What are fibroids? - Fibroids (also called myomas) are non-cancerous growths in or on the muscular wall of the womb. They can vary in number and size, from as small as a pea to as large as a seven-or eight-month-old foetus.

Fibroids are given different names depending on where and how they grow:

• Submucosal fibroids grow on the inside of the womb and extend into the uterine cavity
• Intramural fibroids grow within the uterine/womb wall
• Subserol fibroids grow on the outside of the womb, on the lining between the uterus and the pelvic cavity
• Pedunculated fibroids can be attached either to the inside or outside wall of the womb, and they are characterised by a stalk

Fibroids are very common and can affect 20% of women over the age of 30. They are not common in women under the age of 20 - except in Afro-Caribbean women who are more susceptible to fibroid growths, even in their teens. Fibroids seem to run in families, but we are not sure at present whether this is a genuinely genetic predisposition.

Can fibroids become cancerous?

Although fibroids are called growths and tumours, fibroids are almost always benign. In fact, less than 1 in 1,000 cases will be malignant.

What are the symptoms?

• The main symptom of fibroids is heavy periods. When fibroids grow inside the womb (submucosal or intramural), the mechanism that operates menstrual flow may not work property. The heavy bleeding can be a result of the fibroids making the womb bigger, or the pressure of the fibroids may disrupt the normal blood flow. As a result many women with fibroids will have heavy periods, but experience no pain.
• Some women do experience pain with fibroids - not necessarily intense pain, but a feeling of pressure and a dragging sensation in the abdomen.
• If fibroids are on stalks (pedunculated), they can twist, causing extreme pain.
• In some cases, the bleeding can be so severe that sufferers develop anaemia.
• During menstruation, some women lose clots of Wood that resemble pieces of liver. If the blood flow is heavy, the anti-clotting factors that are normally present in the menstrual blood may not be able to keep the blood flowing smoothly, hence the pieces of clotted blood.
• Other women can experience periods that go on for weeks, sometimes with no real break between one period and the next.
• In many cases, fibroids can be symptom less. If they grow in a way that doesn't cause pressure on the neighboring organs, women can live with sometimes large fibroids for many years without requiring any medical help. In most cases they shrink during the menopause and post-menopause years.
• In some cases the first indication that there may be fibroids is when there is trouble conceiving or maintaining a pregnancy.
• Many women will never know they have them. Significantly large fibroids can enlarge and distort the womb, making it impossible for a fertilised egg to implant. Many women who have been treated for infertility may have perfectly normal cycles. They will not have even known that they were pregnant, because the fertilised egg would have been unable to attach itself to the lining of the uterus with fibroids there.
• If fibroids press on other organs, such as the bladder or bowel, symptoms such as frequent urination, constipation or backache can be experienced.
• Most women experience some abdominal swelling, although it may be minor. In other women, the lower abdomen can look as in the early stages of pregnancy.

What causes fibroids?

Although fibroids are very common, their exact cause is unknown. We do know that fibroids are sensitive to oestrogen; so if HRT is introduced at (he menopause, fibroids can grow. During the menopause, when levels of oestrogen naturally decline, fibroids can shrink.

So, an excess of oestrogen might trigger the growth of fibroids in the first place. As women age, or during times of emotional stress, it is possible to have cycles where ovulation does not occur. During those cycles, oestrogen will be produced without progesterone (which is only released after ovulation) to counterbalance it. In this case, there can be excess oestrogen because the other necessary hormone (progesterone) is not there to balance it.

Diagnosis of fibroids

Fibroids can be diagnosed in several ways. Often they are picked up on a simple internal examination. If the fibroids are small then a pelvic ultrasound can be used. This method is often done to confirm the diagnosis from the internal examination.

The nutritional treatment of fibroids

The aim of the nutritional approach is to improve the diet to decrease excess oestrogen and to use supplements and herbs to help address the hormone imbalance. So, eat a healthy balanced diet and consider the following:

Coffee
Avoid coffee, which increases menstrual flow. Instant coffee has also been shown to increase the likelihood of developing fibroids in mice.

Weight and high saturated fat intake
A high intake of saturated fats (mainly found in animal products) can contribute to weight gain, which can be problematic for someone suffering from fibroids because body fat is a manufacturing plant for oestrogen. Any excess oestrogen will increase the size of fibroids, and possibly contribute to their growth. Saturated fats can also block the body's absorption of the essential fatty acids, which are necessary for helping with fibroids.

Liver function
The liver detoxifies harmful substances and processes the hormones that the body produces, rendering them harmless. It is supposed to deactivate oestrogen, but if the liver is not functioning efficiently an accumulation of oestrogen can develop. Again, this will encourage the growth of fibroids.

Therefore, avoid substances that can compromise the functioning of the liver, e.g. alcohol.

 Fibre

Ensure an adequate intake of fibre. It helps to reduce excess oestrogen levels. Include whole grains and plenty of fresh fruit and vegetables.

Foods containing fibre can help with constipation. It is important that a woman with fibroids is not constipated because the bowels will help to excrete toxins, waste products and hormones.

Phytoestrogens

Phytoestrogens (including soya, chickpeas, lentils and garlic) can actually control levels of excess oestrogen by blocking oestrogen receptors in different parts of the body, preventing the more powerful oestrogens from getting through.

Phytoestrogens have also been found to stimulate the production of sex hormone-binding globulin (SHBG). SHBG is a protein produced by the liver that binds sex hormones such as oestrogen in order to control how much of them are circulating in the blood at any one time. The fewer hormones that are circulating the less there are available to stimulate the fibroid to grow.

Xenoestrogens

Xenoestrogens are foreign oestrogens - they come from environmental sources. Fibroids have been found to contain larger amounts of the pesticide DDT than any other tissue in the womb. Although DDT is banned in the UK it is still used in some developing countries and can therefore enter our food chain through imported goods Buying organic produce is even more important when a woman is suffering from fibroids.

Essential fatty acids

Beneficial prostaglandins, which help to reduce abnormal blood clotting, are produced by essential fatty acids - contained in nuts, seeds, oils and oily fish. They can also be taken as supplements.

Supplements

The use of certain vitamins and minerals can be extremely useful in helping to control fibroids, along with a good diet Vitamins, minerals and essential fatty acids should be taken to control heavy bleeding, while herbs and dietary changes should help control the growth of fibroids.

Vitamin A

Vitamin A is an antioxidant that helps cells reproduce normally and is also needed for red blood cell production Vitamin A deficiency has been found in women with heavy periods. One study showed that 92% of women prescribed supplemental vitamin A found that their heavy Weeding was either cured or alleviated.

B vitamins

The B vitamins are particularly important for heavy periods for a number of reasons. First and foremost, they are needed by the liver to convert excess oestrogen into weaker and less dangerous forms. Vitamin B6 is needed for the production of beneficial prostaglandins which help reduce abnormal blood clotting.

The B vitamins are also crucial for the conversion of linoleic acid to GLA (gamma linoleic acid), which is necessary to produce beneficial prostaglandins. The B vitamins are required to convert Omega 6 oils into a form that can be used by the body to produce the 'good' type of prostaglandins.

Vitamin C

Vitamin C and bioflavonoids help to strengthen the capillaries in the body, which can reduce heavy bleeding. Taken as a supplement vitamin C has also produced excellent results for many women with heavy periods. One study showed that taking 200 mg of vitamin C with bioflavonoids, three limes daily, reduced bleeding in 87 % of the women tested.

Iron

If a woman is bleeding very heavily she runs the risk of becoming anaemic. Common symptoms of anaemia include fatigue, loss of appetite, constipation, irritability and pallor, among other things.

Iron deficiency is a bit of a double-edged sword. If there is heavy Weeding, the woman will become iron deficient. However, one of the symptoms of iron deficiency is also an increased risk of heavy Weeding. Iron helps the blood vessels to contract, which is need to slow down the flow during a period.

Herbs

Herbs are extremely useful in the treatment of fibroids, in terms of hormone balance, and they can also improve liver function for the detoxification of hormones.

Agnus Castus
(Vitex/Chasteberry root)

This herb is best known as a female hormone balancer it helps to regulate the oestrogen and progesterone balance so that progesterone levels are optimum. This in turn reduces any oestrogen dominance that could be stimulating the fibroid

Milk thistle
(silybum marianum, Silymarin)

This is an important herb for the liver Oestrogen should be deactivated by the liver and then excreted. If the liver does not work efficiently there is an accumulation of hormones.

Other herbs

Other herbs helpful for controlling bleeding are cranesbill (Geranium maculatum) and yarrow (Achillea millefolium). Shepherd's purse (Capsella bursa pastoris) is also an excellent herb for the main symptom of fibroids because it is astringent in nature. Shepherd's purse has been used in clinical trials to prevent heavy bleeding. TT

Dr Marilyn Glenville PhD is the UK's leading nutritional therapist specialising in female hormone problems. She is editorial representative on the Food and Health Forum at the Royal Society of Medicine and a registered nutritionist. Dr Glenville is the author of a number of internationally best selling books including 'Fat Around the Middle', Natural Solutions to Infertility', 'New Natural Alternatives to HRT' and 'The Nutritional Health Handbook for Women'. She works in a gynecology clinic in London.
For more in depth information, look on Marilyn's website www.marilynglenville.com.

Reproduced with the kind permission of Today's Therapist