Fibroids, or leiomyomas, are benign tumors of the uterine muscle that are extremely common, affecting almost 25%-35% of women older than 35 years and 70%-80% of women by the age 50. Risk factors for fibroid development include early menarche, African American ethnicity, hypertension, polycystic ovarian syndrome (PCOS), and family history.¹ Although fibroids are often asymptomatic, those causing symptoms have a significant impact on quality of life and health care spending. Most women with fibroids present with abnormal uterine bleeding, pelvic pain, or fertility issues. Transvaginal ultrasound is the diagnostic test of choice.

The cause of fibroids is not well understood. Research demonstrates that fibroid tumors overexpress many growth factors that are responsive to systemic inflammatory mediators.² These growth factors promote proliferation and angiogenesis, leading to vascular abnormalities and excessive bleeding.³ For this reason, therapies that focus on decreasing inflammation in the body may help limit fibroid growth.

Fibroids are sensitive to hormonal influences, including both estrogen and progesterone. In a woman’s life cycle, most fibroids proliferate during perimenopause, when the estrogen to progesterone ratio increases, before becoming dormant in menopause, when this ratio decreases. Many treatment approaches involve interventions that decrease estrogen dominance in the body.

The American College of Obstetricians and Gynecologists recommends that only symptomatic fibroids be treated.⁴ Conventional treatment includes medications, procedures involving uterine ablation or uterine artery embolization, and surgical management with myomectomy and hysterectomy. The American College of Obstetricians and Gynecologists reviews these interventions in their guidelines for the treatment of fibroids.⁵

Despite a lack of extensive research on other ways to address fibroids, there are several approaches that have potential benefits and limited risks and should be offered to women with symptomatic fibroids.

Estrogen Dominance

Treat estrogen dominance, including a diet high in cruciferous vegetables, omega-3 supplementation, avoidance of xenoestrogens, and promotion of a healthy intestinal microbiome. For more information, see the “Estrogen Dominance” Integrative Health tool.