Between 20 and 25 per cent of women over the age of 35 have fibroids. They are benign (non-cancerous) tumours or fibrous lumps, which grow in the muscle lining of the uterus wall, and are the commonest reason why women experience regular heavy periods. One-third of women with fibroids bleed so heavily that they become anaemic . The fibroids are composed of a combination of smooth muscle and connective tissue. Their size can vary from that of a small pea to that of a large orange, or even larger, which would greatly increase the volume of the uterus. Fibroids grow slowly, and can cause heavy bleeding, back pain, pelvic pain and, when large, place pressure on nearby organs or structures like the bladder, bowel or rectum. When there is pressure on the bowel constipation can occur, and when pressure is placed on the rectal or pelvic veins, haemorrhoids or varicose veins in the legs can develop. Only very rarely do they develop into cancer.
• long heavy periods
• infertility
• pressure in the abdomen which may press on other organs like the bowel, and cause constipation, or the bladder and cause frequent urination
• swollen abdomen
• backache
Fibroids can occasionally cause problems in pregnancy. A fibroid may grow in a place which blocks the exit of the baby thereby resulting in a difficult labour or creating a situation where a caesarean section is required. Also, there is a greater than normal chance of the baby lying in an abnormal position in the womb and of heavy bleeding after birth.
• Fibroids are thought to depend on oestrogen, as they do not occur prior to puberty and become smaller after the menopause. Just why they occur in some women and not others is not fully understood.
• There is a higher incidence of fibroids amongst obese women who have above average levels of growth hormone and blood glucose.
• It is thought that genetic factors may also play a part in the predisposition, as black women in the USA, for example, are three to nine times more likely to develop fibroids than their white counterparts.
• Fibroids are also more common in women who have not been pregnant or have small families.
• Eliminate the possibility of pregnancy by testing your urine and examining you.
• Perform a cervical smear to eliminate the possibility of cancer of the cervix.
• Give routine blood tests to check for anaemia, any underlying infection or sinister growth.
• Prescribe a supplement of iron (to be taken with fruit juice) if you are anaemic.
• Give a vaginal ultrasound to check the appearance of the uterus and other related structures. This is easy to perform and is an excellent test.
• Refer you to a gynaecologist for a laporoscopy, a minor investigative operation that, with the use of a laporascope inserted through the abdominal wall, examines the pelvic structures.
• The surgeon may suggest removing the fibroids if they are potentially troublesome, and this procedure is called myomectomy. Laser therapy is sometimes used also these days.
In the main, small fibroids are not troublesome, and are best left alone. If they do become large, and there is fear of them pressing on a nearby organ or blocking the cervix or the Fallopian tubes they will need to be removed. Women with fibroids are often advised to have a hysterectomy. If you receive this advice, and you are not too troubled by your symptoms, then you should certainly question it,
• Waiting to see whether the fibroids cause symptoms that affect the quality of your life is a reasonable policy. If not, they are probably best kept away from the surgeon’s knife.
• In theory a diet that prevents oestrogen surges may help to control fibroids. Concentrate on eating a high-fibre, low saturated fat and low sugar diet
• Avoid or severely limit meat and dairy products unless they are organic. These foods contain an abundance of synthetic hormones and antibiotics. Dairy products are also a primary source of arachidonic acid – the precursor to the pro-inflammatory series-2 prostaglandins. The high saturated fat content of many dairy products is a risk factor for excess oestrogen levels in the body.
• New research shows that it is important to consume regular amount of plant oestrogens, called phytoestrogens. They have a modulating effect on our body’s oestrogen, raising levels if they are too low and conversely lowering them when there are signs of ‘oestrogen dominance’. Phytoestrogens predominate in soya beans and soya bean products like flour, tofu and soya milk, golden linseeds and the herb red clover (tablets, or sprouted seeds).
• Increase your intake of fibre in the form of wholegrains and fresh fruit and vegetables, especially if you suffer with constipation. Fibre promotes oestrogen excretion.
• Women with fibroids should avoid alcohol entirely or consume it in small amounts. Alcohol is stressful to the liver and can affect the liver’s ability to metabolise hormones efficiently. Alcohol also depletes the body’s B-complex vitamins and minerals such as magnesium.
• Sugar, like alcohol, depletes the body’s B-complex vitamins and minerals, which can impair hormone metabolism in the liver and can worsen muscle tension and irritability as well as nervous tension and anxiety.
• Essential fatty acids (EFAs) are beneficial in the treatment of fibroids particularly where menstrual cramps are severe. EFAs are converted into anti-inflammatory hormone-like substances called prostaglandins. These prostaglandins have muscle-relaxant and blood vessel relaxant properties that can significantly reduce muscle cramps and tension. The best sources of EFAs are sunflower oil, safflower oil, walnut oil, raw flaxseed oil, pumpkin seed oil and oily fish such as pilchards, mackerel and sardines.
• Lose weight if you need to as well.
• The B vitamins and magnesium may also help to regulate oestrogen metabolism, so you could try supplements of these. Any response to these treatments is likely to take months if not years. So be patient!
Complementary therapies
Herbal medicine may have quite a bit to offer. It will take an experienced herbal practitioner to work out the right prescription. Homeopathic remedies are worth a try, and so too is acupuncture