Fibroids are benign (non-cancerous) tumors of the uterus. They grow in various locations on and within the muscular wall of the uterus or inside the uterine cavity. Their structure is encapsulated connective tissue that can be single or multiple. They vary in size from a few millimeters to very large, for example, the size of a football, and they affect 20 - 25% of women past the age of 35. Fibroids rarely occur before adolescence and shrink after menopause. They 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 anemia and fatigue as well as painful periods, backache and swelling. Some women will have no symptoms, and symptoms are rare before 30 years of age. 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, and laparoscopy.

Fibroids that are not interfering with fertility or causing unwanted symptoms are often simply left as they are, and require no surgery or drugs to shrink or remove them. Monitoring every six months and employing alternative therapies to moderate their growth and to rebalance the underlying hormones is advisable. In rare cases, they can undergo malignant change and develop into sarcoma.

COMMON THEORIES OF CAUSATION

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

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

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

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

• Nutrition. As illustrated above, highly refined carbohydrates, especially sugar, cause insulin resistance and consequent fibroid growth. Growth hormone is also increased by low concentrations of essential fatty acids in the blood. A highly processed diet lacks fiber and causes constipation, which can increase oestrogen levels as explained above. Coffee, alcohol, cigarettes and other recreational drugs are all liver toxins and exacerbate insulin resistance.

TREATMENTS FOR FIBROIDS

Naturopathic treatments can be useful, especially to improve the symptom of heavy bleeding and to control the underlying hormonal imbalance that is fuelling the growth of the fibroid. However, it is rare that these treatments will shrink the tumor. A reduction in symptoms does not correlate with the size or growth rate of the tumor.

Diet

• Eat regularly: 3 main meals and 2 snacks daily that stimulate your metabolism. If you skip meals, it slows your metabolism down and your blood sugar levels drop, so that you crave sugar or a stimulant to bring them back up again quickly.

• Protein. Having protein in all your meals controls your blood sugars by slowing down the absorption of sugars, stimulating your metabolism, and decreasing hunger and sugar cravings, as well as being important for liver detoxification of the hormones. Vegetarian protein foods are dairy, eggs, beans, legumes, nuts and seeds.

• Preventing anemia (low iron levels from excessive blood loss) is important. This should be checked by a blood test with your doctor - check ferritin (iron stores) as well as hemoglobin (iron in red blood cells). Increase iron-rich foods: red meat, whole grains, spinach, dried apricots, peaches and figs, almonds, molasses, parsley, prunes and others. Iron absorption is enhanced by vitamin C: squeeze lemon juice onto food or use in salad dressings, include berries, tomato, capsicum, broccoli and cabbage with your meals. Iron absorption is inhibited by the following: phytates that occur in whole grains, beans and legumes, but vitamin C, soaking and slow cooking counteract their effects; polyphenols found in black tea, coffee and cola drinks; calcium - take calcium supplements at different times from iron supplements or meals.