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March 20, 2018  |  Login
Fibroids Uterine
by James F. Balch, M.D. and Mark Stengler, N.D.

Contrary to their name, fibroids are not fibrous at all. Rather, they are growths of smooth muscle and connective tissue that most often appear on the walls of the uterus. Although it can be frightening to hear that you have a growth of any kind, rest assured that fibroids are noncancerous and usually harmless. They are also quite common: Fibroids affect more than 50 percent of women overall and are the most common reason for major surgery. For reasons that we don't yet understand, they appear much more often in women of African or Caribbean descent than in any other group. Most women with the condition tend to have several fibroids at once.

Many women who have fibroids experience no symptoms at all; the growths are usually discovered in the course of a routine exam or an ultrasound. In some cases, however, fibroids inside the uterus wear away the organ's lining, resulting in heavy or prolonged menstrual periods, bleeding between periods, or pain and bleeding during sexual intercourse. Persistent blood loss can cause anemia.

A fibroid may also grow so large that it distends the abdomen as it presses on the bladder or the intestines. A woman with a large fibroid may feel pain in her back or lower abdomen; if the growth distorts the bladder, she may feel a frequent urge to urinate. Sometimes the fibroid doesn't cause any pain but simply gives the abdomen a distended appearance. Women may also feel pressure, heaviness, and pain with sexual intercourse, as well as increased urinary frequency. Occasionally, a fibroid will block the fallopian tubes and lead to infertility or compress the ureters (the urinary tract from the kidneys to the bladder), causing impaired kidney function. In some instances the fibroids become calcified.

Fibroids are thought to be dependent upon estrogen; they tend to grow during the reproductive years and pregnancy, and they shrink with menopause, when estrogen levels recede. Fibroids often increase in size during perimenopause, when women do not ovulate regularly and thus have relatively higher estrogen levels (as ovulation increases progesterone). Thus hormone balance is the key factor with this condition.

Although estrogen is obviously an important factor in the development of fibroids, doctors do not know why the growths appear in some women and not in others. A tendency toward fibroids may run in families; the disorder is also more common in women who are obese or who have an underactive thyroid (which contributes to estrogen excess).

It is important that liver function be optimized in women with fibroids. The liver is responsible for breaking down estrogen (and other hormones) and secreting the metabolites into the large intestine for elimination. If the liver does not metabolize estrogen and its metabolites properly, then it is recycled throughout the body.

While the liver is the dominant player in estrogen metabolism, the flora or "friendly bacteria" in the large intestine are also important in estrogen metabolism. They prevent the reactivation and recycling of these unwanted estrogens. Conversely, "unfriendly bacteria" secrete an enzyme called beta-glucuronidase that causes estrogen to be recycled back through the body via the large intestine. A low-fiber and high-fat intake increases the activity of this enzyme.

Conventional medical treatment for fibroids has long been surgical removal of the uterus, a drastic option that should be considered only in those few cases in which fibroids cause severe pain or bleeding or pose a significant health threat. For mild to moderate cases, it is usually far wiser to follow a treatment program of conservative, noninvasive therapies until menopause is reached and the fibroids abate on their own.

Next: What are the Symptoms of Uterine Fibroids

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