Uterine Fibroids in Chinese medicine.
Below is a discussion on uterine fibroids in Chinese medicine, and how we may use acupuncture and Chinese herbal medicines to treat them. We will look at what they are, how Chinese medicine describes them, various treatment options and predicted outcomes.
What are uterine fibroids?
Uterine Fibroids (a.k.a. uterine myoma, leioma, fibroma) are benign (non- cancerous) growths of smooth muscle tissues within the uterine walls.
There are four types of fibroids, which are differentiated by their location.
Fibroid prevalence is very common for women over 35 with studies showing that incidence rate is more than 40%. Moreover, only 20% of fibroid sufferers are aged under 35. The age group of women between 35 to 45 have seen the highest frequency.
Most women with uterine fibroids have no symptoms. However, fibroids can cause a number of symptoms depending on its size, location within the uterus, and how close they are to adjacent pelvic organs.
Abnormal uterine bleeding and pain is the most common symptom of a fibroid. Other symptoms include:
- Pelvic cramping or pain with periods and abnormal uterine bleeding between periods;
- Heavy or prolonged periods (menorrhagia);
- Abdominal discomfort or bloating;
- Constipation or painful defecation;
- Increased urinary frequency or retention;
- Pain during intercourse;
- Back pain.
While fibroids do not interfere with ovulation, some studies suggest that they may impair fertility and could lead to adverse pregnancy outcomes. In particular, submucosal fibroids (fibroids growth underneath the uterine lining) that deform the inner uterine cavity are the most strongly type associated with a decline in fertility. Occasionally, fibroids can be the cause of recurrent miscarriages. The sufferer may not be able to sustain the pregnancy if it is not removed. Only 10-20% of fibroid cases require surgery, as there is always a risk of complications and regrowth after the surgery.
What is the Chinese medical approach?
Chinese medical treatment may see significant improvements regarding pain and bleeding within one week. Furthermore, fibroids up to a size of 2-3cm diameters have been successfully treated to reduce its size to a more comfortable level. In many cases they may be eliminated entirely. Larger myomas are generally treated with surgery, although pre-treatment with Chinese herbs and needling may help to reduce the complications of surgery.
How does Chinese medicine describe uterine fibroids?
Uterine fibroids are principally related to the liver and spleen. The stagnation of the qi and the blood as well as phlegm retention play a major role in the pathogenesis of abdominal masses. The three basic causes are:
- Mental Depression and Qi and Blood Stagnation;
- Improper Diet and Production of Turbid Phlegm;
- Attack by and Retention of Pathogenic Factors- cold, dampness, heat, or toxins.
When women develop turbid phlegm and/or Qi and Blood stagnation a slowing of blood and fluids may occur. Overtime the blockage builds up causing changes of endometrium of uterus. Even after surgery, there could be a high chance that fibroids could regrow if the turbid phlegm and/or Qi and Blood blockage is not treated.
How does Chinese medicine treat uterine fibroids?
Treatment of uterine fibroids usually requires a combination of acupuncture and herbal medicine. The treatment seeks to remove stasis, soften hardness and disperse the masses. It aims to regulate Qi and Blood circulation and reduce pain. Fibroids are dependent on estrogen and progesterone to grow and therefore the treatment will also focus on regulating and balancing hormones. A customised treatment plan will be customised for each patient depending on factors such as duration of disease, symptoms and menstrual cycle.
The duration of individual treatment plans range between 1-8 months, but typically can be treated in several months.
Can foods help?
Nutritional therapy can be used to assist in avoiding developing uterine fibroids as well as to prevent fibroid tumors from growing. The patient should begin a hormone-balancing diet, involving foods with low inflammation effects, and low acidity. The following are some suggestions:
- Eat warm/cooked food as cold and raw food can slow Blood and Qi flow;
- Avoid fried food as it can produce more turbid phlegm;
- Eat seaweeds to promote blood circulation and prevent the formation of blood clots;
- Eat salmon as it helps break down fibrin and is an anti-inflammatory;
- Eat soy products to help to shrink uterine fibroids (contains isoflavones and phytoestrogens to regulate estrogen levels in the body). Soy products include tofu, miso, soy-milk and tempeh;
- Eat legumes to helps strengthen your immune system.
Dietary recommendations would vary for each patient. Please discuss with your practitioner your personalised nutrition plan.
Are there any other things I may do to help combat uterine fibroids?
You could try aerobic exercise such as swimming and walking which consumes oxygen and helps to burn carbohydrates. It is associated with improvement in insulin resistance and sugar utilization as well as hormone balance.
Weight training also helps balance hormones such as growth hormone and testosterone. As fat cells (adipocytes) are known to produce inflammatory mediators and estrogens, limiting them will also reduce estrogen dominance. Regular exercise of either kind has also been shown to lower the incidence of breast cancer and colon cancer.
It is important to note that treatment results vary depending on individual situation, however most patients tend to respond quickly.
If you would like to explore more, feel free to drop us a line at the clinic. You may ask to speak specifically with Dr. Ellen Lee who specialises in gynecology and women’s health.
- Foran T. New therapeutic options for uterine fibroids. How to Treat (powered by Australian Doctor); 7 Sep 2017. https://www.howtotreat.com.au/therapy-update/new-therapeutic-options-uterine-fibroids (accessed Jan 2018).
- Royal Australian and New Zealand College of Obstetricians and Gynaecologists. Uterine artery embolisation for the treatment of uterine fibroids. November 2014. https://www.ranzcog.edu.au/RANZCOG_SITE/media/RANZCOG-MEDIA/Women%27s%20Health/Statement%20and%20guidelines/Clinical%20-%20Gynaecology/Uterine-Artery-Embolisation-(C-Gyn-23)-Review-November-2014.pdf?ext=.pdf (accessed Jan 2018).
- Effects of soy isoflavones on estrogen and phytoestrogen metabolism in premenopausal women. X Xu, A M Duncan, B E Merz and M S Kurzer (1998)
- Integrated identification, qualification and quantification strategy for pharmacokinetic profile study of Guizhi Fuling capsule in healthy volunteers. Yun-Xi Zhong, Xiao-Liang Jin (Scientific Reports volume6, Article number: 31364, 2016)
- Song, S.M., Hou, Y.Z., Wang, A.F., Qian, J.Y. (2006). Gui Zhi Fu Ling capsule treatment of uterine leiomyoma; 504 cases of clinical observation. Applied Journal of General Practice, 2006, 4(3):319.