Fibroids are benign tumors that develop in the uterus and can lead to painful, heavy periods. In some cases, they can become quite large and problematic. In others, they go undetected and are without symptoms. In this article I'm going to review what fibroids are and how to treat fibroids naturally.
Are you one of the millions of women affected by fibroids? The American Journal of Obstetrics and Gynecology estimates the likelihood of developing fibroids as high as 80% for women between the ages of 40 and 50.
Fibroids are also referred to as:
- Uterine myomas
While for some women, uterine fibroids don’t cause discomfort or other any other symptoms, for others, fibroids can be painful and grow to the point that they interfere with other bodily functions. Sometimes, fibroids can cause fertility issues as well.
We understand that fibroid growth is stimulated by estrogen and progesterone, which means by supporting optimal hormone health we can effectively prevent their development. When it comes to treating fibroids, many women end up opting for a combination of surgical, hormonal, and lifestyle interventions. We’ll discuss all your options in this article.
What are uterine fibroids?
Just so I don’t scare anyone — uterine fibroids are tumors, but they are not considered cancerous in most cases. They are growths either in or attached to the wall of the uterus. The medical term for fibroids is leiomyoma.
There are several types of fibroids:
Intramural grow in the muscle wall of the uterus, which is called the myometrium. These are the most common type of fibroid and can become large enough to distort the uterus or cause enlargement.
The serosa is the outside of your uterus. A subserosal fibroid forms under the outside lining of the uterus. They can grow large enough to make the uterus appear “lopsided” or that one side is larger than the other.
Located just below the surface of the uterine lining, submucosal fibroids can protrude into the uterine cavity. There are three types of submucosal fibroids described by the FIGO/European Society of Hysteroscopy classification system:
- Type 0 – Completely within the endometrial cavity
- Type 1 – Extend less than 50 percent into the myometrium
- Type 2 – Extend 50 percent or more within the myometrium
Attached to the uterine wall by a stalk-like growth (which is called a peduncle). These are subserosal fibroids that have a slender base.
Fibroids also vary greatly in size. They can be tiny, like the size of a pea — or they can be so large that they cause a woman's’ midsection to protrude.
Most of the time, fibroids grow in multiples. One woman can have many fibroids in different locations and in different sizes.
What causes uterine fibroids?
While the exact cause of fibroids is not really clear, studies show that genetics likely plays a role.
Estrogen and progesterone are hormones responsible for stimulating the growth of the uterine lining during your menstrual cycle. This may be why fibroids tend to shrink when a woman stops ovulating and having a regular period, as is the case in menopause.
These hormones are created by the ovaries, but require your liver, gut, and kidneys in order to eliminate excess. We’ll discuss more about natural approaches to fibroids in this article, but know that optimizing the levels of estrogen and progesterone are a must, as is the metabolism of these hormones.
And while consensus is that estrogen and progesterone play a significant role, it appears excess testosterone may also contribute the fibroid growth. So if you’re a postmenopausal woman who has not seen fibroids diminish or have developed new ones, it may be due to testosterone. It mays also be because the fibroid is very large and may take time to shrink in the absence of elevated estrogen and progesterone.
Keep reading to learn more about how to optimize your hormones!
If your natural hormones can stimulate fibroids, it makes sense that synthetic ones may do the same. One recent study showed a correlation between oral contraceptives and uterine fibroid development.
What is clear is that hormone levels affect fibroids. Estrogen and progesterone levels are both higher in fibroids than in normal uterine tissue.
In my comprehensive women's hormone book, Beyond the Pill, I help you evaluate and eliminate symptoms of hormone imbalance. If you're a woman struggling with fibroids then I highly recommend you check it out.
I personally experienced this while pregnant with my son. In a routine ultrasound they noted there was a fibroid and nothing to be concerned about. Fibroids are actually a common occurrence in pregnancy and for some women, they resolve postpartum. I took extra steps to resolve mine, which I’ll share here.
What are the symptoms of fibroids in the uterus?
The symptoms for uterine fibroids vary widely. Some women report no symptoms at all. The size of the fibroid, as well as its location in the uterus, is often what determines the degree of symptoms.
In addition, if you’re transitioning into menopause you may experience new or increasing size in fibroids. If the fibroid is small enough, it can shrink postmenopause.
It’s also common to see fibroids develop during pregnancy and then resolve postpartum.
Others have a host of symptoms including:
- Heavy periods
- Bleeding in between periods
- Prolonged periods
- Feeling of fullness in the abdomen
- Pelvic pain
- Lower back pain
- Painful sex
- Need to urinate frequently
- Difficulty urinating
- Fertility issues
Changes in your cycle
The most common complaint most women have that leads to a diagnosis is extremely heavy periods, bleeding in between cycles, or unusually long periods. Especially when there’s a change to normal flow. If there’s a sudden change to your cycle and you’re bleeding a lot more than normal, that can be an indication of fibroids.
If a fibroid has grown to a significant size, often women will complain about a feeling of pressure or fullness in the abdomen — akin to the feeling of having a baby in there.
If you know you are experiencing a strange sensation of fullness in the stomach, or insane bloating that just won’t quit, don’t ignore your intuition. Get to your doc and have them take a look.
Uterine Fibroid Pain
A common symptom of fibroids is pain.
Women with this condition may experience significant pain in their back, abdomen, or pelvis. It’s also a common reason women begin experiencing painful sex.
Just as there’s a wide range of sizes and symptoms, women experience a wide range of pain when dealing with fibroids. Some report a dull aching sensation, while others complain of a stabbing or throbbing pain. It’s often considered not quite as painful as endometriosis, but obviously, for those who are dealing with fibroids, it is not fun either.
Depending on the location and size of the fibroid, many women develop problems in the bathroom.
Sometimes, if the fibroid is situated in a spot that is putting pressure on the bladder, it can cause a sensation of needing to urinate.
Other times, if the location of the fibroid is cramping the urethra, it can make urination extremely difficult.
Likewise, if the fibroid is located near the rectum, it can cause a blockage that makes bowel movements difficult.
When fibroids cause extreme menstrual bleeding, it can take a toll on your body. If the blood loss is severe enough, it can even cause anemia, a condition that means you don’t have enough healthy red blood cells to properly oxygenate your tissues.
When fibroids become this severe, extreme fatigue results. Women will report a lack of energy. Other symptoms of anemia include:
- Shortness of breath
- Cold extremities
- Chest pains
- Irregular heartbeat
- Pale skin tone
Struggling to conceive
Statistics suggest that in 5-10% of cases, fibroids are to blame for infertility. However, that means in most instances fibroids don’t affect fertility at all. So, if you have been diagnosed with fibroids, it’s not necessarily a barrier to conception.
Because fibroids are located in the uterus, a myriad of problems can result that can potentially affect a woman’s ability to conceive.
If the fibroid is located in such a way that it affects the shape of the cervix or uterus, it can possibly interfere with the motility of sperm. If the fibroid is blocking a fallopian tube — that can be an issue.
Fibroids can also mean the blood flow to the uterus is decreased, making it difficult for an embryo to implant in the uterine wall. The change in the contour of the uterine lining can also make embryo implantation more difficult.
How are fibroids diagnosed?
Luckily, fibroids are usually diagnosed in a relatively non-invasive way.
Medical professionals are able to detect fibroids by utilizing:
A regular pelvic exam may be enough to identify the existence of fibroids. Although a Pap smear is only recommended every 3 years in some cases, it is important to meet with your doctor annually for an exam and to discuss your health.
This is the test you typically think of that’s used on pregnant women, where a provider uses a wand over top of the belly to look inside. But to evaluate a fibroid then your doctor may also want to perform a transvaginal ultrasound, which requires inserting a small want in the vagina to visualize the uterus.
Hysterosonogram (or Sonohysterogram)
This is a form of imaging in which an ultrasound is performed while saline is placed in the uterine cavity. This allows doctors to identify fibroids that may not have shown on a routine ultrasound and visualize intramural myomas that are extending into the uterine cavity. This can also be useful for fertility evaluation.
Is a diagnostic procedure where a lighted tube is inserted into the uterus so your physician can visualize your cervix and uterine cavity.
An MRI is another type of imaging device that is by far the most effective in differentiating a fibroid from other conditions like adenomyosis. It is also useful for identifying the location and size of fibroids. However, due to the cost, it is often reserved for surgery planning, especially when it is potentially going to be a more complicated procedure.
What about blood tests for fibroids?
Often, women experience blood loss due to fibroids, sometimes to the point of developing anemia. Blood tests can be a helpful diagnostic tool in this instance or to understand your hormone levels, but a blood test cannot diagnose a fibroid.
Who is at risk for fibroids?
Although all women are potentially at risk of developing fibroids, women of African descent are even more likely than others to have problems with them.
If a woman already has fibroids, pregnancy can increase the size of them — due to the surge in hormone levels.
Some other contributing risk factors include:
Can you feel fibroids in your stomach?
Often, fibroids can be extremely small, in which case, you definitely won’t feel them.
But other times, fibroids can grow to be the size of a grapefruit, or in worst-case-scenarios, the size of a watermelon! When fibroids grow to be this size, they can cause your stomach to protrude.
Some women even look like they are pregnant due to the size of the fibroid.
Do fibroids cause discharge?
While fibroids don’t typically cause discharge in the traditional sense, they can cause bleeding in between periods.
Some women may have a discharge of blood mixed with cervical fluid that could indicate fibroids. See my guide on period blood color for more info.
Can fibroids make you smell bad?
Although a lot of women seem to have this misconception, fibroids aren’t typically associated with odor.
If you’re having discharge with odor, take a visit to your health care provider to get everything checked out. It’s more likely you have an infection, STI, or bacterial vaginosis than fibroids.
Do fibroids make you gain weight?
In the traditional sense, fibroids don’t really cause weight gain. But — they can cause extreme bloating and swelling, particularly in the abdomen. So, if you’re working out and eating right, but your stomach still seems to be protruding…it could possibly be the result of fibroid growth.
If you’re experiencing a frustrating weight gain in the belly and there’s no other good explanation, it may be time to talk to your doctor.
Do fibroids interfere with pregnancy?
In many cases, women have tiny fibroids, get pregnant, and have no issues whatsoever.
But if fibroids are larger, they can cause issues for pregnancy and delivery. Sometimes, fibroids interfere with implantation in the endometrium which makes getting pregnant difficult. They can also be responsible for miscarriage or pre-term birth.
It’s extremely important to make your doctor aware of any issues you have with fibroids if you are pregnant.
The manner and method of your delivery may be affected, as many women with fibroids opt for C-sections rather than vaginal deliveries.
What is the treatment for uterine fibroids?
Some women choose to try a more natural route to resolve and prevent their fibroids. Other women elect to couple natural therapies with surgical intervention in order to alleviate fibroid symptoms. When fibroids reach a particular size, it is often necessary to have surgery to remove them.
How are fibroids treated conventionally?
The size and location of the fibroid largely determine the recommended course of treatment. In worst-case scenarios, a hysterectomy is performed. It’s estimated that hysterectomy accounts for about 70% of fibroid treatments. Removal of your uterus may not be necessary, so definitely chat with your doc about other options or a combination approach.
When should a hysterectomy be considered?
- When women are losing a lot of blood fast and not responding to other therapies.
- Women who have not found success with less invasive therapies.
- Women who are done having children and at risk of cancer and other disease progression. Note that this may also include endometriosis and adenomyosis, but that a hysterectomy does not address the underlying issue and endometriosis lesions could exist outside the uterus.
- Women who are done having children and having significant symptoms like bowel obstruction, pain, heavy periods, and urinary issues.
A myomectomy is also an option for fibroid removal — this is when the fibroids are removed while attempting to keep the uterus intact.
Uterine Artery Embolization
Less invasive options, like uterine artery embolization, have proven to be effective. This procedure is a radiological technique that effectively blocks the blood supply to the fibroid.
Sometimes, if they aren’t concerned with fertility, patients opt for endometrial ablation, a procedure that effectively destroys the lining of the uterus. The excessive menstrual bleeding that accompanies fibroids then ceases.
Hormonal Birth Control
Certain medications can also be used to manage symptoms of the condition. Some doctors may prescribe hormonal birth control in order to attempt to regulate hormone levels and menstruation. I go into this in-depth in Beyond the Pill, but basically hormonal contraception works by preventing ovulation and the endometrium from growing thicker — so bleeding while taking the pill isn’t a true “period.” However, in some women, this treatment is ineffective and may contribute to the growth of fibroids.
Lupron® or Leuprolide induces a menopausal state to reduce the fibroids. If they need hormones to grow, the thought is that this drug temporarily shuts down hormone production, depriving the fibroids of their building blocks. It’s sometimes used as a pre-operative measure to shrink the fibroids before surgery to remove them.
As with all pharmaceuticals, there are side effects you should be aware of. When used for 6 months or more Lupron has been associated with a decrease in bone density. Exacerbation of endometriosis symptoms can occur with some women after the initial dose. In fact, Lupron is only approved for use for 12 months, and is therefore not a long-term treatment option for fibroids.
Depression is another side effect that can come on with initiating this treatment or become worse. If you have depression, be sure to talk to your doctor about this side effect.
Mirena® Intrauterine Device (IUD) helps manage symptoms by releasing hormones into the body which can help by reducing the heavy menstrual bleeding associated with fibroids.
As noted in this analysis of fibroid research, hormonal treatments are used to manage symptoms, but don’t really tend to affect the size of the fibroids.
You can read about Mirena and progestin based IUD side effects here.
How are fibroids treated naturally?
Knowing that hormones contribute to the growth of fibroids, there’s a lot you can do in your daily life to support optimal hormones. It’s more than just making the right amounts of hormones, you also need to have your estrogen metabolism on point.
Nutritional therapy, exercise and stress management can all support healthy hormones and serve as an effective natural treatment of fibroids.
Address Estrogen Dominance
Reducing estrogen levels and supporting the best metabolites is key to overall health and treating fibroids. As a naturopathic physician, I always test estrogen levels and the corresponding metabolites, 2-OH estrone, 4-OH estrone, and 16-OH estrone. We know that metabolites like 4-OH and 16-OH estrone can lead to unfavorable changes in a woman’s body, including the growth of tissues.
To reduce estrogen, you have to eliminate it through bowel movements and support its metabolism in the liver. DIM, broccoli seed extract, and Calcium D-Glucarate can help this process immensely — they are all components of my Balance Women’s Hormone Formula too!
Optimize Your Body Composition
Estrogen is stored in fat cells, so by reducing body fat, you’re also reducing estrogen levels in the body. Since estrogen is a key component of fibroids, this means they are less likely to grow. If you can lose even a little bit of body fat, you may notice a reduction in fibroid symptoms.
Eat a Hormone Friendly Diet
A healthy diet that incorporates plenty of veggies (I recommend shooting for 6-9 cups a day) and fiber works wonders for estrogen elimination too. I urge you to check out my free recipe guide that will give you some easy and tasty ways to support your estrogen levels and balance hormones.
Incorporating inflammation-reducing foods to your diet is always a good idea, too. Things like turmeric and green tea have components in them which cool inflammation and help your entire body to stay healthy, including your reproductive system.
Acupuncture is a minimally invasive treatment that can help with pain relief and reproductive health issues. While we need a lot more research to understand its direct impact on fibroids, we do know is a helpful modality for pain related issues.
Can fibroids turn into cancer?
Very recent studies are revealing a correlation (not causation) between incidence of uterine fibroids and uterine cancer.
This doesn’t mean that fibroids cause cancer or “turn into” cancer, but it does mean that women who develop fibroids appear to be more likely to develop uterine cancer.
Also — the FDA has recently warned of a risk of cancer for a surgical procedure for fibroids known as laparoscopic power morcellation. Research indicates that this particular surgery, while less invasive than hysterectomy or myomectomy, can contribute to the spread of cancer cells throughout the uterus.
Why does this happen? It’s important to note, firstly, that laparoscopic power morcellation is part of both hysterectomies and myomectomies. Morcellation is used to “chop up” (picture a meat grinder — I know…that’s quite a visual!) fibroids and/or the uterus into tiny pieces so that they can be removed from the laparoscopic port sites. This means a big incision does not need to be made. The problem is that when morcellation happens, little bits of fibroid or uterus can spread throughout the abdomen or pelvis, which can cause seeding of cancer if there is any in the uterus or fibroids.
If you are undergoing surgery to treat your fibroids, please get very clear information from your doctor about the method of surgery being performed and make sure it doesn’t involve laparoscopic power morcellation.
What happens if fibroids go untreated?
If fibroids of the small and asymptomatic variety go untreated, the best case scenario is that nothing happens and they continue to not affect your health.
However, if you’re experiencing symptoms from them, it’s best to work with your health care professional to develop a treatment plan.
If left completely unchecked, they may continue to grow in size and quantity — making symptoms worse.
It’s much more inconvenient to continue to battle the symptoms of fibroids than it is to try to halt their growth.
Fibroids don’t have to be a never-ending battle
If you are struggling with fibroids, it may seem like it is a war that will never end.
But relief is possible, with the right combination of treatment and lifestyle changes.
Remember, focus on balancing those hormones, especially if you’ve been on the pill in the past and are now dealing with the side effects of post birth control syndrome and/or fibroids. Check out my best-selling book, Beyond the Pill, for tons of in-depth research and practical advice to get your hormone levels back to good.
And if you’re ever in need of support from a community of amazing women, come join my Instagram tribe — we’d love to be a shoulder for you to lean on!
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