What Are Uterine Fibroids
Uterine fibroids are one cause of chronic pelvic pain.
Chronic pelvic pain is experienced for at least six months, and is unexplained in over half of the women who experience it.
Fibroids are a benign tumor of the uterus smooth muscle.
Around 80% of women have fibroids, but they are only symptomatic 30% of the time.
Fibroids are the primary reason for a hysterectomy.
There are three types of Fibroids:
- Intramural
- Subserosal
- Submucosal
Fibroids are made out of smooth muscle tissue, fibroblasts, and excess extracellular collagenous matrix
Symptoms Associated with Fibroids
- Abnormal uterine bleeding
- Pelvic pain or pressure that is usually worse with menses
- Bowel dysfunction and bloating
- Urinary frequency or urgency
- Urinary retention or incontinence
- Low back pain
- Constipation
- Dysparunia
Risk factors for Fibroids
- African American
- Perimenopausal
- Obesity/Aromatization/Inflammation/Insulin
- Never having a baby
- Mother or sister with fibroids
- Hypertension
- Vitamin D deficiency
- Vitamin E excess
- Diet low in fish, fruit, green vegetables
- Alcohol
- Air pollution
- Endocrine disruptor chemicals
- Heavy metals
Protective Factor Against Fibroids
- Hormonal Contraception
Hormones & Fibroids
Estrogen & Uterine Fibroids
Uterine fibroids are considered to be estrogen dependent.
No fibroids are found in pre-pubescent girls, and few are found in post-menopausal women.
However, plasma estrogen levels are the same for women with and without fibroids. PMID: 27872195
Progesterone & Uterine Fibroids
Progesterone receptors are more highly expressed in fibroids than in the uterine muscle.
Estrogen induces progesterone expression expression, which then induces fibroid growth. PMID: 26107781 PMID: 26107781
Fibroids Are a Hormone Factory
Inside fibroids over expression of the genes 17B-HSD type 1 and aromatase increase local estrogen. This in turn causes increase in estrogen G-protein receptor expression, progesterone receptor expression, over expression of estrogen receptor alpha, and suppression of p53 which prevents tumor growth. Estrogen receptor alpha overexpression is also prompted by hypomethylation of the estrogen receptor alpha promoter.
Taken together, fibroids themselves create a proliferative environment.
PMID: 27872195
Growth Factors & Uterine Fibroids
Fibroid growth is also promoted by the same factors that are activated by M2 macrophages, and by GLP-1 receptor agonists like semaglutide, ozempic, and wegovy.
- Myofibroblasts
- Vascular endothelial growth factor (VEGF)
- Transforming growth factor (TGF)-beta
- Fibroblast growth factor
- Platelet derived growth factor
Chromosomes & Fibroids
Uterine fibroids are promoted by alterations in chromosome 12 and 7 primarily. PMID: 40330123
Genes & Fibroids
The genes associated with uterine fibroids are
- MED12 (45-90% of fibroid cases)
- HMGA2 (7.2% of fibroid cases)
- FH deficiency promotes fibroids in younger women
- COL4A5-COL4A6 (2% fibroid cases)
- MTHFR SNP increases fibroid risk by 43%
Epigenetics & Fibroids
Endocrine Disruptor Chemicals
These chemicals act as hormone mimics, block natural hormones or impact how natural hormones are made or broken down.
They are associated with fibroids, infertility, endometriosis, adenomyosis, early puberty, nervous system and immune function, metabolic issues (like thyroid problems, diabetes, and obesity), cancer, breathing problems, cardiovascular health, growth, and learning disabilities
- Organophosphates (pesticides)
- Glyphosates (RoundUp)
- Fire retardants (PBDEs)
- Phthalates (flexible plastic)
- BPA (durable plastic)
- Perchlorate (fertilizers, explosives)
- Perfluroinated chemicals (non-stick pans)
- Dioxin (by-product of industrial processes)
- Polychlorinated biphenyls PCBs (industrial solvents/lubricants, electronics,building materials
Water is a major source of endocrine disruptor chemicals because these chemicals do not completely biodegrade and cannot be removed from water with conventional means. Furthermore, they bioaccumulate, so this means they become more concentrated over time.
Air Pollution & Fibroids
Chronic exposure to particulate matter 2.5 microns increases risk for fibroids
Air pollution also increases rick for infertility, menstrual irregularity, and endometriosis.
Alcohol & Fibroids
Consuming two alcoholic drinks daily increases the risk of uterine fibroids
Biomedical Treatment of Fibroids
- Contraception
- Gonadotropin-releasing hormone agonist
- Aromatase inhibitor
- Selective estrogen receptor modulator
- Selective progesterone receptor modulator
- Endometrial Ablation
- Uterine Artery Embolization
- Myomectomy
- Hysterectomy
Natural Treatments for Fibroids
Aromatase Inhibitors
- Lose weight
- Decrease inflammation
- Control insulin
- Apigenin
- Chrysin
- Genistein
- Grape seed extract
- Red wine procyanidin
17B-HSD-Type 1 Inhibitor
- Lose weight
- Avoid alcohol
- Licorice
- Apigenin
- Phytoestrogens
Progesterone Receptor Antagonist
- Baicalein
- Prunetin
- Apigenin
Progesterone Receptor Alpha Antagonist
- Kaempferol
- EGCG
- Black Cohosh
Decrease Fibrosis Naturally
- Honokiol – inhibits fibroblasts, anti-inflammatory, antiangiogenic, andantitumor
- Castor oil packs applied to lower belly
- Avoid GLP-1 receptor agonists like semaglutide, ozempic, & wegovy
Support Methylation
If you have an MTHFR mutation take 5-MTHF to side-step the problem
Detox
If you have excess endocrine disruptor chemicals or heavy metals
Conclusion
Natural fibroid management is most productive in the early phase, or even as prevention.
Natural medicine is not great at managing advanced fibroids.
Many risk factors for fibroids are environmental issues and need to be managed at the policy level
If you need a biomedical procedure to manage your fibroids, be sure and get visceral manaipulation manual therapy after-care for adhesions and recovery. Also, this is a great time for herbal intervention to help prevent additional fibroid formation.
