Uterine fibroids, diet, and more
Up to 80% of women develop fibroids by the age of 50. Fibroids are non-cancerous smooth muscle tumors. They are characterized according to position and size within the uterus. They can occur in the uterus’ outer layer (subserosal fibroids) internal layer (submucosal fibroids), within the uterine smooth muscle (intramural fibroids), and on stalks from the outer and inner uterine walls (pedunculated subserosal and pedunculated submucosal fibroids respectively).
Small fibroids are less than 5 cm, medium fibroids are 5-10 cm, and large fibroids are over 10 cm and can grow beyond the size of a grapefruit. They affect women of reproductive age. Estrogen and progesterone promote their growth.
Generally, the closer they are to the inner lining and the larger they are, the more symptoms they will cause. Symptoms include frequent urination, constipation, heavy and/or irregular bleeding, severe pelvic pain, particularly from pressure, infertility, and miscarriages.
Risk Factors for Developing or Exacerbating Fibroids
Aging, genetic predisposition, and onset of menstruation prior to 11 years of age, i.e., early menarche, are some non-modifiable risk factors.
Some modifiable ones include vitamin D deficiency, high consumption of red meats, particularly processed, obesity status, and alcohol consumption. In obesity, fat tissue converts androgens to estrogen and decreases sex-hormone binding globulin (SHBG), thereby increasing free estrogen which then facilitates fibroid growth.
High-fat dairy may indirectly contribute to fibroid growth through their effect on increasing estrogen levels. Sugar sweetened beverages, as they are linked to obesity, may also increase risk.
Dietary Interventions
Fruits and vegetables, with their anti-inflammatory and antioxidant properties have been shown to reduce risk. Consuming foods high in vitamin D such as fatty fish, sun exposed mushrooms, and foods fortified with vitamin D may also lower risk.
Green tea extract contains epigallocatechin gallate (EGCG), which has been shown to reduce fibroid size and symptoms without adverse effects.
Medical/Hormonal Treatments
Gonadotropin-releasing hormone (GnRH) agonists, oral contraceptives, progestins and selective progesterone receptor modulators (SPRMs), such as ulipristal acetate have been shown to control bleeding and may reduce fibroid size.
Non-Surgical Procedures
The uterine artery embolization (UAE) procedure is where tiny sand grain sized particles are injected into the blood vessels leading to the uterus, cutting off the fibroids’ blood supply, shrinking them.
Magnetic resonance-guided focused ultrasound (MRgFUS) uses magnetic resonance to locate the fibroids and then ultrasound shock waves heat up, destroy, and erode them.
Surgical Options
A myomectomy is the surgical removal of the fibroids. It preserves the uterus but can cause excessive bleeding, weaken the uterine wall, compromise future pregnancies, increase scar tissue that potentially increases pain, and reduce fertility.
A hysterectomy is a complete removal of the uterus. While it permanently prevents fibroids, consequences include permanent infertility, potential early menopause symptoms, compromised mental and physical health, and reduced libido.
Summary
While fibroids occur in most women by age 50 and may be considered benign, they can cause severe symptoms prompting invasive removal. Getting sun and consuming vitamin D rich foods, consuming a diet high in fruits and vegetables, taking green tea extract, limiting or eliminating red and cured meats and obesogenic foods such as sugar sweetened beverages may help tremendously in preventing fibroids altogether. If experiencing symptoms such as heavy bleeding and severe pelvic pain, medical intervention may be needed.
About the Author
Patrick Traynor, PHD, MPH, RD, CPT is a registered dietitian with an insurance-based practice, MNT Scientific, LLC in South Lake Tahoe, CA, Minden, NV, & Ashland, OR. In office or video appointments can be requested online at MNTScientific.com or by calling (530)429-7363. Inquiries can be directed to [email protected].
