Uterine Fibroids

Myometrial growths of the uterus. Also termed “fibromyoma” or “leiomyoma.” These occur in 25% of women over age 35 and are often asymptomatic, discovery being made during the pelvic exam. They may, however, cause excess menstrual bleeding and/or pelvic pain or bloating. Their growth is increased during pregnancy and with estrogen therapy, and they tend to atrophy after menopause. They may either grow into the lumen, into the pelvic cavity, or remain in the wall of the uterus. Otherwise known as myoma of the uterus, fibroids are the most common neoplasm of the female genital tract. They are discrete, round, firm, benign lumps of the muscular wall of the uterus, composed of smooth muscle and connective tissue, and are rarely solitary. Usually as small as an egg, they grow gradually to orange or grapefruit size commonly. The largest fibroid on record weighed over a hundred pounds. They often cause, or are coincidental with, heavier periods (hypermenorrhea), irregular bleeding (metrorrhagia), and/or painful periods (dysmenorrhea). Due to their mass, they may cause a cystocele (dropped uterus) later in life when pelvic floor supports weaken, leading to stress urinary incontinence. After menopause, they routinely atrophy. Contemporary medical treatment usually is surgical. Some particularly skillful surgeons are adept at excising only the myoma, leaving the uterus intact. Generally, however, hysterectomy is performed. Here again, natural progesterone offers a better alternative. Fibroid tumors, like breast fibrocysts, are a product of estrogen dominance. Estrogen stimulates their growth and lack of estrogen causes them to atrophy. Estrogen dominance is a much greater problem than is recognized by contemporary medicine. Many women in their 30’s begin to have anovulatory cycles. As they approach the decade before menopause, they are producing much less progesterone than expected but still producing normal (or more) estrogen. They retain water and salt, breasts swell and become fibrocystic, they gain weight (especially around the hips and torso), become depressed and lose libido, their bones suffer mineral loss, and they develop fibroids. All are signs of estrogen dominance, i.e., relative progesterone deficiency. When sufficient natural progesterone is replaced, fibroid tumors no longer grow in size (generally they decrease in size) and can be kept from growing until menopause, after which they will atrophy. This is the effect of reversing estrogen dominance. Anovulatory periods can be verified by checking serum progesterone levels the week following supposed ovulation. A low reading indicates lack of ovulation and the need to supplement with natural progesterone. The cause of anovulation is uncertain but probably attests to premature depletion of ovarian follicles secondary to environmental toxins and nutritional deficiencies common in the U.S. today.

Naturopathic Approach

A naturopathic approachto treating someone with uterine fibroids, would be to start with a complete hormone panel to discover any hormone imbalances as well as a fasting blood sugar and insulin test followed by a two hour post prandial blood sugar and insulin test to rule out underlying insulin resistance as a cause to the fibroids, especially if overweight or obesity is an issue. Most often the imbalance in the hormones is estrogen dominance which can also be accompanied by low progesterone. Therefore treatment would start with an estrogen detoxification program. Estrogen is detoxified through the same p450 enzymatic pathway as caffeine and alcohol so one way to maximize the detoxification of estrogen is to eliminate caffeine and alcohol from the diet. Clinical nutrition may also be added to assist. If insulin resistance is determined on lab findings a low glycemic, high protein meal plan may be recommended to help address the underlying insulin resistance. Bio-identical progesterone may be prescribed or botanical natural progesterone if progesterone is low. Castor oil packs may be prescribed to help manage symptoms as the underlying cause is addressed.