

This was a prospective analytical cross-sectional study carried out amongst black women in Nigeria compared to previous studies. Participants were matched by age, to reduce confounders.

Limitations of the study

This study may not be representative of the general population as it was a hospital-based study.

Conclusions

Women with uterine fibroids have lower serum levels of vitamin C, vitamin D, and calcium. It is possible that these micronutrients and trace elements may play a role in aetiopathogenesis, progression and or proliferation of uterine fibroids. However, whether the findings of low serum levels of these elements are as a cause or an effect of uterine fibroid, is yet to be determined.

What vitamins should I take for fibroids?

Fibroid specialist Dr. Michael Lalezarian discusses how to shrink fibroids fast, covering non-surgical treatments, dietary supplements, vitamins, pills, and medications that can help you with fibroid reduction and to find relief from fibroids without having major surgery.

how to shrink fibroidshow to shrink fibroids

If you’ve recently been diagnosed with fibroids, you now face a number of choices around how to best manage them. You may have been offered contraceptive medications to help with bleeding symptoms, or it might be that your fibroids are troublesome enough that your physician has suggested a major surgery to remove your fibroids (myomectomy) or your entire uterus (hysterectomy).

The reality of a major surgery, especially a hysterectomy, leaves many women asking if there are less drastic treatments that shrink fibroid and relieve symptoms.¹ We’re happy to inform you that non-surgical procedures, dietary supplements, and medications are available that may help you find relief from fibroids and ways on how to shrink fibroids. To help you navigate your options, we review each of these treatments and assess how effective they are in shrinking fibroids.

Non-Surgical Procedure That Shrinks Fibroids

Uterine Fibroid Embolization (UFE)

What is UFE? – Uterine fibroid embolization (UFE, pronounced ‘you-fee’) is a non-surgical procedure that shrinks fibroids by cutting off their blood supply. We chose to cover UFE first in this review because it provides lasting relief from fibroid symptoms and the procedure is clinically proven to shrink fibroids.²

How Does UFE Shrink Fibroids? – The UFE procedure involves the injection of micro sized beads into the arteries that feed the fibroids. Fibroids rely on their own blood supply from the uterine arteries to maintain their size, so cutting off their blood supply causes them to ‘starve’ and shrink over time.

The UFE Procedure  – The UFE procedure is performed by an interventional radiologist. The interventional radiologist uses imaging techniques to navigate a small tube (called a catheter) from an artery in the leg or the arm into the uterine arteries where the micro beads are injected. Because UFE is a non-surgical procedure, there are no major incisions and no cutting, which drastically reduces recovery time compared to surgical approaches. The procedure usually takes no longer than an hour, and usually requires an overnight hospital stay. See UFE in action.

shrink fibroids ufeshrink fibroids ufe

How Long Does It Take Fibroids to Shrink after UFE? – Fibroids begin to shrink immediately after the UFE procedure, and continue to shrink throughout the next year. Many women note improvement in their bleeding symptoms immediately following the procedure, but it can take up to 3 months for fibroids to shrink enough for women to notice major symptom improvements.

On average, fibroids have been observed to shrink by 40% to 75% in the first 6 months following UFE.³ One study followed 200 women that underwent UFE and looked at their symptoms 3 months after the procedure. 87% of women noticed an improvement in their menstrual bleeding, and 93% of women noticed and improvement in pelvic pain and pelvic pressure symptoms.²

Possible Vitamins & Supplements For Fibroid Reduction

A few vitamins & dietary supplements for fibroid reduction have been studied, including green tea extract and a specific type of Vitamin D supplement called 25-OH-D3. Laboratory testing and early human studies have shown encouraging results that suggest these dietary supplements may prevent and even shrink fibroids, but we feel that it’s important to emphasize that the clinical data backing these supplements is in its early stages, and these findings are preliminary at best. Learn more about these supplements & vitamins to shrink fibroids below.

Green Tea Extract (EGCG) May Shrink Fibroids

What is Green Tea Extract? – Green tea extract, also called epigallocatechin gallate or EGCG, is available in several dietary supplements. EGCG belongs to a class of compounds called catechins that are found in high amounts in tea leaves, berries, and cocoa. In the biology lab, EGCG has exhibited anti-inflammatory, antioxidant, and antiproliferative effects, all of which may be relevant to shrinking fibroids.⁴

Vitamins and supplements that may shrink fibroidsVitamins and supplements that may shrink fibroids

Do Green Tea Extract Supplements Shrink Fibroids? – There has only been one clinical study on the effects of green tea extract supplements on fibroids. The study group consisted of 39 women with symptomatic uterine fibroids, 33 of which completed the study. Two thirds of the women (22) received 800 mg/day of green tea extract, and the other third (11) received a placebo. Green tea extract intake helped shrink fibroids by over 30% over the course of 4 months. On the other hand, fibroids grew by nearly 25% in the placebo group.⁴

Study Limitations – Despite the small sample size, this was a rather good-quality study in that participants were randomized to their respective groups and blinded to which treatment they received. With that said, it is important to keep in mind that this was only a pilot study and may have produced an exceptional result.

Vitamin D (25-OH-D3) May Shrink Fibroids

What is Vitamin D? – Vitamin D is a fat-soluble vitamin that helps your body use calcium, magnesium, and phosphate. Vitamin D is also responsible for a number of other biological functions that keep you healthy, and appears to play an important role in preventing fibroid growth.

Uterine Fibroids & Menopause

Vitamin D Deficiency in Women with Fibroids – The relationship between Vitamin D deficiency and fibroids is a relatively new area of study in medical science. A recent study has shown that women that are vitamin D deficient are more likely to have fibroids than women that have sufficient vitamin D levels.⁵ In the biology lab, vitamin D halts the growth of fibroid cells, promotes fibroid cell apoptosis, and has been shown to shrink fibroid size by nearly 75% in animal tests involving rats.⁶

Do Vitamin D Supplements Shrink Fibroids? – Vitamin D supplements 25-OH-D3 have been clinically tested in one study of 108 women with “small burden” uterine fibroids, meaning that the women in this study had less than 5 fibroids, each less than 50 mm in diameter, and did not have severe fibroid symptoms that required immediate medical attention. The study found that women who did not take vitamin D supplements experienced an average fibroid volume growth of 40% in one year of follow-up, whereas women that regularly took vitamin D supplements experienced no fibroid growth during the same timeframe.⁷

Study Limitations – Vitamin D supplements did not shrink fibroids in this study, but their halting effect on fibroid growth and progression are encouraging. Larger fibroids, more study participants, or longer follow-up might reveal that vitamin D supplements also shrink fibroids.

Curcumin May Shrink Fibroids

What is Curcumin? – Curcumin is another substance that may help to prevent or shrink fibroids. Curcumin is a yellow substance produced by some plants such as ginger. Curcumin is known to have antioxidative, anti-inflammatory, and anti-cancer activities, and multiple scientific groups have studied the effects of curcumin on uterine fibroid cells. In the biology lab, curcumin appears to prevent the multiplication of fibroid cells and hinders the production of extracellular matrix that assists in the formation of fibroids.⁸⁻⁹

Do Curcumin Supplements Shrink Fibroids? – Although curcumin supplements are available, readers should be aware that curcumin intake has not yet been studied as a treatment for fibroids in humans.¹⁰ In other words, curcumin supplements have not been tested and may actually have no beneficial effect on fibroids.

Pills & Medications That May Shrink Fibroids

Pills and medications that may shrink fibroidsPills and medications that may shrink fibroids

Women with fibroids should be aware that some medical prescriptions for uterine fibroids are not necessarily intended to shrink fibroids. Currently, GnRH agonists are the only medications approved in the United States that are prescribed with the goal of shrinking fibroids. Other medications - DMPA, progestin-releasing IUDs, and birth control pills - are prescribed mainly to help provide relief from bleeding and pain-related symptoms, but have shown mixed results when it comes to shrinking fibroids. It’s also important to understand that DMPA, progestin-releasing IUDs, and certain types of birth control pills have only been tested in women with small fibroids; their effects may be greater or smaller in cases of larger fibroids.

Medications that are used to manage fibroid symptoms work by altering the balance of hormones in your body. By consequence, they tend to have a number of side effects that some women may find intolerable. We encourage our readers to consult with a physician prior to taking any new medication.

Gonadotropin-Releasing Hormone (GnRH) Agonists

What are GnRH Agonists? – GnRH agonists are FDA approved drugs that are prescribed to prepare women for myomectomy surgery. They are administered by injection or in a nasal spray form. 

 

Do GnRH Agonists Shrink Fibroids– GnRH agonists shrink fibroids, shrink the uterus, alleviate heavy menstrual bleeding, and help with anemia. However, the benefits of GnRH Agonists reverse when women stop taking them.¹¹

Side Effects – GnRH agonists are very effective, but also carry a number of significant side effects. GnRH agonists mimic the natural GnRH decapeptide hormone that is released by the hypothalamus to stimulate the secretion of the gonadotropin hormones. When taken, GnRH agonists cause a massive release of gonadotropin hormones that then drastically reduces as the body becomes desensitized. These alterations in hormone levels cause uncomfortable hot flashes and result in significant bone mineral density loss, which is why GnRH treatment is limited to just 6 months and is typically only prescribed to prepare the uterus for myomectomy surgery.¹¹

Depot-Medroxyprogesterone Acetate (DMPA)

What is DMPA? – DMPA (trade name Depo Provera) is a hormonal contraceptive that works by reducing the body’s estradiol (a type of estrogen) and progesterone levels, and is sometimes prescribed to relieve bleeding and painful periods. It is administered by intramuscular injection every 90 days.¹¹ Some early evidence suggests that DMPA may also help to shrink fibroids, and large observational studies suggest that DMPA use can help prevent fibroids altogether.

Does DMPA Shrink Fibroids? – Only one study has looked at the effects of DMPA on fibroid size. This was a very small pilot study of 20 women that observed a 33% reduction in fibroid volume and a 48% reduction in uterine volume over the course of 6 months.¹² These results suggest that DMPA may shrink fibroids, however this is a very early, low-quality evidence by pharmaceutical standards.

DMP and Fibroid Prevention – A handful of observational studies have looked at the relationship between long-term DMPA use and fibroids specifically in African American women. These studies have found that women with a history of taking DMPA were much less likely to be diagnosed with fibroids than women that had never taken DMPA.¹¹ Readers should be aware that the nature of these studies does not definitively establish cause and effect between DMPA use and fibroid prevention, but they do suggest that DMPA may help to prevent fibroids.

Progestin-Releasing Intrauterine Device (IUD)

What is a Progestin-Releasing IUD? – An IUD is a T-shaped device that is inserted into the uterus to provide birth control. A progestin-releasing IUD differs from a copper IUD in that it has a reservoir of the synthetic hormone levonorgestrel (LNG) that is slowly released inside the uterus. In addition to birth control, a progestin-releasing IUD may be prescribed to help manage heavy bleeding and painful periods in women with fibroids, endometriosis, adenomyosis, or endometrial hyperplasia.¹¹

Do Progestin-Releasing IUDs Shrink Fibroids? – Some studies have reported that a progestin-releasing IUD reduces fibroid size while others have shown that the device has no effect on fibroid size. Because of these inconsistent findings, more recent literature has concluded that these devices do not significantly shrink fibroids.¹³⁻¹⁴

Progestin-Based Oral Contraceptives (Birth Control Pills)

Do Oral Contraceptives Shrink Fibroids? – Progestin-based oral contraceptives (birth control pills) are sometimes prescribed to women with symptomatic uterine fibroids to help with heavy bleeding and period pain. Although many studies have looked at the effects of birth control pills on fibroid size, data that shows a benefit is inconsistent. The general scientific consensus is that oral contraceptives do not significantly shrink fibroids,¹⁵ but they may help to prevent the initial development of fibroids.¹¹

How to shrink fibroidsHow to shrink fibroids

How To Shrink Fibroids Summary

There are treatments available that shrink fibroids and do not require you to have a major surgery.

Uterine Fibroid Embolization (UFE) - UFE is a minimally invasive procedure that has been in practice for over 20 years, and has accumulated a wealth of clinical evidence that supports how effective it is in shrinking fibroids and relieving fibroid symptoms.³

Dietary Supplements - Researchers have only recently started looking at the effects of green tea extract and Vitamin D dietary supplements in women with fibroids. Results so far are encouraging in women with especially small fibroids, but early data is rarely definitive and more studies are needed.

Medications - Hormone-modifying medications such as GnRH agonists, DMPA, and progestin-based contraceptives may be prescribed to provide relief from bleeding and painful periods. GnRH agonists are very effective in shrinking fibroids, but are typically only used in women to prepare for fibroid removal surgery because of their harmful side effects. Whether or not DMPA shrinks fibroids is uncertain, and the current evidence for progestin-based contraceptives suggests that they do not have a significant impact on fibroid size.

Other Fibroid Shrinking Blog Articles

Can Vitamin D Shrink Fibroids?

Shrink Fibroids with Apple Cider Vinegar: Does it Really Work? 

dr michael lalezarian fibroid specialistdr michael lalezarian fibroid specialist

About the Author

Dr. Michael Lalezarian is a practicing interventional radiologist with the Fibroid Specialists of University Vascular in Los Angeles, CA. In addition to patient care, Dr. Lalezarian teaches and supervises medical students, residents, and fellows as a full time teaching Professor in the Department of Radiology at UCLA. He is regarded as an expert in uterine fibroid embolization. You can view Dr. Lalezarian's full bio here.

What foods trigger fibroids?

While there is no foolproof way to avoiding fibroids, balancing one’s hormone levels has been known to assist in the management of this common, benign condition. Hormones, particularly estrogen, are one of the leading causes of new fibroid development and growth.

If you are trying to manage your fibroids and maintain or shrink their current size, balancing your hormones naturally is a great first step. Your diet has a strong influence on your hormone levels, which is why it’s one of the first (and easiest) areas to apply changes.

For best results in managing your fibroids, try restricting the following food and drinks from your diet:

High-Fat, Processed Meats – Red processed meat is known to be high in added hormones, particularly estrogen.

High-fat Dairy Products – Conventional dairy can contain high levels of steroids, hormones, and other chemicals that promote inflation.

Foods High in Salt – Highly salted foods are hard on your liver, which is the organ that is most responsible for removing toxins and balancing hormones.

Refined Carbohydrates – White foods such as pasta, white bread, white rice, cakes, and cookies have been known to alter estrogen levels, causing fibroids to increase in size.

Refined Sugar – High consumption of sugar can result in inflammation and weight gain; there is an association between weight gain and hormone imbalance.

Caffeine – Too much caffeine puts additional stress on your liver, discouraging the organ from working the way it should (think: balancing hormones!)

Alcohol – Over-consumption of alcohol can lead to inflammation of the body and reduced immune function. Reducing or eliminating alcohol can help promote a healthy balance of hormones.

We do realize this puts quite the restriction on your diet however there are many options for substitutes in this dietary change. The following foods can help you manage your fibroids:

Organic foods

Green leafy vegetables

Beta-carotene rich foods (such as carrots and sweet potatoes)

Food high in iron (such as grass-fed beef and legumes)

Flaxseeds

Whole grains

Supplements may also help shrink or maintain fibroid size. Vitex, fish oil, B-complex are a few supplements that have been known for creating a better hormone balance. Be sure to speak with your physician before introducing new supplements into your diet.

When Your Diet Isn’t Enough to Control Your Fibroids

Your diet and lifestyle can only do so much in your attempt to manage your fibroids. If you suffer from common fibroid symptoms such as heavy periods, bloating, frequent urination, constipation, and pelvic pain, Uterine Fibroid Embolization (UFE) may be the next best option.

What are the signs of fibroids shrinking?

Fibroids, also called leiomyomas, are benign (noncancerous) tumors that grow inside or on the outer wall of the uterus. Up to 80% of people with uteruses will develop fibroids by the age of 50.1

Fibroid degeneration is the breakdown of a fibroid through cell death. This is caused by ischemia (a lack of adequate blood supply) in the fibroid.2

This ischemia is usually the result of a fibroid growing too large for its blood supply, but it can also be caused by mechanical compression (blockage) of the feeder arteries.3

Signs of Degenerating Fibroids

Verywell / Jessica Olah

Fibroid degeneration can occur during pregnancy when the growth of the pregnancy compromises the blood supply of the fibroid, or when a pedunculated fibroid (a fibroid attached by a thin stalk to the uterus) becomes twisted (torsion) and cuts off the fibroid's blood supply.4

Degeneration or secondary changes can be found in 65% of uterine fibroids.5

Types of Degenerating Fibroids

The type of degeneration appears to depend on the degree and rapidity of onset of the vascular insufficiency (lack of adequate blood supply).6

Types of degenerating fibroids include:4

Hyaline Degeneration

Accounts for 63% of cases

The fibroid’s normal connective tissue and smooth muscle fibers are replaced by hyaline tissue (the most common type of cartilage, which has a glossy and smooth appearance)

Caused by a fibroid outgrowing its blood supply

Myxoid Degeneration

Accounts for 19% of cases

Gelatinous appearance (looks like it's melting) under a microscope

Has clear and mucus-like connective tissue

No mitotic activity (its cells are not dividing and growing as normal cells do)

Can have similar features as some leiomyosarcomas (rare cancer), so it is important that a pathologist takes the time to make the distinctions between the different types of fibroid degenerations

Calcification

Accounts for 8% of cases

Calcium deposits form when a fibroid is dying

Transforms some of the tissue into a hard mass

Cystic Degeneration

Accounts for 4% of cases

Seen more often after menopause

Presents in a liquid, honeycomb pattern under a microscope

May mimic an ovarian cyst4

Red Degeneration

Accounts for 3% of cases

Also called "carneous"

Usually occurs during pregnancy, but can happen in people who are not pregnant, particularly those using contraceptive drugs

Turns almost completely red due to massive internal hemorrhaging (bleeding)

Usually from a ruptured blood vessel inside the fibroid

Fibroid degeneration during pregnancy is called necrobiosis

Fibroids occur in up to 12.5% of all pregnancies2

Can cause abnormal bleeding and severe abdominal pain

Can be caused by fibroid tissue outgrowing its blood supply

Can be caused by the growing uterus causing distortion and kinking of the blood vessels, interfering with the blood supply to the fibroid

Pain may also be caused by the prostaglandins (hormones that influence pain levels and inflammation) produced by damage to the cells in the fibroid

Pedunculated fibroids (fibroids attached to the uterus by a thin stalk) are more prone to degeneration because they can become twisted and cut off the blood supply to the fibroid. They can be more painful and last longer than regular degeneration.7

I have fibroids causing irregular bleeding: Should I worry?

Symptoms 

Typical symptoms of fibroids can include:6

Menstrual periods lasting longer than seven days

More frequent menstrual periods

Heavier than normal bleeding during menstrual period

Painful menstrual periods

Irregular bleeding between periods

Pelvic pain

Abdominal pain

Sudden or severe abdominal pain

Abdominal bloating and/or cramping

A feeling of fullness or heaviness in the pelvis/lower abdomen

Fever

Pain during sex

Lower back and/or thigh pain

Anemia

Urinary incontinence

Frequent urination

Difficulty urinating or other bladder symptoms

Constipation

Rectal pressure

Difficulty with bowel movements, or other bowel symptoms

In addition to the symptoms of fibroids, signs that fibroids may be degenerating include:1

Acute pain: Most common symptom. A sharp pain in the abdomen that may be accompanied by swelling. May be acute pelvic pain focused on the site of the fibroid. Can last from a few days to a few weeks.

Chronic pain: Less severe, lasting pelvic pain

Fever: Often during pregnancy. May be mild.

Bleeding: May be severe. Seek immediate care for abnormally heavy bleeding, including during menstrual periods.

Temporary elevation in the white blood cell count8

Are Fibroids Always Symptomatic?

Fibroids do not always cause symptoms. Many people with fibroids experience few or no symptoms and may not realize they have fibroids. It is possible for degenerating fibroids to also be asymptomatic, but they tend to cause more, and more severe, symptoms than fibroids alone. For many people, degenerating fibroids are their first indication that they have fibroids at all.1

 Symptoms of Uterine Fibroids

Your Symptoms May Go Away

When a fibroid degenerates, it shrinks. Once it has reduced to a size that can once again be supported by its blood supply, it can stop degenerating. This often causes the pain to decrease or subside.9

Though symptoms may have gone away, it is still important to see a healthcare professional and address the problem. Fibroids will begin to grow again once they start receiving adequate blood supply, and will eventually reach the point they start degenerating again, causing a painful cycle.

When to See a Doctor

Any symptoms of fibroids or degenerating fibroids warrant a visit to a healthcare provider. While fibroids themselves are not usually life-threatening, they can cause discomfort and complications such as anemia, and put stress on surrounding organs.

In addition to the fibroids themselves, symptoms of degenerating fibroids can mimic more serious conditions, and can also be harder to diagnose with imaging equipment.

Seek immediate medical attention if:10

You have severe vaginal bleeding.

You have new or worse belly or pelvic pain.

Preventing Degeneration

The best way to prevent fibroids from degenerating is to treat the fibroids before they degenerate and take measures to stop them from recurring.

Fibroid Treatment

Treatment for fibroids and fibroid symptoms include:6

Medications such as:

Tranexamic acid (TXA)

Combined oral contraceptive pills

Progestin-releasing IUD (intrauterine device)

Progestin pills

Gonadotropin-releasing hormone (GnRH) agonists

NSAIDs (nonsteroidal anti-inflammatory drugs)

Surgeries such as:

Hysterectomy (removal of the uterus)

Myomectomy (removal of the fibroids)

Medical procedures such as:

Uterine fibroid embolization: A catheter is placed through the groin into the uterine artery, where small coils or pellets are released to block the blood supply to the fibroids.

Radiofrequency ablation: High-energy waves are used to generate heat that destroys fibroids.11

Magnetic resonance imaging (MRI)–guided focused ultrasound: High-intensity ultrasound waves are used while the person is in an MRI scanner to heat and destroy the uterine fibroids.

Endometrial ablation: Heat is used to destroy the endometrium (the lining of the uterus).

Frequently Asked Questions

How long does fibroid degeneration take?

The pain from a degenerating fibroid can last from a few days to a few weeks, but everyone experiences fibroids differently.

It is still important to seek medical care after the symptoms subside, as fibroids are likely to grow and degenerate again.9

How do you help fibroid degeneration pain?

In the short term, pain from a degenerating fibroid can be managed by taking an NSAID medication, such as ibuprofen (Advil, Motrin), or naproxen (Aleve).1

For long-term, and often permanent, relief, the fibroids need to be treated and/or removed.

What happens to a fibroid after degeneration?

Fibroids shrink during degeneration until they are small enough to reestablish an adequate blood supply.9

Once this happens, the fibroids begin to grow again until they get too big and start the process of degeneration again.

For this reason, it is important to seek medical care for degenerating fibroids, even if symptoms subside.

A Word From Verywell

Fibroid degeneration can be painful and may cause unpleasant symptoms, but it can be managed and even go away completely with treatment.

If you notice any signs of fibroids or fibroid degeneration, see your healthcare provider.

Was this page helpful?

What can dissolve fibroids?

Uterine fibroids are common, noncancerous growths that develop in the uterus. Some people use natural treatments and dietary changes to relieve the symptoms associated with fibroids. But do these treatments work?

Not all uterine fibroids cause symptoms, and they do not always need treatment. Fibroids can shrink and disappear, especially after menopause. A person may have fibroids without knowing it.

Doctors can recommend some medical treatments for fibroids, but some people may also try dietary methods and herbal medicines to relieve symptoms. However, there is very little research to say that they are effective.

In this article, we explore the evidence behind natural treatments for fibroids, including herbal remedies, and dietary and lifestyle changes.

What are fibroids?

A person with fibroids may experience heavy periods.

Fibroids, also called leiomyomas, are noncancerous tumors that sometimes develop in the uterus. They are the most commonTrusted Source noncancerous gynecological tumor in premenopausal people. Estimates vary, but according to the Office on Women’s Health, fibroids may affect between 20 and 80%Trusted Source of people before age 50.

Around 1 in 3 females with fibroids may experience symptoms that can include:

Treatment for Uterine Fibroids - Women's Health

heavy or painful periods

abdominal or lower back pain

frequent urination

constipation

dyspareunia, or pain during sex

Can natural treatments help with fibroids?

In many cases, fibroids shrink and disappear without treatment. However, if a person experiences bothersome or severe symptoms, a doctor may recommend treatment, which includes birth control pills or surgery.

Some medications can shrink fibroids, but they often result in adverse side effects. For this reason, doctors typically only prescribe drugs for short term use or in preparation for surgery.

However, there have been few studies to date that confirm whether changes in diet or using herbal remedies can help treat fibroids or prevent someone from developing them.

One 2016 article investigated the possible role of diet and complementary or alternative medicine in treating fibroids. It concluded that although some foods might reduce the risk of developing fibroids, others might increase the risk. It was also unable to confirm whether herbal medicines can help.

Of the studies that do exist, most cite research from cell cultures or animals. This means that researchers do not know whether the remedies will have the same effects in humans.

Scientists must carry out more research on humans before medical professionals can recommend any complementary medicine or other natural remedies for the management or treatment of fibroids.

However, some experts believe that some lifestyle changes can enhance a person’s quality of life and help improve some of the symptoms associated with fibroids, such as painful periods and depression. These changes include eating a healthful diet, getting regular exercise, and using relaxation techniques.

The following sections look in more detail at some of the natural treatments that may help a person with fibroids.

Dietary changes

The following sections look at dietary changes that might help with fibroids:

Meat

A plant based diet may help reduce symptoms of fibroids.

Some research suggests that people who eat a diet high in red meat and high energy-dense foods, which are foods that contain lots of calories, fat, and sugar, may be more likely to develop fibroids. Replacing red meat (beef, ham, or lamb) with white meat (chicken or turkey) may help.

In general, replacing red meats with white meats or plant based sources of protein, such as beans, could be a good move for health. According to the American Heart AssociationTrusted Source, meat contains high levels of saturated and trans fats, which can raise cholesterol and worsen heart disease.

Vitamins

The results of a study from 2011Trusted Source, which looked at over 22,583 premenopausal females, suggested that people who ate more fruit and more animal-derived vitamin A were less likely to have uterine fibroids. They did not find links with vitamins C or E, folate, or carotenoids.

Animal sources of vitamin A includeTrusted Source dairy products, fish, and meat.

Foods that contain certain vitamins may protect against fibroids and also increase the healthfulness of a person’s diet. These include:

oily fish, such as salmon, mackerel, and tuna

foods rich in flavonoids, including berries

green vegetables, such as broccoli, spinach, and lettuce

citrus fruits, such as lemons and limes

soya products

broad beans

If a person is unable to get enough of a particular vitamin through their diet, they can consider taking vitamin supplements.

Alcohol and caffeine

A study from 2004Trusted Source looked at the link between fibroids and alcohol and caffeine in black females in the United States. The results suggested that fibroids had links with alcohol, particularly beer, but they did not find an association with caffeine.

When considering these studies, it is important to note that just because there is a link between factors (correlation), it does not mean that one causes the other (causality). For example, if a specific diet has associations with a higher likelihood of fibroids, it does not mean that people who follow that diet will develop fibroids.

Herbal remedies

Small scale research studies have looked at the effects of various herbal remedies for fibroids, such as green tea and Chinese medicine. More research is needed before doctors recommend these treatments. The following sections discuss current research.

Green tea

Green tea contains chemicals called flavanols, which are antioxidants. Antioxidants help to reduce cell damage in the body by reducing oxidative stress. Oxidative stress is a significant cause of disease.

A 2013 studyTrusted Source looked at the effects of taking green tea extract (epigallocatechin gallate) on 33 females with one or more fibroids. The participants took either 800 milligrams (mg) of green tea or a placebo for 4 months. The authors report that those who took green tea extract had less severe fibroids symptoms and that their fibroids became smaller.

Drinking green tea may, therefore, help with fibroids. However, more research is needed before healthcare professionals recommend green tea for fibroids.

Resveratrol

Resveratrol is a chemical that plants produce when they are under environmental stress and infection. Natural foods that contain resveratrol include blueberries, mulberries, raspberries, and grapes.

Research suggestsTrusted Source that resveratrol may stop cell growth and reproduction of uterine fibroid cells. However, these studies looked at the effects of resveratrol on cell cultures. Researchers do not know if eating foods that contain resveratrol will affect fibroids.

Curcumin

Curcumin is one of the active ingredients in turmeric. It has antioxidant, anti-inflammatory, and antibacterial properties.

Some research suggests thatTrusted Source curcumin can destroy fibrotic cells or stop them from reproducing. Again, cell cultures form the bases of these studies, and researchers need to look at its effects on humans to know whether it will be useful.

Lifestyle changes

Regular exercise may improve symptoms.

Some people may find that lifestyle factors can help improve symptoms associated with fibroids, such as painful or heavy periods and depression. These include:

regular exercise

breathing exercises

eating a healthful diet

tai-chi

yoga

Fibroids are more common in people who are overweight or obese, so maintaining a healthful weight can also protect against fibroids. Getting regular exercise and eating a healthful diet are very effective ways to lose weight.

Medical treatments

Not all fibroids require treatment. If they produce symptoms, a doctor may recommend a range of treatments depending on how severe the symptoms are.

Birth control pills and progesterone-like treatments — such as Depo-Provera injections or intrauterine devices (IUDs) — can help control heavy menstrual bleeding. However, they do not shrink the fibroids.

Doctors can prescribe drugs that shrink fibroids, called gonadotropin-releasing hormone agonists (GnRHa), such as Lupron. However, they can have severe side effects, such as bone loss, so people usually take them for just 6 months. When they stop taking them, the fibroids often grow back.

A range of surgical optionsTrusted Source can also help treat fibroids. People can talk to their doctor about the best treatment options for them.

MEDICAL NEWS TODAY NEWSLETTER

Knowledge is power. Get our free daily newsletter.

Dig deeper into the health topics you care about most. Subscribe to our facts-first newsletter today.

Enter your email

Your privacy is important to us. Any information you provide to us via this website may be placed by us on servers located in countries outside of the EU. If you do not agree to such placement, do not provide the information.

Summary

Uterine fibroids are common noncancerous growths in the uterus. Although they may not be cancerous, they can affect a person’s quality of life.

Doctors can prescribe hormonal therapy and other medications to treat the symptoms of uterine fibroids, though their effectiveness is limited. Surgery is the most effective treatment.

Although some research suggests that diet and herbal remedies can help with fibroids, many studies in this area not methodologically strong or not carried out in humans. Further research is necessary to confirm these findings, and people should speak with their doctor about any dietary changes they can make to improve their health.

 Can FlaxSeed shrink fibroids?

Dr Romana Nowak and her team, from the University of Illinois, focus their research on determining the physiological causes of uterine leiomyoma formation and investigating potential treatments for this disease.

Uterine leiomyomas (fibroids) can be detected in an extraordinary number of women: projected numbers range from 20–80% being affected by the age of 50. Uterine leiomyomas are thought to arise as a response to local inflammation in the myometrial tissue, which is the muscle layer of the uterus. Ovarian hormones, such as oestrogen, influence uterine fibroid formation by stimulating smooth muscle cell proliferation and collagen deposition. Fibroid dimensions vary considerably, from microscopic to grapefruit-sized and many women may be asymptomatic and unaware that they have this disease. This can be dangerous as uterine leiomyomas can ultimately cause extensive uterine bleeding, anaemia and, most devastatingly, infertility and miscarriages.

Hormonal therapy, surgical procedures (such as myomectomy or hysterectomy) and arterial embolism are the main therapeutic options currently used to treat uterine fibroids. In the USA alone, approximately 200,000 hysterectomies and 30,000 myomectomies are performed annually. However, these treatments can have severe side-effects. Hormonal therapy can cause menopausal-like symptoms including osteoporosis and hot flushes, and hysterectomies render patients infertile. Furthermore, these treatments are expensive – they cost the USA 5.9–9.34 billion dollars annually. Clearly, there is a compelling case to develop cost-effective and efficient alternative treatments.

As one of the most common gynaecological problems, it is shocking that we know so little about the specific physiological pathways regulating the development of these tumours. Dr Nowak’s research focuses on improving our understanding and investigating preventative therapeutic options to inhibit fibroid formation, reducing the risk of lasting damage and the potential need for surgical intervention.

Researching Pathologies Using Animal Models

Animal models are common research tools used to further our knowledge of certain human pathologies – and uterine fibroids are no exception. Dr Nowak and her team have confirmed that the domestic laying hen is the most appropriate animal model used to study uterine fibroid formation because hens suffer from oviductal leiomyomas (the oviduct is a long tube where the egg becomes fully formed) that are histologically and physiologically very similar to uterine fibroids found in women.

What does the ‘Hen Model’ show?

Dr Nowak and her team performed a histological analysis on 263 sexually mature hens and found that over the four year reproductive lifespan of hens, the incidence of oviductal fibroids increased dramatically from 2.5% in year one to 77.3% in year four. Furthermore, the team confirmed that oviductal leiomyomas increased in frequency and size in the older population.

Dr Nowak’s research has shown that year-three laying hens given a diet of 10% flaxseed exhibited uterine fibroids that were 40% smaller on average compared to those found in control hensQuote_brain

Immunohistochemical analysis indicated that, like uterine fibroids, hen oviductal leiomyomas are comprised of smooth muscle cells and collagen. Gene expression analyses supported this finding – the tumour cells showed an increased expression of oestrogen/progesterone receptors and fibrosis genes, such as collagen type 1.

Overall, these results support Dr Nowak’s hypothesis that uterine fibroid formation results from inflammation or damage caused by menstruation or pathogen exposure (uterine fibroid incidence in pathogen-free hens was 10% – significantly lower compared to pathogen-exposed hens). Resultant inflammation within the uterine myometrial tissue reduces blood supply, causing oxidative stress and hypoxia, contributing to fibroid formation.

Treatment Using FlaxSeed

Using this hypothesis, Dr Nowak’s research team are now focused on identifying effective treatments to decrease the inflammatory response and hence reduce the number and severity of uterine fibroids. In fact, initial research suggests that dietary intervention could offer a revolutionary new type of treatment.

Dr Nowak’s research has shown that year-three laying hens given a diet of 10% flaxseed exhibited uterine fibroids that were 40% smaller compared to those found in control hens. This may be because flaxseed is rich in bioactive components such as omega-3 fatty acids which have significant anti-inflammatory activity.

Reduction in inflammation

This exciting finding was supported by genetic studies which analysed the mRNA expression levels of cyclooxygenase-2 (Cox-2) encoded by the prostaglandin synthetase 2 gene. Cox-2 is an enzyme involved in prostaglandin production which triggers inflammation. It was found that hens fed on flaxseed had significantly reduced expression levels of Cox-2, compared to the control hens, because the omega-3 fatty acids inhibit the Cox-2 enzyme, thus suppressing prostaglandin production and reducing inflammation.

Dr Nowak has also shown that curcumin – the active component of turmeric – is also anti-inflammatory and, when fed to hens, similarly reduces Cox-2 expression.

Lowered oestrogen activity

Flaxseed also contains a phytoestrogen called lignin that has been shown to reduce oestrogen activity by inhibiting the aromatase enzyme (which converts androgens to oestrogen) and blocking oestrogen receptors located on the surface of fibroid smooth muscle cells. Oestrogen inhibition may reduce the proliferation of the smooth muscle cells and collagen deposition further limiting fibroid formation and growth.

Dr Nowak has also shown that treating human fibroid smooth muscle cells in culture with mushroom polysaccharides reduces smooth muscle cell proliferation, and inhibits collagen type 1 and aromatase gene expression.

Other Therapeutic Benefits of FlaxSeed

Interestingly, flaxseed could also be an effective therapeutic option for diseases other than uterine fibroids. Currently, Dr Nowak and her team are investigating the effects of flaxseed on chronic gut-associated diseases such as Crohn’s colitis and inflammatory bowel disease (IBD). Microbiota activity is extremely important for gut health and Dr Nowak is looking to investigate the effects of flaxseed on the microbiome composition. This will be achieved by feeding hens a diet of 10% flaxseed and comparing their gut microflora against control-diet-fed birds. The team hypothesises that the anti-inflammatory properties of flaxseed may also reduce the severity of these gut-associated diseases by altering the gut microbiome.

Further Research

Finally, Dr Nowak and her team are investigating other dietary factors that could be used as potential treatments, comparing their efficiency against flaxseed. For example, they are currently looking at vitamin D (known to have potent anti-inflammatory properties) and halofuginone (an anti-fibrotic drug). Initial research indicates that both of these may inhibit cell proliferation and collagen deposition.

Overall, preliminary results arising from Dr Nowak’s various studies indicate that flaxseed could offer a promising alternative to existing therapies which may have unpleasant side effects or involve invasive surgery. Although further research is needed to validate these results, Dr Nowak’s work could lead to a radical change in how we treat inflammatory disease, including uterine leiomyomas, through dietary intervention.

Background: Uterine fibroids are hormonally responsive; estradiol and progesterone stimulate their growth, and gonadotrophin-releasing hormone agonists shrink them. Phytoestrogens, including isoflavones and lignans, can act as weak estrogens or antiestrogens.

Objective: The objective of this case-control study was to evaluate the relation between uterine fibroid risk and phytoestrogen exposure.

What are Fibroids? What are the symptoms?

Design: Two overnight urine collections (48 h apart) from 170 uterine fibroid cases and 173 controls were analyzed for isoflavonoids (ie, daidzein, genistein, equol, and O-desmethylangolensin) and lignans (enterodiol and enterolactone). Logistic regression was used to determine associations between the mean excretion of the 2 collections and the risk of uterine fibroids.

Results: Unadjusted isoflavone excretion did not differ significantly between cases and controls (2.33 +/- 5.82 and 2.60 +/- 5.90 nmol/mg Cr, respectively; P = 0.68), but cases excreted significantly less lignans than did controls (2.86 +/- 3.45 and 4.57 +/- 6.67 nmol/mg Cr, respectively; P < 0.01). The trend for a reduced risk of uterine fibroids with increasing quartiles of lignan excretion was significant (odds ratio for highest versus lowest quartile = 0.31; 95% CI: 0.17, 0.58; P for trend < 0.01). When adjusted for age, BMI, race, family history of uterine fibroids, and isoflavone excretion, this trend remained but was attenuated (P = 0.07).

Conclusions: Our findings suggest a modest inverse association between lignan excretion and uterine fibroid risk. Whether this relation represents an effect of lignans per se or of other constituents of lignan-containing foods on the development of uterine fibroids remains to be determined. No association was found between isoflavone excretion and uterine fibroids; however, the intake of soy foods, the primary source of isoflavones, was low in this population.

How can I get rid of fibroids naturally without surgery?

Fibroids are abnormal growths in the uterus. They’re also called uterine fibroids, myomas, and leiomyomas.

Fibroids aren’t cancerous or life threatening, but they can sometimes cause complications and health problems.

Fibroids form in and around the uterine walls. They’re made of muscle and other tissues. They may be as tiny as a seed or grow larger than a tennis ball. You may have multiple fibroids or just one.

Doctors don’t know exactly what causes fibroids. Having overweight or obesity increases your risk, as does having low levels of some types of nutrients.

Prevalence

Almost 80 percentTrusted Source of women have fibroids in their lifetime. This condition may also be genetic. You’re at higher risk if your mother or sister has fibroids.

Fibroids can cause symptoms and complications such as:

pain

heavy menstrual bleeding

constipation

anemia

difficulty getting pregnant

miscarriages

However, only 20 to 50 percentTrusted Source of women with fibroids have symptoms. In most cases, treatment isn’t needed. Your doctor may recommend waiting and watching to see if the fibroids go away on their own.

While foods can’t treat or prevent fibroids, your daily diet and lifestyle may play a role in reducing your risk. Diet can help balance hormones that may trigger these growths. Certain foods may also help ease fibroid symptoms.

Diet and lifestyle changes to lower risk

There are a number of changes you can make that might help reduce your risk for fibroids.

Follow a Mediterranean diet

Add plenty of fresh and cooked green vegetables, fresh fruit, legumes, and fish to your plate. A Mediterranean diet is one way to do this. Research shows that eating these foods regularly may help lower your risk for fibroids. On the other hand, eating beef, ham, lamb, and other red meat may raise your risk.

Check out a beginner’s guide to the Mediterranean diet for tips and a meal plan.

Cut back on alcohol

Drinking any type of alcohol may increase your risk for fibroids. This can happen because alcohol raises the level of hormones needed for fibroids to grow. Alcohol may also trigger inflammation.

One study found that women who drank one or more beers a day increased their risk by more than 50 percent. Avoid or limit alcohol to help reduce your risk.

Balance estrogen

Estrogen is a hormone important for healthy fertility in both women and men. However, too much estrogen can increase your risk for fibroidsTrusted Source or make them worse.

Many treatments for fibroids work by lowering estrogen levels. Other ways to balance estrogen levels include:

Losing weight. Obesity and excess weight increase the risk for fibroids. Fat cells make more estrogen, so losing weight may help prevent or slow the growth of fibroids.

Avoiding hormone-disrupting chemicals. Natural and synthetic chemicals can throw off your endocrine balance, raising estrogen levels. These chemicals can leach into your body through skin and food. Avoid or limit coming into contact with chemicals found in:

fertilizers

pesticides

plastics such as BPA

nonstick coatings on cookware

fire retardants

dyes

paints

some personal care products

Lower blood pressure

Research shows that a high number of women with severe fibroids also have high blood pressure. More research is needed to find out if there’s a link.

Balancing blood pressure is vital for your overall health. Try these tips:

Avoid added salt. Flavor food with herbs and other spices instead.

Limit high-sodium processed and packaged foods.

Check your blood pressure daily with a home monitor.

Exercise regularly.

Lose weight, especially around the waist.

Avoid or limit alcohol.

Increase potassium by eating a majority of plants at each meal.

Quit smoking and avoid secondhand smoke.

If you have high blood pressure, take medication as prescribed.

See your doctor for regular checkups.

Get enough vitamin D

Vitamin D may help reduce your risk of fibroids by almost 32 percentTrusted Source. Your body makes this “sunshine vitamin” naturally when your skin’s exposed to sunlight. If you have darker skin or live in cooler climates, you’re more likely to be deficient.

Supplements can help raise your levels, along with foods such as:

egg yolks

fortified milk, cheese, and dairy products

fortified cereals

fortified orange juice

fatty fish such as salmon, tuna, and mackerel

cod liver oil

A note about smoking and diet

Eating brightly colored fruits and vegetables is good for your general health. Consuming a variety of red, yellow, and orange foods will provide rich antioxidants. Dark greens are also nutrient dense and will provide healthful benefits. These nutrients may help protect you from disease, including some cancers.

However, a study found that beta carotene found in red, yellow and orange foods didn’t lower the risk for fibroids. In smokers, beta carotene may even increase risk. Further research is needed on why this might happen. In any case, smoking is harmful to your health and may increase your risk of fibroids.

Foods to eat if you have fibroids

Diet alone can’t treat fibroids. However, a balanced diet may also help ease some fibroid symptoms and complications. Certain foods may help slow fibroid growth in some cases.

Fiber

Fiber-rich foods aid weight loss and balance hormones. They also help to keep blood sugar levels steady. For these reasons, fiber may help prevent and slow the growth of fibroids. Add these whole foods to your diet:

cooked and raw vegetables

cooked, raw, and dried fruit

whole grain bread and pasta

cruciferous vegetables

oats

lentils

barley

beans

Potassium

Potassium helps to counter the effects of salt to balance blood pressureTrusted Source. Add these potassium-rich foods to your daily diet:

avocado

bananas

citrus

cantaloupe

collard greens

dates

lentils

oat bran

potatoes

tomatoes

Dairy

Add dairy products such as yogurt and full-fat cheese to your diet. Dairy is rich in calcium, phosphorus, and magnesium. These minerals may help prevent fibroids and slow their growth. Fortified milk also contains vitamin D.

Green tea

Green tea contains several antioxidants. A studyTrusted Source found that one of these, epigallocatechin gallate, may help slow the growth of fibroids by bringing down inflammation and high estrogen levels. Green tea may also improve symptoms of heavy bleeding due to fibroids, such as low iron.

Shop for green tea online.

Foods to avoid if you have fibroids

Sugar

Sugary foods and simple carbohydrates may trigger or worsen fibroidsTrusted Source. These foods spike blood sugar levels. This causes your body to make too much insulin. Excess insulin can cause weight gain and affect fibroid growth.

Avoid refined carbs and added sugars such as:

table sugar

glucose

dextrose

maltose

corn syrup

high fructose corn syrup

white bread, rice, pasta, and flour

soda and sugary drinks

fruit juice

potato chips

crackers

packaged energy bars

Estrogen-increasing foods

Some foods contain natural ingredients that mimic the estrogen in the body, called phytoestrogens. Other foods have added hormones or trigger your body to make more estrogen.

Some of these foods may have protective effects when consumed in small to moderate amounts, but have negative effects when consumed in high amountsTrusted Source. You may need to limit or avoid foods such as:

What is a Fibroid?

red meat from sources that include added hormones

soy beans

soy milk

tofu

flax seed

The takeaway

Eating a balanced diet and maintaining a healthy weight is important for your overall health. You may not be able to prevent fibroids, no matter what precautions you take. See your doctor if you think you may be at risk or if you experience any changes in your health.

If you have fibroids, your doctor will determine the best type of treatment. Healthy diet and lifestyle changes are the first step to treating fibroids and relieving symptoms.

Following a diet plan is critical even if you have surgery, drug therapy, or other treatment for fibroids.

Your doctor may also recommend natural remedies, alternative pain relief, stress management, and supplements to help ease symptoms. Talk with your doctor and dietitian about the best diet plan for you and other ways to prevent and reduce the effects of fibroids.

When do fibroids need to be removed?

So you’ve just come back from your annual gynecological exam and your doctor told you that you might have uterine fibroids. What are fibroids? Are they dangerous? Can they be removed? Should they be removed?

First, take a deep breath. Fibroids are pretty common — between 20-70 percent of women will develop fibroids during their reproductive years. And they’re almost always (99 percent of the time) harmless.

But that doesn’t mean you should ignore them. Fibroids can cause complications like excessive bleeding and reproductive problems. Johns Hopkins gynecologist Mindy Christianson, M.D. , who specializes in treating uterine fibroids, explains how women can manage these common growths.

What are uterine fibroids?

Uterine fibroids are benign, or noncancerous, fibrous growths that form in the uterus. They’re very common. They can grow on the outside of the uterus (called subserosal fibroids), inside the muscle of the uterus (called intramural fibroids), or into the uterine cavity (called submucosal fibroids).

What causes fibroids?

There's definitely a genetic component, but we haven’t found any lifestyle factors that cause uterine fibroids.

What are the symptoms of fibroids?

Some women have no symptoms at all from fibroids and don't even know they have them. Other women have severe symptoms. Symptoms can include very heavy menstrual cycles. Some women have so much bleeding that they become anemic —that's a hallmark symptom. Fibroids that cause severe bleeding are usually closer to the uterine cavity.

Some women can have very large fibroids that cause the uterus to be up to 10 times its normal size. This causes what we call “bulk symptoms.” For example, a woman may feel that her uterus is very enlarged, like she's pregnant. She may have related symptoms due to its bulk size, like constipation or increased urination.

Can other issues cause these symptoms?

If a woman sees her doctor because she is having increased bleeding or a heavy menstrual cycle, the doctor will likely check for uterine fibroids, but these symptoms can also be due to things such as uterine polyps, dysfunctional uterine bleeding or bleeding caused by hormonal imbalances.

How are fibroids diagnosed?

Fibroids are typically diagnosed by ultrasound. That’s really the easiest way to see the uterus, and fibroids are usually very easily seen. The first step might be an exam by your doctor, where he or she would feel an enlarged uterus and suspect fibroids. For smaller fibroids, the only way to diagnose them is often with ultrasound. Some doctors may choose to also do an MRI of the pelvis as a way to see exactly where the fibroids are.

How are fibroids treated?

It depends on symptoms and size. For example, if a woman has fibroids inside the uterine cavity, we may do a hysteroscopic myomectomy, in which we look inside the uterus with a camera. At the same time, we can do a surgical procedure to remove the fibroids if they’re just inside the uterine cavity.

If a woman has severe symptoms, and if the fibroids are in the muscle or outside of the uterus, surgery may be the best option. In that case, robotic-assisted laparoscopic myomectomy is more common. This is a minimally invasive procedure that involves making four to five small incisions in the abdomen. We then use small instruments attached to robotic arms to remove the fibroids through these very small openings.

In severe cases, a woman would have an open myomectomy, which is also called abdominal myomectomy. This surgery requires an incision either in the bikini area or a vertical incision along the abdomen. We then remove the fibroids through this incision.

Some nonsurgical management of uterine fibroids may include medicine that can help suppress their growth, such as birth control pills. There's also a medication called leuprolide acetate, which can help shrink them.

How might fibroids might affect fertility and pregnancy?

Their impact on fertility depends on the location and the size of the fibroids, as well as the type of symptoms a woman has. Fibroids inside the uterine cavity can stop an embryo from implanting, which prevents it from growing into a fetus. Larger fibroids—about four centimeters or more—that are in the muscle of the uterus can also impact implantation. Fibroids that are inside the muscle of the uterus might block the fallopian tubes, which can cause infertility.

Sometimes fibroids can affect the mode of delivery of a baby. For instance, if a woman has a fibroid in the lower part of her uterus, it might make it difficult for the cervix to open completely, which might make a C-section difficult.

It's really important for each woman and her obstetrician to have a game plan for delivery.

What foods cause fibroids to grow?

If you suffer from uterine fibroids, a specific diet can play an important role in managing your symptoms. There may be foods that you want to think about avoiding, or they could exacerbate your symptoms. Below is a list of foods you should cut back on, or avoid entirely if you suffer from fibroids.

For the best results in managing your fibroids, try restricting the following food and drinks from your diet:

High-fat Processed Meats: Red processed meat is known to be high in added hormones, particularly estrogen.

High-fat dairy products: Conventional dairy can contain high levels of steroids, hormones, and other chemicals that promote inflation.

Foods High in Salt: Highly salted foods are hard on your liver, which is the organ that is most responsible for removing toxins and balancing hormones.

Refined Carbohydrates: While foods such as pasta, white bread, white rice, cakes, and cookies have been known to alter estrogen levels, causing fibroids to increase in size.

What is the best treatment for fibroids?

Treatment for fibroids can range from no treatment at all to surgery. Unless fibroids are causing excessive bleeding, discomfort or bladder problems, treatment usually isn't necessary.

If you have fibroids, you should be evaluated periodically to review symptoms, and to monitor the fibroid and uterus size with abdominal and pelvic examinations. If you don't have symptoms, routine pelvic ultrasounds have very little benefit. Fibroids are likely to grow each year until menopause, but this isn't an indication that you need treatment, unless the change is accompanied by disabling symptoms.

The following are treatment options for fibroids:

Medications

Currently, the medications available for fibroids can temporarily improve symptoms but do not make the fibroids go away. For women with heavy bleeding, it is worth trying medication before undergoing a surgical procedure. Women with pressure symptoms caused by large fibroids won't benefit from any medicines currently available.

There are several promising new drugs on the horizon that will treat the fibroids themselves, not just the symptoms.

Contraceptive Pills and Progestational Agents

Women with heavy menstrual periods and fibroids are often prescribed hormonal medications to try to reduce bleeding and regulate the menstrual cycle. These medications will not shrink fibroids or make them grow at a faster rate.

If the medication has not improved your bleeding after three months, consult your doctor. Women over the age of 35 who smoke should not use oral contraceptives.

GnRH Agonists (Lupron)

GnRH agonists are a class of medications that temporarily shrink fibroids and stop heavy bleeding by blocking production of the female hormone, estrogen. Lupron is the most well known of these drugs. Although Lupron can improve fibroid symptoms, it causes unpleasant menopausal symptoms such as hot flashes. Long-term use can cause bone loss.

Lupron is recommended only for very specific cases. It may be recommended if you have heavy bleeding and serious anemia, and would need a blood transfusion during fibroid surgery. If you take Lupron for two to three months before surgery, your periods may temporarily stop and eliminate the need for a blood transfusion. Lupron also may be recommended if you have very large fibroids — greater than 10 to 12 centimeters — prior to fibroid surgery. Lupron should not be used solely to shrink fibroids unless surgery is planned, because fibroids will re-grow to their original size as soon as you stop taking Lupron.

Intrauterine Devices (IUD)

Although IUDs are typically used to prevent pregnancy, they have other benefits as well. An IUD that releases a small amount of hormone into the uterine cavity can decrease bleeding caused by fibroids.

An IUD can be inserted during a routine office appointment.

Myomectomy

A myomectomy is an operation to remove fibroids while preserving the uterus. For women who have fibroid symptoms and want to have children in the future, myomectomy is the best treatment option.

Myomectomy is very effective, but fibroids can re-grow. The younger you are and the more fibroids you have at the time of myomectomy, the more likely you are to develop fibroids again in the future. Women nearing menopause are the least likely to have recurring problems from fibroids after a myomectomy.

A myomectomy can be performed several different ways. Depending on the size, number and location of your fibroids, you may be eligible for an abdominal myomectomy, a laparoscopic myomectomy or a hysteroscopic myomectomy.

Abdominal Myomectomy During this operation, an incision is made through the skin on the lower abdomen (a "bikini cut"). The fibroids are removed from the wall of the uterus, and the uterine muscle is sewn back together using several layers of stitches. You will be asleep for the procedure. Most women spend two nights in the hospital and four to six weeks recovering at home.

Laparoscopic Myomectomy In a laparascopic myomectomy, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the fibroids. The uterine muscle is then sewn back together, the gas is released and the skin incisions are closed. You will be asleep for the procedure. The recovery is shorter than for an abdominal myomectomy — typically, women spend one night in the hospital and two to four weeks recovering at home.

Hysteroscopic Myomectomy Only women with submucosal fibroids — fibroids that expand from the uterine wall into the uterine cavity — are eligible for this type of myomectomy. Fibroids located within the uterine wall cannot be removed with this technique. During the procedure, you will lie on your back with your feet in gynecology stirrups. You will most likely be asleep for the procedure. A speculum is placed in the vagina and a long, slender telescope is placed through the cervix into the uterine cavity. The uterine cavity is filled with fluid to lift apart the walls of the uterus. Instruments passed through the hysteroscope are used to shave off the submucosal fibroids. This is an out-patient procedure, and you may go home after several hours of observation in the recovery room. Most women spend one to four days resting at home to recover.

Read more about myomectomy.

Hysterectomy

Hysterectomy is a major surgical procedure in which the uterus is removed. Many women choose hysterectomy to definitively resolve their fibroid symptoms. After hysterectomy, menstrual bleeding stops, pelvic pressure is relieved, frequent urination improves and new fibroids cannot grow. A woman can no longer become pregnant after a hysterectomy.

The ovaries are not necessarily removed during a hysterectomy. Generally, if a woman is in menopause or close to menopause, the ovaries are removed. The ovaries may also be removed if they look abnormal or if the patient wants to decrease her chance of developing ovarian cancer later in life. In pre-menopausal women, removal of the ovaries can cause hot flashes, vaginal dryness and other symptoms. You should discuss the pros and cons of ovarian removal with your doctor.

What are Fibroids?

There are several hyterectomy surgical approaches: a vaginal hysterectomy, an abdominal hysterectomy and a laparoscopic hysterectomy. The choice of procedure will depend on the size of the uterus and several other factors.

Vaginal Hysterectomy A vaginal hysterectomy is performed by removing the uterus through the vagina, rather than through an incision on the abdomen. To be eligible for a vaginal hysterectomy, your uterus cannot be too large. You will be asleep for the procedure. Most women stay two nights in the hospital. The recovery involves significant pain for 24 hours and mild pain for 10 days. Full recovery usually takes four weeks.

Abdominal Hysterectomy In an abdominal hysterectomy, the uterus is removed through a horizontal incision on the lower abdomen, called a "bikini cut." If the uterus is very large or if there is a scar from an earlier operation, it may be necessary to make a vertical incision instead. A total abdominal hysterectomy means removing the uterus and the cervix. Women who have had abnormal pap smears are usually encouraged to have their cervix removed. A subtotal or supra-cervical hysterectomy means removing only the upper part of the uterus. Women who retain their cervix may have less bladder leakage and vaginal relaxation later in life; however, this has not been scientifically proven. Women who have had a supra-cervical hysterectomy will continue to need periodic pap smears. In addition, some women will have monthly spotting or light bleeding if endometrial glands are still embedded in the cervical tissue. You will be asleep during the procedure. Most women spend three nights in the hospital and six weeks recovering at home. Some women experience a complication that results in a longer recovery time.

Laparoscopic Hysterectomy This is a new procedure in which the uterus is removed through very small incisions on the lower abdomen. The cervix remains in place. Women with large fibroids or a large uterus may not be candidates for a laparoscopic hysterectomy. In the procedure, four one-centimeter incisions are made in the lower abdomen: one at the belly button, one below the bikini line near the pubic hair, and one near each hip. The abdominal cavity is filled with carbon dioxide gas. A thin, lighted telescope is placed through an incision so the doctors can see the ovaries, fallopian tubes and uterus. Long instruments, inserted through the other incisions, are used to remove the uterus. A special instrument is used to cut the uterus into smaller segments for removal through the small incisions. At the end of the procedure, the gas is released and the skin incisions are closed. You will be asleep during the procedure. Most women spend one night in the hospital and two to four weeks recovering at home.

Read more about hysterectomy.

Uterine Artery Embolization (UAE)

Uterine artery embolization is a relatively new procedure and an alternative to open surgery for fibroids. Embolization is a technique that blocks the blood flow to the fibroid or fibroids, causing them to shrink and die. This also often decreases menstrual bleeding and symptoms of pain, pressure, urinary frequency or constipation.

UAE is performed in a radiology suite rather than an operating room, by an interventional radiologist. An intravenous (IV) line will be placed before beginning the procedure, and you will be sedated. You will remain awake, but sleepy, throughout the procedure.

A needle is placed in an artery in your leg, at the groin crease. A small catheter is then placed into the artery and X-rays are taken of the arteries — a test called an arteriogram — that supply the fibroids. The catheter is then used to select these arteries and slowly inject particles called polyvinyl alcohol, which are the size of a sand grain. The particles block the flow of blood. After the left and right uterine arteries are embolized, another arteriogram is performed to confirm the procedure is complete.

Afterward, you must rest in bed for six hours, lying flat with your leg straight. The amount of pain patients experience varies. The most significant pain usually occurs immediately following the procedure and over the next six hours. Patients usually stay overnight in the hospital, so we can monitor the arterial access site and provide adequate pain control. You will be discharged the next morning. Most women can return to full activity in a week.

When blood flow to the fibroid is blocked, the fibroid gets no oxygen and will begin to die. This process happens over days to months. During this time the fibroid shrinks by about 40 to 50 percent and the uterus by about 30 to 40 percent. Our experience and the scientific literature suggest that symptoms will improve in 80 to 90 percent of patients. For some, UAE is ineffective. Serious complications occur in less then four percent of patients.

Read more about uterine artery embolization.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

How do you stop fibroids from growing?

If you have uterine fibroids, you may or may not need treatment. It depends on whether they cause you any problems.

Not all fibroids grow. Even large ones may not cause any symptoms, and most shrink after menopause.

Still, you and your doctor should check on their growth, especially if you develop symptoms like bleeding or pain. So you should at least get pelvic exams every year.

Can I Try Home Remedies?

You can’t cure fibroids on your own. But you can do things that help you feel better. When fibroids grow on the outside of the uterus, you may become aware of a mass on your abdomen. You can lie down and put a hot pack or hot water bottle on your lower belly to ease the pain. You’d need to do this several times a day.

What Medicines Help?

You can take pain relievers, such as ibuprofen. But be sure to follow the instructions on the label so you don’t accidentally take too much. If you and your doctor decide you need to take something for your fibroids, you may want to consider these other options:

Hormone therapy. To help prevent more growth of the fibroid, your doctor may recommend that you stop taking birth control pills or hormone replacement therapy. But in some cases, your doctor may prescribe birth control pills to help control the bleeding and anemia from fibroids, even though the hormones may cause fibroids to grow.

GnRH antagonists..GnRH is a hormone your body naturally makes. GnRH antagonists put your body in menopause as long as you take them by surpressing the estrogen which stimulate the growth of uterine fibroids.These drugs are expensive. You shouldn’t take them for more than 6 months because they can make you more likely to get osteoporosis, which makes your bones too frail. Your doctor may also prescribe a low dose of progestin, or a low dose combination estrogen/progestin pill, to make osteoporosis less likely.

GnRH agonists. Your doctor may prescribe one to shrink fibroids and reduce anemia. They carry the same precautions as GnRH antagonists. And as with GnRH antagonists, when you stop taking a GnRH agonist, your fibroids can grow back. Still another possible option is a medication which combines all three, an GnRH antagonist, estrogen and progesterone.

SERMs. SERMs are a type of medicine that works on your estrogen levels. (SERMs stands for selective estrogen receptor modulators.) They may be able to shrink fibroids without causing menopause symptoms. But researchers aren’t yet sure how well they work for this purpose.

SUGGESTED

Will an IUD Help?

An IUD is a birth control device. Some also release the hormone progestin. It won’t shrink your fibroids. But it can control the bleeding and cramping that they cause.

What Procedures Might Work?

There are several possibilities that you and your doctor can consider.

Fibroid embolization can shrink a fibroid. Your doctor will inject polyvinyl alcohol (PVA) into the arteries that feed the fibroid. The PVA blocks the blood supply to the fibroid, which makes it shrink. It’s not surgery, but you may need to spend several nights in the hospital because you may have nausea, vomiting, and pain in the first few days afterward.

Endometrial ablation is a procedure in which doctors destroy the lining of uterus to cut down on the bleeding linked to small fibroids.

Myomectomy is a surgery to remove fibroids. If you plan to become pregnant, your doctor may recommend this over other procedures. But it may cause scarring that can lead to infertility. You’ll need to wait 4 to 6 months after surgery before you try to conceive. In most women, symptoms go away following a myomectomy. But in others, the fibroids come back. Whether it works will partly depend on how many fibroids you have and whether the surgeon could remove them all. A myomectomy may be abdominal surgery, or your surgeon may use a hysteroscope or laparoscope to remove the fibroids without having to make a large cut on your abdomen. There is also a newer method that uses MRI-guided intense ultrasound energy to pinpoint the fibroids and shrink or destroy them.

Hysterectomy is surgery to remove the uterus. Many women don’t need treatment that’s this drastic. You won’t be able to get pregnant after this operation.

Uterine fibroids are growths in your uterus. Because they’re typically not cancerous, you can decide whether or not you want to have them removed.

You may not need surgery if your fibroids don’t bother you. However, you might consider surgery if your fibroids cause:

heavy menstrual bleeding

bleeding between periods

pain or pressure in your lower belly

frequent urination

trouble emptying your bladder

Surgery might also be an option if you want to get pregnant in the future. Sometimes fibroids can increase your risk of having a miscarriage or complications during your pregnancy.

If you decide to have fibroid surgery, you have two options:

myomectomy

hysterectomy

Surgery can relieve your fibroid symptoms, but it does come with risks. Your doctor will talk you through your options. Together, you can decide whether to have a procedure and, if so, which one to have.

Types of fibroid surgery

There are two types of fibroid procedures. Which one you have depends on:

the size of your fibroids

the number of fibroids you have

where in your uterus they’re located

whether you want to have children

Myomectomy

Myomectomy removes your fibroids and can relieve bleeding and other symptoms. This surgery is an option if you’d like to have children in the future, or if you want to keep your uterus for another reason.

About 80 to 90 percent of women who have a myomectomy get relief from their symptoms or see their symptoms reduced. The fibroids won’t grow back after surgery, but you may develop new fibroids. Up to 33 percent of women who have this surgery will need a repeat procedure within 5 years because they grow new fibroids.

This surgery can be done in one of three ways, depending on the number, size, and location of your fibroids. You’ll be under general anesthesia for all of these procedures.

Hysteroscopy

This procedure is more effective for women with smaller and fewer fibroids. Hysteroscopy can also remove fibroids that have grown into the inside of your uterus.

During the procedure, the doctor inserts a long, thin, lighted telescope through your vagina and cervix into your uterus. Fluid is injected into your uterus to expand it and help your doctor see your fibroids.

Then, the surgeon uses a device to cut or destroy your fibroids. The fibroid pieces wash out with the fluid that was used to fill your uterus.

With hysteroscopy you may go home the same day as your surgery.

Abdominal myomectomy

This procedure, also known as a laparotomy, is better for large fibroids, but it leaves a bigger scar than the other two types of myomectomy. For this procedure, your surgeon makes a cut in your lower belly and removes your fibroids.

After abdominal myomectomy, you’ll stay in the hospital for one to three days. Complete recovery takes 2 to 6 weeks.

Laparoscopy

Laparoscopy is used for women who have smaller and fewer fibroids. During laparoscopy, your surgeon makes two small cuts in your belly. A telescope is inserted into one of the openings to help your doctor see inside your pelvis and around your uterus. A tool is inserted into the other opening to remove your fibroids.

Your surgeon may cut your fibroids into small pieces before removing them. In robotic laparoscopy, your surgeon uses robotic arms to perform the procedure.

Laparoscopic procedures may require an overnight hospital stay but have a faster recovery than abdominal myomectomy.

What are the symptoms of Fibroid?

Hysterectomy

Hysterectomy removes part or all of your uterus. This procedure may be an option if you have a lot of fibroids, they’re large, and you’re not planning to have children.

The surgeon can remove your uterus in a few different ways:

Laparotomy or abdominal hysterectomy. Your surgeon makes a cut in the lower abdomen and removes your uterus.

Vaginal hysterectomy. The surgeon removes your uterus through your vagina. This approach may not work for very large fibroids.

Laparoscopic hysterectomy. The surgeon inserts the instruments and removes the uterus through small incisions. This procedure can be done robotically.

The surgeon may leave your ovaries and cervix in place. Then you will continue to produce female hormones.

Complete recovery from an abdominal hysterectomy takes 6 to 8 weeks. Recovery from laparoscopic and vaginal hysterectomy is quicker.

Hysterectomy is the only surgery that cures uterine fibroids and fully relieves their symptoms. However, you will no longer be able to have children.

Endometrial ablation

Endometrial ablation isn’t surgery, but this procedure is still minimally invasive. It destroys the lining of your uterus. It works best in women who have small fibroids located close to the inside of the uterus.

Ablation doesn’t remove your fibroids, but it does help relieve heavy bleeding. It’s also not for women who want to get pregnant in the future.

Endometrial ablation can be done in your doctor’s office or a hospital. Sometimes it’s performed at the same time as other procedures.

You may get general anesthesia during the procedure. Or, you may get spinal or epidural anesthesia to numb you from the waist down.

During the procedure, the doctor will insert a special instrument into your uterus and burn off your uterine lining using one of these methods:

an electric current

a balloon filled with heated fluid

high-energy radio waves (radio frequency)

a cold probe

microwave energy

heated fluid

You can go home on the same day as your procedure. Your recovery time will depend on the type of ablation you had.

Endometrial ablation is effectiveTrusted Source for relieving heavy bleeding from fibroids.

Benefits

Fibroid surgery and endometrial ablation can help relieve symptoms like heavy bleeding and abdominal pain. Removing your uterus provides a permanent solution to most fibroid-related symptoms.

Risks

All of these procedures are safe, but they can have risks, such as:

bleeding

infection

the need for a repeat procedure

damage to organs in your abdomen, such as your bladder or bowel

scar tissue in your abdomen, which can form bands that bind organs and tissue together

bowel or urinary problems

fertility issues

pregnancy complications

rare chance that you’ll need a hysterectomy

Laparoscopy causes less bleeding and other complications than laparotomy.

Surgery and fertility

How fibroid surgery affects your fertility depends on which type of procedure you have. You will not be able to carry a child after hysterectomy since your uterus will be removed. You should be able to conceive after myomectomy.

After an ablation, you likely won’t be able to get pregnant, but you should use contraceptionTrusted Source following the procedure. This is because the procedure removes the endometrial lining where the egg would normally implant. If you do conceive, you’ll be at higher risk of having a miscarriage as well other serious pregnancy complications.

If you have a procedure that allows you to get pregnant in the future, you may need to wait three months or more before trying to conceive to be sure your uterus has fully healed.

Other treatment options

Surgery isn’t the only way to treat fibroids. Certain medications can be used to help reduce the symptoms that go along with fibroids, but these options will not eliminate your fibroids. Other options include:

Medications

Nonsteroidal anti-inflammatory drugs like ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) can help relieve pain.

Birth control pills and other types of hormonal birth control methods such as progestin-releasing IUDs can help with heavy bleeding.

Anti-hormonal drugs like progestin or danazol block estrogen to treat fibroids.

Gonadotropin-releasing hormone agonists (Lupron, Synarel) block the production of estrogen and progesterone, and put you into temporary menopause, which shrinks your fibroids. Your doctor might prescribe these to make your fibroids smaller before surgery.

Tranexamic acid (Lysteda) reduces heavy bleeding during your periods.

Noninvasive procedures

MRI-guided focused ultrasound surgery uses sound waves guided by an MRI scanner to heat and destroy your fibroids through your skin.

Uterine artery embolization injects tiny particles into the arteries that supply your uterus. Cutting off blood flow to the fibroids causes them to shrink.

Myolysis, such as the Acessa procedure, uses an electric current or heat to destroy your fibroids and the blood vessels that supply them.

Cryomyolysis is similar to myolysis, except that it freezes the fibroids.

Takeaway

Surgery can often relieve pain, heavy bleeding, and other uncomfortable symptoms of uterine fibroids. These procedures can have side effects. And if you have a hysterectomy, you’ll no longer be able to have children.

Talk with your doctor about all of your treatment options. Learn the benefits and risks of each one before making your decision.

Can I get pregnant with fibroids?

Fibroids are benign tumors that grow in or on the uterus, or womb. They may impact fertility and pregnancy chances.

Uterine fibroids are very common. About 20 to 80 percentTrusted Source of women develop these noncancerous growths by age 50, and 30 percentTrusted Source of women between 25 and 44 have symptoms of fibroids. That means uterine fibroids are commonTrusted Source during a woman’s childbearing years.

Read on to learn more about why fibroids develop and how they affect pregnancy.

What are the effects on pregnancy?

Most women will experience no effects from fibroids during their pregnancy. However, a 2010 review suggests 10 to 30 percentTrusted Source of women with fibroids develop complications during pregnancy. Researchers note the most common complication of fibroids during pregnancy is pain. It’s seen most often in women with fibroids larger than 5 centimeters who are in their last two trimesters.

Fibroids may increase your risk for other complications during pregnancy and delivery. These include:

Fetal growth restriction. Large fibroids may prevent a fetus from growing fully due to decreased room in the womb.

Placental abruption. This occurs whenthe placenta breaks away from the uterine wall because it’s blocked by a fibroid. This reduces vital oxygen and nutrients.

Preterm delivery. Pain from fibroids may lead to uterine contractions, which can result in an early delivery.

Cesarean delivery. WomensHealth.gov estimates women with fibroids are six timesTrusted Source more likely to need a cesarean delivery (C-section) than women who don’t have these growths.

Breech position. Because of the abnormal shape of the cavity, the baby may not be able to align for vaginal delivery.

Miscarriage. Research notes the chances for miscarriage are doubledTrusted Source in women with fibroids.

What are the effects of pregnancy on fibroids?

The majority of fibroids don’t change in size during pregnancy, but some do. In fact, one-thirdTrusted Source of uterine fibroids may grow in the first trimester, according to a 2010 review. Fibroid growth is possibly influenced by estrogen, and estrogen levels rise during pregnancy. This may lead to growth.

Still, for other women, fibroids may actually shrink during pregnancy. In a 2010 study, researchers found that 79 percentTrusted Source of fibroids that were present before a pregnancy decreased in size after delivery.

Sara Explains What It’s Like To Have Uterine Fibroids

What are the effects of fibroids on fertility?

Many women who have fibroids can get pregnant naturally. Treatment may not even be necessary for conception.

In some cases, however, fibroids can impact your fertility. For example, submucosal fibroids, which are a type of fibroid that grows and bulges into the uterine cavity, increase your risk for infertility or pregnancy loss.

While fibroids may cause infertility for some women, other explanations for infertility are more common. If you’re having trouble conceiving or maintaining a pregnancy, your doctor may explore other possible causes before attributing the issue to fibroids.

Next steps if you’re trying to conceive with fibroids

Talk with your doctor about the size or position of any fibroids you have. Ask if they could cause problems with your attempts to get pregnant or the ability to carry a pregnancy. Likewise, ask your doctor if fibroid treatments can help improve your odds for pregnancy success.

How are fibroids treated during pregnancy?

During pregnancy, treatment for uterine fibroids is limited because of the risk to the fetus. Bed rest, hydration, and mild pain relievers may be prescribed to help expectant mothers manage symptoms of fibroids.

In very rare cases, a myomectomy can be performed in women in the second half of their pregnancies. This procedure removes fibroids from the outside of the uterus or from within the uterine wall while leaving the uterus intact. Fibroids growing in the uterine cavity are generally left in place due to the possible risks to the fetus.

How are fibroids treated before pregnancy to improve fertility?

Treating uterine fibroids before pregnancy may improve your fertility risk. The most common treatments for fibroids that preserve fertility include:

Myomectomy. This surgical procedure is used to remove fibroids. It may increase the need for cesarean delivery, and you’ll likely need to wait about three months following the procedure before attempting to conceive.

Hormonal birth control pills. While you’re on the pill, you won’t be able to become pregnant. But this contraceptive can help ease symptoms of the condition, such as heavy bleeding and painful periods.

Intrauterine device (IUD). Like the birth control pill, an IUD will prevent pregnancy as long as you’re using it. However, it can help eliminate some of symptoms while preserving fertility.

Gonadotropin-releasing hormone (Gn-RH) agonists. This type of medication blocks the production of the hormones that lead to ovulation and menstruation, so you won’t be able to become pregnant while taking this medication. It can help shrink fibroids.

Myolysis. This procedure uses an electric current, laser, or radio-frequency energy beam to shrink the blood vessels that feed the fibroids.

Other treatments are available for women with fibroids who may want to have children in the future. Each treatment carries its own risk and complications, so talk with your doctor about your options.

Likewise, ask your doctor how long you’ll have to wait before attempting to become pregnant after treatment. With some treatments, such as the birth control pill, you can try for pregnancy as soon as you stop using it. For others, there may be a waiting period.

What are the symptoms of fibroids?

You may not have any symptoms of fibroids. If you do have symptoms, the most common symptoms include:

heavy or painful periods

bleeding between periods (spotting)

anemia from heavy or long-term bleeding

prolonged periods

feeling “full” or a mild pressure in your lower abdomen

pain during sex

low back pain

constipation

reproductive issues, including infertility, miscarriage, and preterm labor

frequent urination

difficulty emptying your bladder

Fibroids may be felt during a pelvic exam. If your doctor suspects you have the noncancerous growths, they may order an imaging test, such as an ultrasound, to confirm the growths are indeed fibroids and not something else.

WERBUNG

What’s the outlook?

Uterine fibroids may affect your fertility. They may also impact your ability to carry a pregnancy successfully. However, most women will experience no fertility issues or pregnancy complications as a result of these tumors.

If you have fibroids and wish to start a family, talk with your doctor about your options for treatment and your risks. Together, the two of you can decide what’s safest for your future pregnancy.

While you can’t prevent fibroids, a healthy lifestyle may lower your risk. Likewise, a healthy lifestyle, which includes maintaining a healthy weight, may lower your risk for fertility issues and high-risk pregnancies.

What are the symptoms of fibroid in a woman?

Uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren't associated with an increased risk of uterine cancer and almost never develop into cancer.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. You can have a single fibroid or multiple ones. In extreme cases, multiple fibroids can expand the uterus so much that it reaches the rib cage and can add weight.

Many women have uterine fibroids sometime during their lives. But you might not know you have uterine fibroids because they often cause no symptoms. Your doctor may discover fibroids incidentally during a pelvic exam or prenatal ultrasound.

Products & Services

Assortment Women's Health Products from Mayo Clinic Store

Show more products from Mayo Clinic

Symptoms

Many women who have fibroids don't have any symptoms. In those that do, symptoms can be influenced by the location, size and number of fibroids.

In women who have symptoms, the most common signs and symptoms of uterine fibroids include:

Heavy menstrual bleeding

Menstrual periods lasting more than a week

Pelvic pressure or pain

Frequent urination

Difficulty emptying the bladder

Constipation

Backache or leg pains

Rarely, a fibroid can cause acute pain when it outgrows its blood supply, and begins to die.

Fibroids are generally classified by their location. Intramural fibroids grow within the muscular uterine wall. Submucosal fibroids bulge into the uterine cavity. Subserosal fibroids project to the outside of the uterus.

When to see a doctor

See your doctor if you have:

Pelvic pain that doesn't go away

Overly heavy, prolonged or painful periods

Spotting or bleeding between periods

Difficulty emptying your bladder

Unexplained low red blood cell count (anemia)

Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.

What happens when you have fibroids?

Uterine fibroids are a common type of noncancerous tumor that can grow in and on your uterus. Not all fibroids cause symptoms, but when they do, symptoms can include heavy menstrual bleeding, back pain, frequent urination and pain during sex. Small fibroids often don’t need treatment, but larger fibroids can be treated with medications or surgery.

Appointments 216.444.6601

APPOINTMENTS & LOCATIONS

REQUEST AN APPOINTMENT

HAVE MY BABY AT CLEVELAND CLINIC

Symptoms and Causes Diagnosis and Tests Management and Treatment Prevention Outlook / Prognosis

OVERVIEW

What are uterine fibroids and what are the risk factors?

What are uterine fibroids?

Uterine fibroids (also called leiomyomas) are growths made up of the muscle and connective tissue from the wall of the uterus. These growths are usually not cancerous (benign). Your uterus is an upside down pear-shaped organ in your pelvis. The normal size of your uterus is similar to a lemon. It’s also called the womb and it’s the place where a baby grows and develops during pregnancy.

Fibroids can grow as a single nodule (one growth) or in a cluster. Fibroid clusters can range in size from 1 mm to more than 20 cm (8 inches) in diameter or even larger. For comparison, they can get as large as the size of a watermelon. These growths can develop within the wall of the uterus, inside the main cavity of the organ or even on the outer surface. Fibroids can vary in size, number and location within and on your uterus.

You may experience a variety of symptoms with uterine fibroids and these may not be the same symptoms that another woman with fibroids will experience. Because of how unique fibroids can be, your treatment plan will depend on your individual case.

Are fibroids common?

Fibroids are actually a very common type of growth in your pelvis. Approximately 40 to 80% of women have fibroids. However, many women don’t experience any symptoms from their fibroids, so they don’t realize they have fibroids. This can happen when you have small fibroids — called asymptomatic because they don’t cause you to feel anything unusual.

Who is at risk for uterine fibroids?

There are several risk factors that can play a role in your chances of developing fibroids. These can include:

Obesity and a higher body weight (a person is considered obese if they’re more than 20% over the healthy body weight).

Family history of fibroids.

Not having children.

Early onset of menstruation (getting your period at a young age).

Late age for menopause.

Where do fibroids grow?

There are several places both inside and outside of your uterus where fibroids can grow. The location and size of your fibroids is important for your treatment. Where your fibroids are growing, how big they are and how many of them you have will determine which type of treatment will work best for you or if treatment is even necessary.

There are different names given for the places your fibroids are located in and on the uterus. These names describe not only where the fibroid is, but how it’s attached. Specific locations where you can have uterine fibroids include:

Submucosal fibroids: In this case, the fibroids are growing inside the uterine space (cavity) where a baby grows during pregnancy. Think of the growths extending down into the empty space in the middle of the uterus.

Intramural fibroids: These fibroids are embedded into the wall of the uterus itself. Picture the sides of the uterus like walls of a house. The fibroids are growing inside this muscular wall.

Subserosal fibroids: Located on the outside of the uterus this time, these fibroids are connected closely to the outside wall of the uterus.

Pedunculated fibroids: The least common type, these fibroids are also located on the outside of the uterus. However, pedunculated fibroids are connected to the uterus with a thin stem. They’re often described as mushroom-like because they have a stalk and then a much wider top.

What do fibroids look like?

Fibroids are typically rounded growths that can look like nodules of smooth muscle tissue. In some cases, they can be attached with a thin stem, giving them a mushroom-like appearance.

Are fibroids cancer?

It’s extremely rare for a fibroid to go through changes that transform it into a cancerous or a malignant tumor. In fact, one out of 350 women with fibroids will develop malignancy. There’s no test that’s 100% predictive in detecting rare fibroid-related cancers. However, people who have rapid growth of uterine fibroids, or fibroids that grow during menopause, should be evaluated immediately.

SYMPTOMS AND CAUSES

What causes uterine fibroids?

The causes of fibroids are not known. Most fibroids happen in women of reproductive age. They typically aren’t seen in young women who haven’t had their first period yet.

What are the symptoms of uterine fibroids?

Most fibroids do not cause any symptoms and don’t require treatment other than regular observation by your healthcare provider. These are typically small fibroids. When you don’t experience symptoms, it’s called an asymptomatic fibroid. Larger fibroids can cause you to experience a variety of symptoms, including:

Excessive or painful bleeding during your period (menstruation).

Bleeding between your periods.

A feeling of fullness in your lower abdomen/bloating.

Frequent urination (this can happen when a fibroid puts pressure on your bladder).

Pain during sex.

Low back pain.

Constipation.

Chronic vaginal discharge.

Inability to urinate or completely empty your bladder.

Increased abdominal distention (enlargement), causing your abdomen to look pregnant.

The symptoms of uterine fibroids usually stabilize or go away after you’ve gone through menopause because hormone levels decline within your body.

Treatment for uterine fibroids: Mayo Clinic Radio

What does uterine fibroid pain feel like?

There are a variety of feelings you might experience if you have fibroids. If you have small fibroids, you may feel nothing at all and not even notice they’re there. For larger fibroids, however, you can experience discomforts and even pains related to the condition. Fibroids can cause you to feel back pain, severe menstrual cramps, sharp stabbing pains in your abdomen and even pain during sex.

Can fibroids change over time?

Fibroids can actually shrink or grow over time. They can change size suddenly or steadily over a long period of time. This can happen for a variety of reasons, but in most cases this change in fibroid size is linked to the amount of hormones in your body. When you have high levels of hormones in your body, fibroids can get bigger. This can happen at specific times in your life, like during pregnancy. Your body releases high levels of hormones during pregnancy to support the growth of your baby. This surge of hormones also causes the fibroid to grow. If you know you have fibroids before a pregnancy, talk to your healthcare provider. You may need to be monitored to see how the fibroid grows throughout the pregnancy. Fibroids can also shrink when your hormone levels drop. This is common after menopause. Once a woman has passed through menopause, the amount of hormones in her body is much lower. This can cause the fibroids to shrink in size. Often, your symptoms can also get better after menopause.

Can fibroids cause anemia?

Anemia is a condition that happens when your body doesn’t have enough healthy red blood cells to carry oxygen to your organs. It can make you feel tired and weak. Some women may develop intense cravings for ice, starch or dirt. This is called pica and is associated with anemia. Anemia can happen to women who have frequent or extremely heavy periods. Fibroids can cause your periods to be very heavy or for you to even bleed between periods. Some treatments like oral iron pills — or if you're significantly anemic, an iron infusion (by IV) — can improve your anemia. Talk to your healthcare provider if you are experiencing symptoms of anemia while you have fibroids.

DIAGNOSIS AND TESTS

How are uterine fibroids diagnosed?

In many cases, fibroids are first discovered during a regular exam with your women’s health provider. They can be felt during a pelvic exam and can be found during a gynecologic exam or during prenatal care. Quite often your description of heavy bleeding and other related symptoms may alert your healthcare provider to consider fibroids as a part of the diagnosis. There are several tests that can be done to confirm fibroids and determine their size and location. These tests can include:

Ultrasonography: This non-invasive imaging test creates a picture of your internal organs with sound waves. Depending on the size of the uterus, the ultrasound may be performed by the transvaginal or transabdominal route.

Magnetic resonance imaging (MRI): This test creates detailed images of your internal organs by using magnets and radio waves.

Computed tomography (CT): A CT scan uses X-ray images to make a detailed image of your internal organs from several angles.

Hysteroscopy: During a hysteroscopy, your provider will use a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus.

Hysterosalpingography (HSG): This a detailed X-ray where a contrast material is injected first and then X-rays of the uterus are taken. This is more often used in women who are also undergoing infertility evaluation.

Sonohysterography: In this imaging test, a small catheter is placed transvaginally and saline is injected via the catheter into the uterine cavity. This extra fluid helps to create a clearer image of your uterus than you would see during a standard ultrasound.

Laparoscopy: During this test, your provider will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

MANAGEMENT AND TREATMENT

How are uterine fibroids treated?

Treatment for uterine fibroids can vary depending on the size, number and location of the fibroids, as well as what symptoms they’re causing. If you aren’t experiencing any symptoms from your fibroids, you may not need treatment. Small fibroids can often be left alone. Some women never experience any symptoms or have any problems associated with fibroids. Your fibroids will be monitored closely over time, but there’s no need to take immediate action. Periodic pelvic exams and ultrasound may be recommend by your healthcare provider depending on the size or symptoms of your fibroid.If you are experiencing symptoms from your fibroids — including anemia from the excess bleeding, moderate to severe pain, infertility issues or urinary tract and bowel problems — treatment is usually needed to help. Your treatment plan will depend on a few factors, including:

How many fibroids you have.

The size of your fibroids.

Where your fibroids are located.

What symptoms you are experiencing related to the fibroids.

Your desire for pregnancy.

Your desire for uterine preservation.

The best treatment option for you will also depend on your future fertility goals. If you want to have children in the future, some treatment options may not be an option for you. Talk to your healthcare provider about your thoughts on fertility and your goals for the future when discussing treatment options. Treatment options for uterine fibroids can include:

Medications

Over-the-counter (OTC) pain medications: These medications can be used to manage discomforts and pain caused by the fibroids. OTC medications include acetaminophen and ibuprofen.

Iron supplements: If you have anemia from the excess bleeding, your provider may also suggest you take an iron supplement.

Birth control: Birth control can also be used to help with symptoms of fibroids — specifically heavy bleeding during and between periods and menstrual cramps. Birth control can be used to help control heavy menstrual bleeding. There are a variety of birth control options you can use, including oral contraceptive pills, intravaginal contraception, injections and intrauterine devices (IUDs).

Gonadotropin-releasing hormone (GnRH) agonists: These medications can be taken via a nasal spray or injection and they work by shrinking your fibroids. They’re sometimes used to shrink a fibroid before surgery, making it easier to remove the fibroid. However, these medications are temporary and if you stop taking them, the fibroids can grow back.

Oral therapies: Elagolix is a new oral therapy indicated for the management of heavy uterine bleeding in premenopausal women with symptomatic uterine fibroids. It can be used up to 24 months. Talk to your doctor for pros and cons of this therapy. Another oral therapy, Tranexamic acid, is an antifibrinolytic oral drug that’s indicated for the treatment of cyclic heavy menstrual bleeding in women with uterine fibroids. Your doctor will monitor you during this therapy.

It’s important to talk to your healthcare provider about any medication you take. Always consult your provider before starting a new medication to discuss any possible complications.

Fibroid surgery

There are several factors to consider when talking about the different types of surgery for fibroid removal. Not only can the size, location and number of fibroids influence the type of surgery, but your wishes for future pregnancies can also be an important factor when developing a treatment plan. Some surgical options preserve the uterus and allow you to become pregnant in the future, while other options can either damage or remove the uterus.

Myomectomy is a procedure that allows your provider to remove the fibroids without damaging the uterus. There are several types of myomectomy. The type of procedure that may work best for you will depend on where your fibroids are located, how big they are and the number of fibroids. The types of myomectomy procedure to remove fibroids can include:

Hysteroscopy: This procedure is done by inserting a scope (a thin, flexible tube-like tool) through the vagina and cervix and into the uterus. No incisions are made during this procedure. During the procedure, you provider will use the scope to cut away the fibroids. Your provider will then remove the fibroids.

Laparoscopy: In this procedure, your provider will use a scope to remove the fibroids. Unlike the hysteroscopy, this procedure involves placing a few small incisions in your abdomen. This is how the scope will enter and exist your body. This procedure can also be accomplished with the assistance of a robot.

Laparotomy: During this procedure, an incision is made in your abdomen and the fibroids are removed through this one larger cut.

If you aren’t planning future pregnancies, there are additional surgical options your healthcare provider may recommend. These options are not recommended if pregnancy is desired and there are surgical approaches that remove the uterus. These surgeries can be very effective, but they typically prevent future pregnancies. Surgeries to remove fibroids can include:

Hysterectomy: During this surgery, your uterus is removed. A hysterectomy is the only way to cure fibroids. By removing your uterus completely, the fibroids can’t come back and your symptoms should go away. If your uterus alone is removed — the ovaries are left in place — you will not go into menopause after a hysterectomy. This procedure might be recommended if you’re experiencing very heavy bleeding from your fibroids or if you have large fibroids. When recommended, the most minimally invasive procedure to perform hysteroscopy is advisable. Minimally invasive procedures include vaginal, laparoscopic or robotic approaches.

Uterine fibroid embolization: This procedure is performed by an interventional radiologist who works with your gynecologist. A small catheter is placed in the uterine artery or radial artery and small particles are used to block the flow of blood from the uterine artery to the fibroids. Loss of blood flow shrinks the fibroids — improving your symptoms.

Radiofrequency ablation (RFA): This is a safe and effective treatment for women with symptomatic uterine fibroids and can be delivered by laparoscopic, transvaginal or transcervical approaches.

There’s also a newer procedure called magnetic resonance imaging (MRI)-guided focused ultrasound that can be used to treat fibroids. This technique is actually done while you’re inside a MRI machine. You are placed inside the machine — which allows your provider to have a clear view of the fibroids — and then an ultrasound is used to send targeted sound waves at the fibroids. This damages the fibroids.

Are there any risks related to fibroid treatments?

There can be risks to any treatment. Medications can have side effects and some may not be a good fit for you. Talk to your healthcare provider about all medications you may be taking for other medical conditions and your complete medical history before starting a new medication. If you experience side effects after starting a new medication, call your provider to discuss your options.

There are also always risks involved in surgical treatment of fibroids. Any surgery places you at risk of infection, bleeding, and any inherent risks associated with surgery and anesthesia. An additional risk of fibroid removal surgery can involve future pregnancies. Some surgical options can prevent future pregnancies. Myomectomy is a procedure that only removes the fibroids, allowing for future pregnancies. However, women who have had a myomectomy may need to deliver future babies via Caesarean section (C-section).

How large do uterine fibroids need to be before being surgically removed?

The normal uterine size is the size of a lemon or 8 cm. There isn’t a definitive size of a fibroid that would automatically mandate removal. Your healthcare provider will determine the symptoms that are causing the problem. Fibroids the size of a marble for instance, if located within the uterine cavity, may be associated with profound bleeding. Fibroids the size of a grapefruit or larger may cause you to experience pelvic pressure, as well as make you look pregnant and see increased abdominal growth that can make the abdomen enlarged. It’s important for the healthcare provider and patient to discuss symptoms which might require surgical intervention.

PREVENTION

Can fibroids be prevented?

In general, you can’t prevent fibroids. You can reduce your risk by maintaining a healthy body weight and getting regular pelvic exams. If you have small fibroids, develop a plan with your healthcare provider to monitor them.

Can I get pregnant if I have uterine fibroids?

Yes, you can get pregnant if you have uterine fibroids. If you already know you have fibroids when you get pregnant, your healthcare provider will work with you to develop a monitoring plan for the fibroids. During pregnancy, your body releases elevated levels of hormones. These hormones support the growth of your baby. However, they can also cause your fibroids to get bigger. Large fibroids can prevent your baby from being able to flip into the correct fetal position, increasing your risk of a breech birth or malpresentation of the fetal head. In very rare cases, you may be at higher risk of a pre-term delivery or a C-section delivery. In some cases, fibroids can contribute to infertility. It can be difficult to pinpoint an exact cause of infertility, but some women are able to become pregnant after receiving treatment for fibroids.

OUTLOOK / PROGNOSIS

Will fibroids go away on their own?

Fibroids can shrink in some women after menopause. This happens because of a decrease in hormones. When the fibroids shrink, your symptoms may go away. Small fibroids may not need treatment if they aren’t causing any symptoms.

Gynecologist Explains: Fibroid Uterus

A note from Cleveland Clinic

Uterine fibroids are a common condition that many women experience during their life. In some cases, fibroids are small and don’t cause any symptoms at all. Other times, fibroids can cause challenging symptoms. Talk to your healthcare provider if you experience any kind of discomfort or pain. Fibroids can be treated and, often, your symptoms can be improved.

What is the main cause of fibroids?

What are fibroids?

Fibroids are growths made of smooth muscle cells and fibrous connective tissue. These growths develop in the uterus and appear alone or in groups. They range in size, from as small as a grain of rice to as big as a melon. In some cases, fibroids can grow into the uterine cavity or outward from the uterus on stalks.

An estimated 20% to 50% of women of reproductive age currently have fibroids, and up to 77% of women will develop fibroids sometime during their childbearing years. Only about one-third of these fibroids are large enough to be detected by a health care provider during a physical exam, so they are often undiagnosed.

In more than 99% of fibroid cases, the tumors are not cancerous and do not increase the risk for uterine cancer.

What causes fibroids?

The cause of fibroids is not known. Research suggests each tumor develops from an abnormal muscle cell in the uterus and multiplies rapidly when encountering the estrogen hormone, which promotes the tumor’s growth.

Who is at risk for fibroids?

Women in their reproductive age are most likely to be affected by fibroids.

Other risk factors may include:

Family history of fibroids

Obesity

Diet high in red meat

High blood pressure

Black women are more likely to develop fibroids than other women, they are diagnosed at younger ages and they more often require treatment. It is not clearly understood why fibroids disproportionately affect Black women.

Fibroids Symptoms

It is common that women who have fibroids do not experience any noticeable symptoms. Other women with fibroids experience severe symptoms that interfere with their daily lives. Common fibroid symptoms include:

Heavy or prolonged periods

Bleeding between periods

Abdominal discomfort and/or fullness

Pelvic pain

Lower back pain

Bladder symptoms, such as frequent urination or difficulty emptying the bladder

Bowel symptoms, such as constipation or excessive straining with bowel movements

Women with fibroids can also experience:

Infertility

Complications during pregnancy

Pain during intercourse

Emergency Fibroid Symptoms

In rare cases, women with fibroids need emergency treatment. You should seek emergency care if you have sharp, sudden pain in the abdomen that is unrelieved with pain medication, or severe vaginal bleeding with signs of anemia such as lightheadedness, extreme fatigue and weakness.

How are fibroids diagnosed?

Fibroids are most often found during a routine pelvic exam. During this exam, your health care provider will press on your abdomen and may feel a firm, irregular mass that might indicate a fibroid.

To diagnose uterine fibroids, your doctor may order one of the following tests:

Pelvic Ultrasound. A procedure during which a small instrument, called a transducer, is either inserted into the vagina or pressed over the abdomen to produce pictures of the internal organs using sound waves. The doctor can see the size, shape and texture of the uterus and evaluate any growths.

Magnetic resonance imaging (MRI). This is a form of advanced imaging technology that provides highly detailed images of internal organs. These images help your provider determine the exact location and characteristics of fibroids and, if needed, plan minimally invasive treatments.

Hysterosalpingography. This is a type of X-ray exam of the uterus and fallopian tubes. Your doctor will use a special dye to more easily visualize these organs and determine if the fibroids have blocked your fallopian tubes.

Hysteroscopy. This is a visual exam of the canal of the cervix and the interior of the uterus using a viewing instrument (hysteroscope) inserted through the vagina.

Woman speaking with her gynecologist

Johns Hopkins Fibroid Center

Our experts offer women experiencing fibroids a wide range of treatment options, including alternatives to hysterectomy. We are at the forefront of fibroid research aimed at improving our patients’ quality of life.

Learn more about our fibroid center

How are fibroids treated?

Since the growth of most fibroids slows as you approach menopause, your health care provider may simply suggest “watchful waiting” if your symptoms are tolerable. With this approach, the health care provider closely monitors your symptoms with frequent follow-up visits and ultrasounds to make sure there are no significant changes in your condition.

Treatment may be necessary if your fibroids cause significant symptoms. Treatment options include medicinal and surgical approaches. Your doctor will recommend treatment based on your symptoms, location and size of the fibroids, your age and medical history, and your health goals such as a desire for pregnancy.

In some cases, women also require treatment for iron-deficiency anemia due to heavy or prolonged periods, or because of abnormal bleeding between periods.

Medicinal Treatment Options

Anti-inflammatory painkillers such as ibuprofen or naproxen may reduce menstrual bleeding caused by fibroids and provide pain relief. This is the most conservative treatment method and is recommended for women with occasional pelvic pain or discomfort due to fibroids.

Hormonal treatment can include:

Gonadotropin-releasing hormone agonists (GnRH agonists). This treatment lowers your estrogen level and triggers a temporary “medical menopause.” GnRH agonists are used to shrink the fibroid(s). They are also used to stop your period in preparation for surgery or to improve your blood count. Doctors will not typically administer this medication for longer than a year — and the medication’s effects are reversed once it leaves your system.

Oral contraceptive pills (or a patch or vaginal ring) can help reduce bleeding associated with fibroids.

Progesterone-containing agents — pills, implant, injection or intrauterine device (IUD) — may also control bleeding.

Procedural Treatment Options

Conservative surgical therapy. Myomectomy is a procedure during which the fibroids are removed but the uterus stays intact. This approach is recommended for women who want to preserve their fertility. There are three primary myomectomy methods:

Uterine Fibroids are common for women, but not normal

Traditional open myomectomy. The procedure is performed via an abdominal incision and carries some risks, including bleeding and scar tissue formation at the incision site and a longer recovery. This approach may be necessary depending on the size and number of fibroids.

Laparoscopic or robotic myomectomy. This outpatient procedure uses small “keyhole” abdominal incisions and a laparoscope. This minimally invasive approach often results in less bleeding and a faster recovery, but it is not suited for all patients. Most patients go home the day of surgery and recover within a few weeks. Your doctor will determine if you are a good candidate for this procedure.

Hysteroscopic myomectomy. During this outpatient procedure, your doctor uses a camera inserted through the vagina to shave off visible portions of the fibroid tumors. This method only treats fibroids that have formed inside the uterine cavity.

Uterine artery embolization (UAE), also called uterine fibroid embolization, is a newer technique. This minimally invasive procedure shrinks fibroids by cutting off their blood flow. An interventional radiologist performs UAE, using X-rays for guidance. Health care providers are looking at this procedure’s long-term implications regarding fertility and regrowth of the fibroid tissue.

Magnetic resonance guided focused ultrasound, also a newer technique, focuses sound waves on fibroids that are at the front of the uterus. The potential effects on fertility are not yet understood.

Radiofrequency ablation of fibroids is another newer technique, during which — under laparoscopic and ultrasound guidance — heat is applied into the fibroids to make them smaller and softer. The potential effects on fertility are not currently well understood.

Hysterectomy for Fibroids

During a hysterectomy, the entire uterus is removed. Fibroids are the #1 reason for hysterectomies in the U.S.

The procedure can be performed vaginally or abdominally via a large incision, laparoscopically or robotically, depending on the size of your uterus, location of the fibroids and your medical history.

Because a hysterectomy is a major surgery, it is only recommended to treat fibroid cases for women who are not interested in preserving their fertility. It is the most effective method of fibroid treatment because it eliminates the possibility of recurrence.

Fibroids and Pregnancy

Uterine fibroids can affect fertility in a variety of ways. If fibroids grow and block the uterus or fallopian tubes, they may make it harder to become pregnant. They may also have other negative effects on pregnancy including:

Increased risk of miscarriage and preterm labor

Abnormal attachment of the placenta

Increased likelihood of delivery by cesarean section

Postpartum hemorrhage

If you have fibroids and are experiencing infertility, consult a reproductive endocrinologist who specializes in treatment of women with fibroids. A fertility specialist can develop a treatment plan that maximizes your chances of a successful pregnancy. If surgery to treat fibroids is needed before pursuing fertility treatment, myomectomy is likely your best option.

Dr Mindy Christianson with patient

Johns Hopkins Fertility Center

Our expert team of infertility specialists, reproductive endocrinologists, clinical nurses and embryologists uses state-of-the-art assisted reproductive technology to provide comprehensive fertility care.

Learn more about our fertility center

Fibroids After Menopause

Typically, once a woman goes through menopause, fibroids will stop growing or will shrink down. So, postmenopausal women with fibroids do not often experience symptoms related to their fibroids. In some cases, however, surgery may be necessary if the woman has significant symptoms including post-menopausal bleeding, pressure related symptoms or pain. If a fibroid grows during menopause, it might indicate an unexpected cancer such as leiomyosarcoma— additional testing is needed to determine the cause of the fibroid growth and to develop a treatment plan.

what is fibroids?

Fibroids are non-cancerous growths that develop in or around the womb (uterus).

The growths are made up of muscle and fibrous tissue, and vary in size. They're sometimes known as uterine myomas or leiomyomas.

Many women are unaware they have fibroids because they do not have any symptoms.

Women who do have symptoms (around 1 in 3) may experience:

heavy periods or painful periods

tummy (abdominal) pain

lower back pain

a frequent need to urinate

constipation

pain or discomfort during sex

In rare cases, further complications caused by fibroids can affect pregnancy or cause infertility.

Seeing a GP

As fibroids do not often cause symptoms, they're sometimes diagnosed by chance during a routine gynaecological examination, test or scan.

See a GP if you have persistent symptoms of fibroids so they can investigate possible causes.

If the GP thinks you may have fibroids, they'll usually refer you for an ultrasound scan to confirm the diagnosis.

Read more about diagnosing fibroids.

Why fibroids develop

The exact cause of fibroids is unknown, but they have been linked to the hormone oestrogen.

Why more women need to pay closer attention to the symptoms of fibroids

Oestrogen is the female reproductive hormone produced by the ovaries (the female reproductive organs).

Fibroids usually develop during a woman's reproductive years (from around the age of 16 to 50) when oestrogen levels are at their highest.

They tend to shrink when oestrogen levels are low, such as after the menopause when a woman's monthly periods stop.

Who gets fibroids?

Fibroids are common, with around 1 in 3 women developing them at some point in their life. They most often occur in women aged 30 to 50.

Fibroids are thought to develop more frequently in women of African-Caribbean origin.

It's also thought they occur more often in overweight or obese women because being overweight increases the level of oestrogen in the body.

Women who have had children have a lower risk of developing fibroids, and the risk decreases further the more children you have.

Types of fibroids

Fibroids can grow anywhere in the womb and vary in size considerably. Some can be the size of a pea, whereas others can be the size of a melon.

The main types of fibroids are:

intramural fibroids – the most common type of fibroid, which develop in the muscle wall of the womb

subserosal fibroids – fibroids that develop outside the wall of the womb into the pelvis and can become very large

submucosal fibroids – fibroids that develop in the muscle layer beneath the womb's inner lining and grow into the cavity of the womb

In some cases, subserosal or submucosal fibroids are attached to the womb with a narrow stalk of tissue. These are known as pedunculated fibroids.

Uterine Fibroid Surgery: Back to Work in 1 Day

Diagram of different types of fibroidsCredit:

Treating fibroids

Fibroids do not need to be treated if they are not causing symptoms. Over time, they'll often shrink and disappear without treatment, particularly after the menopause.

If you do have symptoms caused by fibroids, medicine to help relieve the symptoms will usually be recommended first.

There are also medications available to help shrink fibroids. If these prove ineffective, surgery or other, less invasive procedures may be recommended.