The first time that I went for a pelvic ultrasound was for suspected cysts. But imagine my surprise when I found out that I was also sprouting a small fibroid. Uh, weird, I never had any problems with my menstrual health. I shared this discovery with my sister, who revealed that she also has a fibroid, which was incidentally discovered at her first-trimester ultrasound. She did not have any symptoms as well and her pregnancy progressed normally.
Uterine Fibroids are muscular tumors that grow in the wall of the uterus, also known as Leiomyomas, are benign tumors of uterine smooth muscle (the middle layer of the 3-layered uterine wall). It is one of the most prevalent gynecological tumors in premenopausal women. Despite being a benign tumor, fibroids carry great clinical significance and may impact the quality of life.
Uterine fibroids arise from three pathways
1) Genetic Abnormalities
2) Sex Hormones
3) Disordered wound healing
An inciting event will induce genetic changes, which will alter the way the smooth muscle cells would respond to hormones and growth factors. A hypersensitive response of uterine smooth muscle cells would lead to the growth phase. This would cause excessive formation and deposition of extracellular matrix (collagen, fibronectins, etc) within the leiomyoma, thus contributing to its growth (and at times, large size).
The range of symptoms varies amongst women, from heavy painful periods to infertility. However, in most cases, women may not have any symptoms at all.
- Heavy longer periods which can lead to anemia and fatigue
- Painful periods or intercourse
- Constipation, increase in urinary frequency, urinary retention (these can occur due to the mass effect of a large fibroid)
- Abdominal protuberance
- Reproductive problems: impaired fertility, pregnancy complications or loss, adverse obstetric outcomes
Some symptoms can be managed conservatively, but when these symptoms become overwhelming, seeking medical treatment can be helpful.
Fibroids respond to hormones, which is why hormonal therapy will help reduce its size and control its symptoms. Surgical treatment involves the removal of the fibroid, this provides a permanent solution and improves fertility.
However, both of these options have their adverse effects. Hormonal therapy has side effects like hot flashes, loss of bone mass, no periods (which means decreased ability to conceive while on treatment). Surgery on the other hand is costly and the procedure has its risks.
We can control modifiable risk factors that have been associated with leiomyomas. Cessation of smoking, maintaining healthy body weight, limiting caffeine and alcohol intake, and consuming a plant-based diet are known to have protective effects against leiomyomas.
Vitamin D decreases the size of the tumor and its deficiency is a known risk factor for the development of uterine fibroids. Increasing Vitamin D intake through dietary changes or high-dose supplementation will help decrease the bulk symptoms of fibroids.
The most abundant antioxidants found in our diet are polyphenols. They are present in fruits, vegetables, seeds, whole grains, beans legumes, tea, coffee, and wine. Polyphenols such as epigallocatechin gallate, quercetin, curcumin, and resveratrol may help shrink the size of leiomyoma and control the symptoms.
Green Tea contains the polyphenol Epigallocatechin Gallate (EGCG), which has anticarcinogenic, anti-inflammatory, and anti-oxidative properties. EGCG decreases the proliferation of the abnormal fibroid cells thereby decreasing the volume of the tumor.
Resveratrol is found in numerous plant species and red wine. It is also found in food sources such as grapes, blueberry, bilberry, cranberry, juice, and peanuts. It has been found that resveratrol inhibits the proliferation of the fibroid cells and the uterine smooth muscle cells, which decreases the growth of the tumor. Another study found that it also inhibits the proliferation of cervical cancer cells.
Having fibroids is not a choice. Despite following every ‘rule’ in the book we may still end up being stuck with a leiomyoma. This burden is not our fault, it could be due to our
genetics, age, and race. Most of us are lucky enough to not experience any symptoms, while some of us may be stuck with the worst symptoms.
What we can do is keep an eye on our menstrual health.
It is not unusual for women to dismiss their heavy painful periods, most of us probably assume that this is the new normal now. However, when it does not feel normal, do seek out help. Do try every ‘rule’ in the book. And most importantly, do reach out to other women because there are others with a uterine fibroid and everyone will have a unique story and everyone uses different remedies to help them cope with it.
1) Arje, S., Darsareh, F., Asl, Z. A., & Kutenaei, M. A. (2020). Effect of oral consumption of vitamin D on uterine fibroids: A randomized clinical trial. Complementary Therapies in Clinical Practice, 101159.
2) Farzaneh, F., Sadeghi, K., & Chehrazi, M. (2020). Vitamin D Status in Women with Uterine Fibroids: A Cross-sectional Study. Open Access Macedonian Journal of Medical Sciences, 8(B), 109-113.
3) Li, S., Chen, B., Sheng, B., Wang, J., & Zhu, X. (2020). The associations between serum vitamin D, calcium, and uterine fibroids in Chinese women: a case-controlled study. Journal of International Medical Research, 48(5), 0300060520923492.
4) Ahmed, Reda Saber Ibrahim, et al. "Discovery of Green Tea Polyphenol-Based Antitumor Drugs: Mechanisms of Action and Clinical Implications." Medicinal Plants. Springer, Cham, 2019. 313-332.
5) Idowu, O. O. (2017). Green tea extract and reproduction: A review. J. Med. Res, 6(1), 001-5.
6) Tian B, Liu J. Resveratrol: a review of plant sources, synthesis, stability, modification, and food application. J Sci Food Agric. 2020 Mar 15;100(4):1392-1404. DOI: 10.1002/jsfa.10152. Epub 2019 Dec 14. PMID: 31756276.
7) Li, L., Qiu, R. L., Lin, Y., Cai, Y., Bian, Y., Fan, Y., & Gao, X. J. (2018). Resveratrol suppresses human cervical carcinoma cell proliferation and elevates apoptosis via the mitochondrial and p53 signaling pathways. Oncology Letters, 15(6), 9845-9851.
8) Chen, H. Y., Lin, P. H., Shih, Y. H., Wang, K. L., Hong, Y. H., Shieh, T. M., ... & Hsia, S. M. (2019). Natural antioxidant resveratrol suppresses uterine fibroid cell growth and extracellular matrix formation in vitro and in vivo. Antioxidants, 8(4), 99.
9) Islam MS, Ciavattini A, Petraglia F, Castellucci M, Ciarmela P. Extracellular matrix in uterine leiomyoma pathogenesis: a potential target for future therapeutics. Hum Reprod Update. 2018 Jan 1;24(1):59-85. DOI: 10.1093/humupd/dmx032. PMID: 29186429.
10) Wise LA, Laughlin-Tommaso SK. Epidemiology of Uterine Fibroids: From Menarche to Menopause. Clin Obstet Gynecol. 2016 Mar;59(1):2-24. DOI:
10.1097/GRF.0000000000000164. PMID: 26744813; PMCID: PMC4733579.
11) Donnez J, Dolmans MM. Uterine fibroid management: from the present to the future. Hum Reprod Update. 2016 Nov;22(6):665-686. DOI: 10.1093/humupd/dmw023. Epub 2016 Jul 27. PMID: 27466209; PMCID: PMC5853598.
12) Zepiridis LI, Grimbizis GF, Tarlatzis BC. Infertility and uterine fibroids. Best Pract Res Clin Obstet Gynaecol. 2016 Jul;34:66-73. DOI: 10.1016/j.bpobgyn.2015.12.001. Epub 2015 Dec 23. PMID: 26856931.
13) Fuldeore MJ, Soliman AM. Patient-reported prevalence and symptomatic burden of uterine fibroids among women in the United States: findings from a cross-sectional survey analysis. Int J Women’s Health. 2017 Jun 7;9:403-411. DOI:
10.2147/IJWH.S133212. PMID: 28652819; PMCID: PMC5476627.
14) He Y, Zeng Q, Dong S, Qin L, Li G, Wang P. Associations between uterine fibroids and lifestyles including diet, physical activity, and stress: a case-control study in China. Asia Pac J Clin Nutr. 2013;22(1):109-17. DOI: 10.6133/apjcn.2013.22.1.07. PMID: 23353618.
15) Parazzini F, Di Martino M, Candiani M, Viganò P. Dietary components and uterine leiomyomas: a review of published data. Nutr Cancer. 2015;67(4):569-79. DOI: 10.1080/01635581.2015.1015746. Epub 2015 Mar 31. PMID: 25826470.
16) Cione E, La Torre C, Cannataro R, Caroleo MC, Plastina P, Gallelli L. Quercetin, Epigallocatechin Gallate, Curcumin, and Resveratrol: From Dietary Sources to Human MicroRNA Modulation. Molecules. 2019 Dec 23;25(1):63. DOI:
10.3390/molecules25010063. PMID: 31878082; PMCID: PMC6983040.
17) Al-Hendy A, Myers ER, Stewart E. Uterine Fibroids: Burden and Unmet Medical Need. Semin Reprod Med. 2017 Nov;35(6):473-480. DOI: 10.1055/s-0037-1607264. Epub 2017 Nov 3. PMID: 29100234; PMCID: PMC6193285.