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Fibroids


What are Fibroids?
Fibroids are benign (non-cancerous) tumours of the uterus. They grow in various locations on and within the muscular wall of the uterus or inside the uterine cavity. They are encapsulated connective tissue that can be single or multiple. They vary in size from a few millimetres to very large, eg. size of an orange. They affect 20-25% of women past the age of 35. They rarely occur before adolescence and shrink after menopause. Fibroids can run in families, although environmental factors play a huge role in whether a disease is ever expressed.

Signs and Symptoms.
Most commonly there is heavy, clotty and prolonged bleeding which can lead to anaemia and fatigue as well as painful periods, backache, swelling. Some women will have no symptoms and symptoms are rare before 30 years. Larger fibroids will start to put pressure on adjacent abdominal organs causing increased urinary frequency, feelings of heaviness and congestion in the lower abdomen and abdominal enlargement. Depending on the location of the fibroid it may cause miscarriage or infertility.

Diagnosis. Diagnosis is made by pelvic ultrasound, pelvic examination and palpation, laporoscopy.
Fibroids that are not interfering with fertility or causing unwanted symptoms are often simply left and require no surgery or drugs to shrink or remove them. Monitoring every six months and alternative therapies to moderate their growth and rebalance the underlying hormones is advisable. Rarely, they can undergo malignant change and develop into sarcoma.

Common Theories of Causation
  • Oestrogen It is unknown why the uterine muscle starts to rearrange itself but it is known that its growth is stimulated by oestrogen. This is illustrated by pregnancy that reduces the risk of developing fibroids and the fact that a fibroid will shrink after menopause. Obesity, however, is related to an increased risk as there is increased conversion of oestrogen in fatty tissue. One study found that there are more oestrogen and progesterone receptors in fibroid tissue than in a normal uterus.

  • Xenoestrogens are synthetic environmental oestrogens or chemicals that mimic oestrogen and to which we are increasingly exposed. Xenoestrogens include many pesticides, herbicides, dioxin, growth hormones stored in animal fat, PCBs in plastics which are released once heated or used for hot food or drinks, waterways due to the urine of women taking birth control pills or Homone Replacement Therapy(HRT) containing synthetic oestrogen, nonylphenols that are breakdown products of surfactants used in detergents, cosmetics and other toiletries and spermicides used in diaphragm jellies, condoms and vaginal gels.

    • Toxicity The liver and bowel are particularly important as the liver breaks down oestrogen to be detoxified which is then carried out in the faeces. If the liver is functioning poorly and/or there is constipation, then there will be a consequent build up of excess oestrogens in the blood. In today's modern world of high pollution, chemicals and highly refined Western diets often both the liver and digestion is compromised.

    • Insulin High insulin levels, that control blood sugar, stimulate the release of growth hormone that in turn increases the fibroid growth.

    • Stress Stress lowers melatonin, causing increased growth hormone that stimulates the fibroid growth. Stress also raises prolactin levels that inhibits progesterone, causing a relative excess of oestrogen.

    • Nutrition As illustrated above, highly refined carbohydrates and sugars cause insulin resistance and the consequent fibroid growth. A low glycaemic diet is essential. Growth hormone is also increased by low concentrations of essential fatty acids in the blood. A highly processed diet lacks fibre and causes constipation so that more oestrogen is reabsorbed back into the bloodstream. Coffee, alcohol, cigarettes and other recreational drugs are all liver toxins and exacerbate insulin resistance.

    Surgical Treatment of Uterine Fibroids
    If the fibroid is too large impinging on other organs causing pressure symptoms or structurally interfering with fertility by preventing implantation, a myomectomy (surgical removal of fibroid) is warranted and herbal and nutritional remedies can be used to aid healing and correct the underlying hormonal imbalance. Submucosal and intramural fibroids reduce fertility while subserosal have less impact on the uterus lining. After a myomectomy it is advised, however, to have six months of herbal treatment before conceiving to ensure the health of the uterus and prevent miscarriage and premature labour.

    • Laparoscopic removal: difficult to close wound in uterus easily and suture well. Therefore risk of uterine rupture in pregnancy is theoretically increased.
    • Laparotomy removal: favoured if complex or numerous fibroids because of speed of removal, better wound closure, less blood loss.
    • Embolisation (laporoscopically or radiologically): artery supplying fibroid is clotted so fibroid dies. Can cause a lot of pain and toxicity; can prolapse through the cervix; little research on post-operative implantation rates.
    • Hysteroscopic removal: for submucosal fibroids only.

    If surgery is required, naturopathic treatments are highly recommended both prior and after surgery to speed healing.

    Naturopathic Treatments for Fibroids
    Naturopathic treatments are useful especially to improve symptoms of heavy bleeding and control the underlying hormonal imbalance that is fuelling the growth of the fibroid. However, it is rare that they will shrink the tumour, especially fibroids of > 5 cm in size. Also a reduction in symptoms does not correlate to the size or growth rate of the tumour. Therefore, often naturopathic treatment must be used in conjunction with surgery if the fibroid is very large. Treatment length for fibroids usually requires 6-12 months, depending on the size and number of the fibroids and their location in the womb.

    • Dietary and lifestyle changes are essential for successful treatment and for maintenance of the condition long term to prevent further growth. Herbal medicines and nutritional supplements are individually prescribed to:
    • Balance hormones to improve the relative oestrogen excess and prevent further growth by correcting underlying hormonal imbalance
    • Ensure normal menstrual flow and uterine function; decrease heavy bleeding, intermenstrual bleeding or spotting and clotting
    • Improve fertility if required
    • Decrease constriction of blood vessels and muscular spasm, thereby decreasing pelvic congestion and pain
    • Improve liver function which breaks down and removes excess oestrogen, other hormones and toxins
    • Calm and nourish the nervous system as well as balance mood swings
    • Improve iron levels and prevent anaemia

    You will be referred to your doctor or GP for extensive blood tests unless these have already been done. If surgery or laporoscopy is required, support is given to aid healing, reduce the risk of adhesions and correct the underlying hormonal imbalance to prevent reoccurrences.

    Claudette provides comprehensive advice regarding lifestyle factors covering exercise, creativity, personal hygiene products, environmental factors, pain relief packs and referrals to complementary and supportive therapies.

    Using the work of Christiane Northrup, author of Women's Bodies Women's Wisdom, and the work of Vianna Stibal, ThetaHealing(R), the emotional connections to fibroids are discussed to address any underlying emotional issues or creativity blocks so as to create healthy boundaries in all areas of your life. Claudette's supportive approach makes this journey towards optimum health and balance rewarding and empowering.