Diet

No dietary approach is known to prevent or shrink uterine fibroids. However, there are very strong rationales for several dietary interventions. For example, a diet high in saturated fats is associated with higher blood levels of estrogen and therefore could have the potential to exacerbate fibroids. Also, low-fiber diets are associated with elevated estrogen levels and poor excretion of estrogen. Dietary change by itself is unlikely to reduce the size of fibroids, but good dietary habits are still important for general health; moreover, they may reduce some of the gastrointestinal symptoms that can be associated with large fibroids or pedunculated fibroids and an enlarged uterus. Clinical observation has demonstrated that natural therapies work best in the context of a healthy lifestyle, including dietary changes. Improving one’s diet can help to decrease heavy bleeding or the pain and discomfort caused by the fibroids. In addition to these potential benefits, dietary improvements enhance general well-being.

The tradition of naturopathic medicine holds firmly to the influence of the health of the liver on the health and vitality of an individual. The liver metabolizes estrogen, which can be eliminated from the body by converting it to estrone and finally to estriol, a weaker form of estrogen that has very little ability to stimulate the uterus. Failure of the liver to effectively metabolize estradiol may be one mechanism by which the uterus becomes overestrogenized and responds with fibroid growths.

Saturated fats, sugar, caffeine, alcohol, and “junk foods” are presumably problematic in two main ways. First, they interfere with the body’s ability to metabolize estradiol to estrone to estriol. Second, some of them are deficient in B vitamins or interfere with B-vitamin metabolism. If B vitamins are lacking in the diet, the liver will lack some of the raw materials it needs to carry out its metabolic processes and regulate estrogen levels.

Whole grains—such as brown rice, oats, buckwheat, millet, and rye—are excellent sources of B vitamins. Whole grains also help the body excrete estrogens through the bowel. The role of whole-grain fiber in lowering estrogen levels was first reported in 1982.¹ This study found that vegetarian women who eat a high-fiber, low-fat diet have lower blood estrogen levels than omnivorous women with low-fiber diets. Once again, the logic of a high-fiber diet would have implications in preventing and perhaps reducing uterine fibroids because of the stimulating effect of estrogen on fibroid growth.

A high-fiber diet may also help to relieve some of the bloating and congestion sometimes associated with fibroids. Fiber, by bulking up the stool and regulating bowel movements, may relieve some of these symptoms. Some women have a hard time tolerating increased fiber in their diets because their digestive function is otherwise compromised.

Because there is an association between having uterine fibroids and a fourfold increase in the risk of endometrial cancer,¹ three dietary considerations stand out above the others: to increase dietary fiber, lower dietary fat, and increase the intake of soy products and other legumes. A case-control study in a multiethnic population (Japanese, white, Native Hawaiian, Filipino, and Chinese) examined the roles of dietary soy, fiber, and related foods and nutrients as related to the risk of endometrial cancer.² A total of 332 women with endometrial cancer were compared with women in the general multiethnic population, and all were interviewed by means of a dietary questionnaire. The researchers found positive associations between a higher level of fat intake and endometrial cancer, between a higher level of fiber intake and a reduction in risk for endometrial cancer, and between a high consumption of soy products and other legumes and a decreased risk of endometrial cancer. Similar reductions in risk were found for a greater consumption of other sources of phytoestrogens, such as whole grains, vegetables, fruits, and seaweeds. The researchers concluded that plant-based diets low in calories from fat, high in fiber, and rich in legumes (especially soybeans), whole-grain foods, vegetables, and fruits reduce the risk of endometrial cancer. These dietary associations may explain at least in part the lower rates of uterine cancer in Asian countries as compared with the United States.

Some have suggested that because soy foods are high in phytoestrogens (specifically isoflavones), which have a weak estrogenic effect, women with uterine fibroids or endometrial cancer should avoid phytoestrogens. This issue deserves some clarification. Soy phytoestrogens do not appear to have an estrogenic effect on the human uterus except in doses higher than 150 mg isoflavones daily in postmenopausal women. They appear to be selective in terms of the tissues on which they have an estrogenic effect and the tissues or organs on which they have an antiestrogenic effect. Soy foods may be analogous to a newer class of drugs called selective estrogen receptor modulators: they act one way in one part of the body and another way in a different part of the body. It seems that in the uterus, soy isoflavones have an antiestrogenic effect.

Nutritional Supplements

Many of the symptoms related to uterine fibroids can be effectively treated with natural therapies. This section presents nutritional supplements that may control or diminish the growth of fibroids. Unfortunately, these recommendations are based more on tradition, theory, logic, and clinical experiences than on scientific evidence.

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