Fibroids are benign tissue growths on the uterus. About 30 percent of women have fibroids, though fewer than half ever show symptoms. Fibroids, also called uterine leiomyoma, are the main cause of hysterectomy.

Diet and Fibroids

• Soy. Soy foods reduce your estrogen level, says Maryland botanist/herbalist James Duke, Ph.D., author of The Green Pharmacy. Tofu and other soy items are high in two plant estrogens (phytoestrogens), genistein and daidzein. They bind to the same cellular receptors as estrogen, and in effect, lock it out.

• Beans. In the recent rush to soy, Dr. Duke says the phytoestrogens in other beans have been ignored. “Pinto beans have almost as much genistein and diadzein as soybeans. Other beans high in phytoestrogens include: kidney beans, black beans, split peas, and mung, lima, and fava beans—and peanuts.”

Dr. Duke also suggests adding generous helpings of beans sprouts to salads and other dishes. “As beans germinate, their total phytoestrogen content increases.”

• Veg out. A low-fat, vegetarian diet also helps reduce your estrogen level, according to women’s health specialist Christiane Northrup, M.D., a founder of Women to Women health center in Yarmouth, Maine, and a past president of the American Holistic Medical Association. The fiber in fruits, vegetables, and beans binds with estrogen in your digestive tract and speeds its elimination, Dr. Lark explains. A high-fat diet, on the other hand, one with lots of meat and whole-milk dairy products, sends estrogen back into the bloodstream, where it can spur the growth of your fibroids.

• Fish. Dr. Hudson suggests eating more oily, cold-water fish: salmon, tuna, and mackerel. The fish oil they contain has anti-inflammatory effects that may help relieve your symptoms.

Exercise

• Exercise. Regular, moderate exercise is a good idea for everyone. But if you have fibroids, it offers added benefits, says family practitioner Anne Simons, M.D., an assistant clinical professor of family and community medicine at the University of California’s San Francisco Medical Center. Exercise reduces your estrogen level, which may help shrink your fibroids. It also releases endorphins, the body’s own mood-elevating, pain-relieving compounds that can help minimize any discomfort you feel. Finally, exercise helps control your weight. Compared with slim women, those who are heavy are at higher risk for fibroids, explains naturopath Jackie Germain, N.D., of Middletown, Connecticut, because stored fat increases your estrogen level.

Relaxation Therapies

• Visualize erasure. Fibroids often cause anxiety, Dr. Lark explains, which can disrupt your delicate hormone balance and spur your fibroids to faster growth. She recommends a daily stress-management routine, notably meditation or this vizualization exercise:

Sit comfortably and breathe deeply with your eyes closed. Imagine looking deep inside your reproductive tract. Next, imagine a giant blackboard eraser wiping away your fibroids. As the eraser removes your fibroids, your uterus shrinks down to normal size and shape. You feel wonderful. Enjoy the sense of peace and well-being you feel. Open your eyes.

Stress-management specialist Martin Rossman, M.D., co-director of the Academy for Guided Imagery in Mill Valley, California, has produced many relaxation tapes that combine music and visualization exercises. For a catalog, write the Academy for Guided Imagery at P.O. Box 2070, Mill Valley, CA 94942.

Lifestyle

• Limit your alcohol and caffeine. Dr. Germain also advises limiting coffee and booze. These drugs are processed by your liver, which also regulates the amount of estrogen in your blood. Stressing your liver with alcohol and caffeine can increase your estogen level, and spur the growth of your fibroids.

• Reconsider the Pill and hormone replacement therapy. Both birth control pills and postmenopausal hormone replacement therapy (HRT) contain estrogen, which spurrs fibroid growth. But the dose is low, and they often have no effect on fibroid size. On the other hand, they might. “Consider getting off the Pill,” Dr. Simons says, “or taking a break from HRT to see how the change affects your fibroids.”

Herbal Medicine

• Love your liver. The healthier your liver is, the better able it is to remove estrogen from your blood, Dr. Germain explains. The leading liver-supporting herb is milk thistle (Silybum marianum). Health food stores and herb shops sell a standardized extract (silymarin). Dr. Germain recommends 100 mg twice a day before meals.

Chinese Medicine

• Free your Blood and chi. Chinese medicine views Fibroids as an overaccumulation of Blood in the uterus caused by stagnation of Blood and chi , says San Francisco Chinese physician Efrem Korngold, L.Ac., O.M.D., co-author (with Harriet Beinfield, L.Ac.) of Between Heaven and Earth: A Guide to Chinese Medicine. “The overaccumulation solidifies and becomes the tumors.”

To treat fibroids, Dr. Korngold recommends several herb formulas, notably: Fu ke zhong zi wan, a combination of Chinese angelica (dang gui), bupleurum root, peony root, and several other herbs. If Cold plays a role in your fibroids, he augments this formula with warming herbs: ginger, cinnamon, and cardamom.

• The acupuncture alternative. Dr. Korngold also recommends the following acupuncture points to treat fibroids:

• Liver 3. In the hollow behind and between your big toe and second toe.
• Heart 7. On the palm side of your wrist creast, on the side of your little finger, next to its bone.
• Conception Vessel 4. On the midline of your abdomen, two thumb widths above your pubic bone, and four finger widths below your navel.

Ayurvedic Medicine

• Purify your blood. Ayurvedic medicine views fibroids as raktaja gulma, tumors resulting from impurity of your blood, according to Alakananda Devi, M.D. Ayurveda, of Boulder, Colorado. Treatment varies depending on your constitutional type, but Dr. Devi often recommends increasing exercise, limiting alcohol and high-fat foods, and taking several herbs, among them, chitrak, which helps eliminate tumors (200 mg three times a day after meals with 2 tablespoons of aloe vera gel), and ashoka, which relaxes the uterus, reduces menstrual flow, and helps shrink fibroids (300 to 500 mg a day three times a day after meals with hot water).

And Finally…

If you consult a mainstream doctor for fibroids, the first thing you typically receive is a pregnancy test to rule out the possibility that you’re carrying a fetus, and not a fibroid.

The next step is usually an endometrial biopsy, to check for uterine cancer.

Once those two possibilities have been eliminated, you may also have an ultrasound exam and possibly other test to confirm your diagnosis, and to show where there are in your uterus.

Mainstream medicine offers three treatment options: watchful waiting, drugs, or surgery. “Fibroids often grow during your perimenopausal years,” Dr. Simons explains, “and then shrink as you become menopausal. If your fibroids are not causing much discomfort, you might decide to just live with them until menopause shrinks them naturally. If you have heavy periods, you can take an iron supplement.”

Drug treatment for fibroids is aimed at suppressing the estrogen that makes them grow. Two popular drugs are leuprolide (Lupron) and nafarelin (Synarel), both of which reduce estrogen by increasing secretion of gonadotropin-releasing hormone (GnRH). Recent studies show that they can shrink fibroids by up to 50 percent, according to Samantha Pfeifer, M.D., an assistant professor of obstetrics and gynecology at the University of Pennsylvania School of Medicine in Philadelphia. The problem is that these drugs cause menopausal symptoms–hot flashes, vaginal dryness, and possibly insomnia and pain on intercourse–not to mention that they cost more than $300 a month. A chearper option is the female sex hormone, progesterone, which can shrink fibroids up to 25 percent.

For fibroids that cause severe symptoms, surgery is your last resort. The conservative approach, myomectomy, removes just your fibroids and leaves your uterus intact. A number of different procedures have been developed, some vaginal, some abdominal. But myomectomy may not be possible if you have lots of fibroids or if they are hard to reach. Furthermore, if you have a myomectomy, there’s a 25 percent chance your fibroids will recur. Scientists aren’t sure if recurrences are new fibroids or growth of small ones that were there all along, but missed during your myomectomy. Ether way, if your fibroids return, you might need more surgery.

The other surgical alternative is hysterectomy. It’s more radical, but there’s no risk of fibroid regrowth because you no longer have your uterus. Fibroids account for about one-third of the 550,000 hysterectomies performed in the U.S. each year. If you have your ovaries removed, you may suffer a loss of libido afterward because your ovaries make hormones (androgens, notably testosterone) that fuel women’s sex drive. Supplemental androgens can treat this problem.

“There’s rarely any urgency to treating fibroids,” Dr. Simons says. “Get several opinions, and don’t rush into surgery.”

Red Flags

If you have fibroids, beware of sudden sharp pelvic pain. It might mean that one of your fibroids has become twisted enough to cut off its own blood supply. That’s a potential medical emergency. Call your doctor right away. You may need immediate surgery to remove the strangled fibroid.

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