The Elix Guide to Uterine Fibroids

Dr. Jessica Ritch, MD helps to treat patients and get them back to their lives faster through behavioral modifications, physical therapy, medical treatment and surgical treatment including robotic surgery, advanced laparoscopy, hysteroscopy and vaginal procedures. She specializes in the management of benign gynecologic conditions such as abnormal bleeding, pelvic pain, fibroids, endometriosis, and polycystic ovarian syndrome (PCOS).

What Are Uterine Fibroids? 

Uterine fibroids are benign (not cancerous) tumors that can cause pain, swelling, abnormal bleeding, bulk symptoms and possibly infertility for people with periods. Also known as myomas or leiomyomas, these fibroids are composed of smooth and fibrous tissue and can be found in (or around) the uterus. The size of these fibroids can range as small as a pea to as large as a melon, and can grow at different rates during reproductive years. 

Although it’s estimated that 26 million women in the United States between the ages of 15 and 50 have uterine fibroids, many aren’t aware they have fibroids. This is often due to lack of adequate information, or the fact that not all uterine fibroids cause detectable symptoms.

What Are The Symptoms Associated With Fibroids? 

Fibroids don’t always cause symptoms and do not need to be treated if asymptomatic. In those that do, symptoms to look out for include:

• Heavy or prolonged menses
• Bleeding / spotting between periods
• Significant cramping
• Pelvic Pain 
• Excessive bloating in the lower abdomen
• Frequent urination
• Pain during sex
• Chronic vaginal discharge.
• Inability to urinate or completely empty your bladder
• Unexplained low red blood cell count (anemia) 
• Constipation or difficulty having bowel movements
• Abdominal protrusion (looking pregnant when you’re not)

In rare cases, uterine fibroids can become abnormally large, twisted, or infected. These situations can create intense symptoms, and may require immediate medical treatment from a minimally invasive gynecologist.

How Are Uterine Fibroids Diagnosed?  

During a routine evaluation, a healthcare provider may ask questions about menstrual symptoms, medical history, or even conduct a pelvic exam. Symptoms like excessive bleeding or others listed above,  may lead a healthcare professional to suspect fibroids as a cause of these gynecological problems.  A pelvic exam and pelvic ultrasound are typically the first steps in evaluating for fibroids.

Diagnostic tests may include: 

• A pelvic ultrasound 
• Magnetic resonance imaging (MRI)
• A CT scan
• Hysteroscopy: A test that uses a device called a scope (a thin, flexible tube with a camera on the end) to look at fibroids inside your uterus. The scope is passed through your vagina and cervix and then moved into your uterus.
• Sonohysterography: An imaging test performed after the uterus is filled with fluid, allowing for a clearer image of your uterus than you would see during a standard ultrasound.
• Laparoscopy: In this procedure, your doctor will make a small cut (incision) in your lower abdomen. A thin and flexible tube with a camera on the end will be inserted to look closely at your internal organs.

If you are experiencing mild or no symptoms, you and your doctor might choose to leave your fibroids untreated. However, if you are experiencing painful or uncomfortable symptoms that are affecting your quality of life, there are a variety of holistic support and treatment options available to you. 

Holistic, Natural Support Options for Fibroids

1. Pelvic Floor Physical Therapy

For those experiencing pelvic pain caused by fibroids, pelvic floor physical therapy can help to strengthen your muscles and relieve pain in the pelvis. Pelvic massage therapy can also help to break up the scar tissue that can restrict your range of motion, alleviating the pain. This will not directly treat the fibroids or fibroid pain, but can help relieve pain to surrounding areas caused by fibroids and help with bladder and bowel function.

2. Acupuncture 

Conducted by Traditional Chinese Medicine (TCM) practitioners, acupuncture is a great option to reduce pain, relax the body, and promote healthy energy (Qi) circulation. While acupuncture may not completely treat your fibroids, TCM looks at the root cause, and underlying imbalances in the body that are causing the fibroids to help reduce their size, manage heavy bleeding and discomfort, and regulate your menstrual cycle.  

3. Diet and Lifestyle Changes

The power of nutrition is incredible, and with some dietary modifications, you may start to notice a difference in the severity and prevalence of fibroid symptoms. Eating a balanced diet with fruits and vegetables and getting plenty of healthy exercise can help balance hormones, manage stress levels, and reduce inflammation that could be making your fibroid symptoms worse.  While there are no specific foods that have been found to treat fibroids, red meats, dairy, alcohol and caffeine have all been shown to worsen fibroids and their symptoms

4. Herbal Supplements

Chinese herbal medicine has also been shown to reduce symptoms connected to uterine fibroids by balancing hormones, reducing inflammation, and decreasing pain. Some of the herbs in Elix’s formulas that target these specific concerns include:

• Angelica Sinensis: Regulates hormones & has anti-inflammatory properties. 
• Poria: An edible mushroom that suppresses inflammation, reduces cramps, and promotes relaxation. 
• Moutan: known for its powerful ability to reduce inflammation and promote blood flow, making it an excellent treatment for severe menstrual cramps.

Treatment Options for Fibroids

1. Minimally Invasive Surgery

Surgical options such as a myomectomy (or the removal of fibroids) are available. For fibroids that are found on the inside of the uterine cavity, a hysteroscopic myomectomy is conducted where the gynecologist uses a camera to go through the vagina and cervix, to remove the fibroids without an incision, generally resulting in faster recovery times. 

An abdominal myomectomy on the other hand is conducted when the fibroids are located on the outside of the uterus. This is done through an incision (similar to a c-section), or through smaller laparoscopic or robotic incisions. Recovery time here is dependent on the size of the incision, and the size and location of the fibroids. Both types of surgeries are safe for those wanting to become pregnant with minimal complications.

2. Fibroid Ablation

If you are not interested in becoming pregnant, then a fibroid ablation might be an option for you—especially if you are not looking to go through major surgery. For this procedure, a radiologist will go through the blood vessels in the groin that connect to the blood vessels of the uterus, and block off the blood supply to the uterus and fibroids, causing the fibroids to shrink by 30-60% depending on their size and location.

Newer technology is also available using an internal ultrasound that located fibroids in the uterus, and ablates them, causing the fibroids to shrink over time, along with the symptoms associated with them. This is also a fairly quick procedure with no incisions in the skin, resulting in a faster recovery time and minimal discomfort. 

Another option is High Intensity Focused Ultrasound (HIFU), where an MRI device is used to locate the fibroids, and a beam of ultrasound is used to target and shrink/ablate the fibroids. While there are many options to choose from to get relief, it’s important to talk to your doctor to discuss which is right for you.

Additional Resources

If you are struggling with symptoms associated with uterine fibroids, it can be difficult to navigate through as every case is different from person to person. But, as we discover more holistic options for support, it’s important to stay informed and choose the right doctor to provide you with the care and treatment that best suits you.

For fibroids:
Office On Women's Health

For general information on menstrual health:
Mayo Clinic

For pelvic floor physical therapy: 
Women’s Health Apta
Pelvic Rehab

Elix is here to support every cycle of your journey. Take our Health Assessment and discover your personalized herbal formula to address your worst menstrual symptoms and heal from within.

This article was reviewed by Dr. Elizabeth Fine.

Dr. Elizabeth Fine is currently the Dean of Clinical Education at Emperor’s College, the #2 ranked colleges for TCM. She has been practicing Acupuncture and Herbal Medicine for over 20 years, with a specialization in women’s reproductive health.