Managing Fibroids with Natural Medicine
By Belle McCaleb – originally published InnerSelf Magazine
Fibroids are solid non-cancerous tumours of the uterus that may lead to very heavy menstrual periods and resultant anemia and disability. If the fibroids are very large they can also cause bowel, bladder and intercourse issues. Fertility can be affected either by the fibroids themselves or medical treatment. It is estimated up to 40% of women develop fibroids by the age of 40 and they are the primary reason for hysterectomy. Fibroids are hormone dependent. Estrogen is the main driver – fibroid tissue is hypersensitive to estrogen & lacks the normal regulatory mechanism that limits estrogen response. However fibroid growth is may also be influenced by progesterone, growth hormone, insulin, insulin like growth factors and prolactin.
Medical treatment of fibroids is dependent upon the severity of symptoms. Pharmaceutical drugs called GnRH agonists suppress estrogen and progesterone production at the level of the central nervous system and can suppress symptoms as well as shrink fibroids. However, they are not without possible side effects including hot flashes, headaches, vaginal dryness, reversible bone loss, depression and decreased libido. If symptoms are not well controlled or the pharmaceutical agents are not well tolerated, removal of the fibroids or the whole uterus is the most common surgical approach.
Natural medicine approaches focus mainly on balancing the hormonal milieu, particularly estrogens & progesterone, and limiting the menorrhagia (heavy bleeding) by enhancing uterine tone & circulation. Estrogen production, metabolism and clearance are influenced by many factors including poor diet, obesity, excess alcohol, high insulin levels, exposure to pesticides, chemicals, plastics and the consumption of hormone laden meat. Correction of these factors and minimising exposure to exogenous estrogens are essential. In addition specific dietary, herbal and nutritional approaches can help reduce estrogen load.
In the liver, estrogen is metabolised down 1 of 3 pathways. One of these (2-OH pathway) produces weak estrogenic activity, the other two produce strong estrogenic activity.
Dietary approaches that promote the 2OH pathway include a diet high in cruciferous vegies such as broccoli, cabbages, kale and Brussels sprouts. Citrus contain a substance called d-limonene which promotes detoxification of estrogen. Additional nutrients for supporting the 2-OH pathway are EPA fish oils, B vitamins (especially B6, B12 and folic acid), Vitamin E and magnesium. Many herbs support the preferred metabolic pathway including Rosemary, garlic and green tea.
Estrogen management also requires a healthy gut. If there is an overgrowth of certain bacteria in the gut the bound estrogen from liver detoxification that is heading for excretion via the faeces can be “unbound” via bacterial activity. This leads to reabsorption of estrogen into the system. Correcting gut flora through a comprehensive program including specfic prebiotics, probiotics and herbal anti-bacterials is essential. Also general liver and gall bladder herbs are recommended including herbs that promote healthy bile production and liver detoxification stimulants such as Barberry, Schisandra and St Mary’s Thistle.
In addition very specific hormone modulating herbal medicines are useful for fibroid management. Chaste Tree & Black Cohosh are the primary herbs used for fibroid management in the Western Herbal Tradition. Chaste Tree “balances” estrogens by increasing progesterone and decreases prolactin. The mechanism behind Black Cohosh is not well understood but it does not raise estrogen levels and seems to have an impact on neurotransmitters. We have also “borrowed” herbal approaches from Traditional Chinese Medicine including the use of White Peony that may act as an LH-releasing antagonist with weakly anti-estrogenic effects.
Management of the heavy bleeding associated with fibroids is via uterine tonics, astringents and haemostatics. These include Blue Cohosh, Motherwort, Red Raspberry, Cramp Bark, Yarrow, Ladies Mantle and numerous others. Poor uterine/pelvic circulation, a condition called pelvic congestion or blood stasis, is also thought to contribute to the heavy bleeding. Uterine circulatory stimulants may be used to address this aspect including Cinnamon, Ginger, Red and White Paony. If pain is associated with the menses uterine anti-spasmodics such as Cramp Bark and Wild Yam may be used.
Since fibroids often shrink significantly in menopause, women are often looking for a way to manage the situation without major medical intervention until their hormone levels naturally fall. Of course, the success of natural medical approaches will vary depending upon many factors including size, number and location of uterine fibroids as well as contributing factors such as obesity. However, for many women these dietary, lifestyle and herbal approaches can significantly improve symptoms and provide a viable alternative to hysterectomy.
McCaleb Health Pty Ltd
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