Counseling Sheet

Agatha M. Thrash, M.D.
Preventive Medicine

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Fibroids occur in women who tend to have higher levels of estrogen, as compared to other female hormones. Growth factors are responsible for the growth promotion effects on the smooth muscle of the uterus by estrogen and progesterone. Avoid overweight, as the increased estrogen can stimulate fibroid growth. The growth factors increase the number of receptors for estrogen and progesterone and provide the basis of the growth of the fibroid. The growth factors include epidermal growth factor, platelet-derived growth factor, keratinocyte growth factor, and both insulinlike growth factor and insulin. Since some of these growth factors are responsive to diet, in families having a history of early fibroids in the women, the diet should be regulated so that insulin resistance and insulin overproduction will not be a feature of the woman's lifestyle.—Infertility and Reproductive Clinics of North America,7(1):5-18;1996

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Questions and Answers

1. Please explain to me about fibroids.

Many women I talk with seem to have them. Fibroids are very common. In fact 20 percent of women between the ages of 30 and 45 have these non-cancerous growths of the uterus, consisting of a blend of muscle and fibrous tissue, giving them the name fibroids. They are benign tumors of the same significance as moles on the skin. They tend to grow to a certain size determined by unknown factors; and, just like moles, they tend to maintain that size with only minor, if any, additional growth for many years. Then, when the menopause comes, they usually shrink to a fraction of their original size.

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2. What problems are associated with fibroids?

The most troublesome problem from uterine fibroids is bleeding, and the next is the cosmetic enlargement of the abdomen. I recommend that even with these problems, the simple remedies be applied, and that the woman simply delay more invasive measures, unless her symptoms force her to have an operation. Since the uterus shrinks, as well as the fibroids, after menopause, the bleeding usually stops promptly after menopause; and the size of the abdomen reduces.

Fibroids, if large enough, can press on the bladder in front of the uterus or on the rectum behind the uterus, causing either scanty, frequent urination or constipation. Fibroids may interfere with the ability to become pregnant, if they bulge into the interior of the uterus; and they may also be responsible for miscarriages. Rarely, a large fibroid the size of a baby's head can even block the birth canal, necessitating a cesarean section. But the vast majority of fibroids give little evidence of their presence; and a woman may keep them for years without knowing they are there. Multiple pregnancies can occur even with fairly large tumors. The doctor can often feel fibroids, if they are large enough during a pelvic exam. Just because they are present, however, does not mean the uterus or the fibroids must be removed.

If you do not have any symptoms, you certainly should not have an operation. Uterine fibroids are benign tumors, and if you handle yourself correctly, you should not have any difficulty from them. The risk of anything serious happening, if you keep them, is far less than the risks of a complication or even death from the surgery.

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3. What causes fibroids?‍

Until recently, the cause was unknown. One good theory is that the fibrous tissue and the muscle of the uterus are stimulated to grow by small bits of endometrial tissue that get squeezed backward during the menstrual period, along lymphatic vessels into the wall of the uterus, and cause an irritation of the muscle tissue. The same process when it grows to a greater degree is the cause of endometriosis.

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4. What makes fibroids get bigger?‍

Hormones are necessary for the beginning growth of fibroids and even for keeping them large. Fibroids develop and grow in menstruating women; but they usually stop growing after a time, rarely getting larger than grapefruit size.

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5. What, if any, effect does hormone-replacement-therapy have on fibroids?

If a woman takes estrogen after menopause, as many do, the fibroids may stay large for quite a while or even grow larger.

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6. Do fibroids ever go away by themselves?‍

There are several things that can be done to shrink fibroids, but it is unlikely, if not impossible, they will go away completely.The earlier in life they begin, the greater the likelihood they will grow to a fairly large size (large orange or grapefruit size).

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7. My husband says that fibroids might turn into cancer. Is that true?

‍No, fibroids do not become malignant. Large fibroids can degenerate because the blood supply is too low to maintain the cells in the central area; but most authorities say fibroids do not become malignant.

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8. Do symptoms always go away after surgery?

‍Many women realize after the uterus has been removed that the symptoms she thought were from the uterus or fibroids, were actually from the bowel or the skeleton or elsewhere, and she is no better or maybe even worse. She was also subjected to many serious risks.

Whites were more likely than Blacks to have surgery for cancer, uterine prolapse, or endometriosis, while Blacks were more likely to have surgery for fibroids. According to a conservative estimate published by the Journal of the American Medical Association, May 10, 1993, four of every ten hysterectomies are probably unneeded. My experience as a hospital pathologist evaluating hysterectomies would lead me to think it is more like eight out of ten. Hysterectomy is the second most common major surgery in the United States, running behind only cesarean sections. One in three American women can expect to have a hysterectomy by the age of 60.—Prodigy Interactive Personal Service, May 6, 1993

Generally, unless there are unusual circumstances, her hemoglobin must be below 9.0 grams, hematocrit below 27, and her pain or constipation quite incapacitating before I recommend a hysterectomy.

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9. Why can't a doctor just remove the fibroids instead of removing the entire uterus?

‍Since hysterectomies are usually recommended, it may come as a surprise to some women that if their fibroids are positioned just right and are present in an accessible area, the fibroid itself may be removed without removing the entire uterus. The procedure of myomectomy—removal of the fibroids alone—is in many ways, however, the more difficult procedure, often with more blood loss than a hysterectomy; and then, fibroids recur in one out of three women after myomectomy, particularly when the women are younger than 35.

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10. Are there any treatments for fibroids other than surgery?‍

Yes, there are natural treatments for fibroids. Successful treatment consists not in the fibroids disappearing, but in the control of bleeding or other symptoms, and in avoiding an operation. It may take several months to a year of treatments for improvement to occur. Do not be discouraged if improvement is slow. The objective is to tide you over, until menopause causes the natural shrinkage in size we always expect. Most fibroids require no treatment other than providing relief for any kind of symptom the woman may have. Surgery to prevent the development of symptoms is seldom, if ever, warranted.—Obstetrics and Gynecology Clinics of North America, 22(4):659;1995‍

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Treatment recommendations include the following five things:‍

1. Eat a plant-based diet, rich in fiber (minimum of 20-30 grams per day). The fiber assists the liver in processing and eliminating excess estrogen. Avoid all animal products, which naturally contain estrogens. Also, avoid coffee, and imported beans, which are typically heavily sprayed with DDT, as they can exacerbate fibroids.
2. Take a liver-supporting herbal formula that includes some or all of the following herbs: bupleurum, milk thistle, barberry or goldenseal, burdock root, yellow dock, dandelion root.
3. Take a uterus-healing herbal formula that includes some or all of the following herbs: myrrh, red raspberry, cayenne, bupleurum, yarrow, chaste tree, lady's mantle.
4. Use a castor oil pack two to four times a week. Basically, you would cut four layers of flannel in a shape large enough to cover your lower abdomen (from umbilicus to top of pubic hair, and over to both sides). Soak all four layers of the flannel in castor oil and apply them to the abdomen a layer at a time, one on top of the other. The flannel should be well-saturated with the castor oil, but not dripping. Wring out the excess. Cover the flannel layers with plastic (use a grocery bag or garbage bag) and tape in place, or wrap with a cloth and pin to hold the packs in place. Then cover the plastic with a heating pad that has been protected by slipping it into a plastic bag. Keep the castor oil pack quite warm for one hour, and the heating pad can be laid aside for the remainder of the night. Put on old clothing that you don't mind getting stained, if the castor oil should leak over the top. The clothing should not bind, but fit nicely against the skin, and should be warm. Wear the pack overnight, removing it in the morning. The same pack can be used up to three times, adding more oil as needed. The flannel layers can be hand-laundered and air-dried for reuse.
5. Begin using a natural progesterone cream. Begin on day 10, 11, or 12 of your cycle (Day 1 is the day you start your period) and continue until day 26 to 30. Stop, and you should have a period; then resume again on day 10, 11, or 12, continuing until day 26 to 30, and so forth. This should help shrink the fibroid and is safe to continue for years (until menopause, when fibroids naturally shrink). Very small amounts of the cream are used each day—as small as one-quarter teaspoon. It is applied to skin that is thin, such as the inside of your arm, your neck, your chest (see what the package instructions tell you). You should use about one ounce of the cream with each cycle. It does not have to be exact, but don't grossly overdo or underdo your dose.

It may be your third or fourth cycle, following this treatment, that you begin noticing improvements. It takes at least two months to start getting things balanced.

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Natural Douche

It is believed by some naturopaths and chiropractors that these disorders are all due to a reduced quantity of tissue iodine in the uterus. We had occasion to suggest to one woman that she use the following routine. She felt she was benefited, but she got weary of the process and had a hysterectomy. You can try it. We have no guarantee.

• Use two tablespoons of liquid chlorophyll, unflavored (which contains iodine)
• One teaspoon of liquid dulse
• The woman should lie in the knee-chest position or on one side with hips elevated on a pillow, and inject the liquid with a bulb syringe into the vagina as a retention douche. Wear a pad to catch any leakage. The next night the woman should lie on the other side and have the retention douche. Do the douches every night, and stay in the same position as long as possible before moving. In two to three weeks the fibrocystic disease or fibroids will begin shrinking, if they are going to respond to the treatment.
• Some treatments will encourage sufficient shrinkage to eliminate major symptoms.
• Avoid supplements that contain PABA or large amounts of folic acid.‍

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Another Castor Oil Pack

• Cut a piece of cotton flannel large enough to wrap all around the torso from just below the breasts to extend to the groin. The flannel should be wide enough to wrap all the way around the back as well.
• Cut a piece of substantial plastic, such as a shower curtain, large enough to extend past the flannel two inches on all sides.
• Get a long, thin towel large enough to completely cover the plastic. Lay it on the bed first, and then lay the plastic on the towel.
• Then wet the flannel well in castor oil. Spread the flannel on the top of the plastic.
• Lie down on the flannel and wrap the flannel around yourself first, then the plastic, then the towel.
• Pin it snugly in place with safety pins.
• Wear it all night (at least 8 hours) on a daily basis for 6 weeks.
• Take a two-week break and resume for six more weeks—and so on for a year.

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Herbal Suppository

An herbal suppository can be made from powdered herbs mixed with cocoa butter. Use red raspberry and equal quantities of wild yam pulverized in a blender or seed mill and mixed with melted cocoa butter (coconut oil), until you have a thin paste. Cool the mixture in the refrigerator, until softly congealed. Dip up one tablespoon-size portion, and roll into suppository size bars. Flatten slightly, and cool in refrigerator before inserting. Use one nightly.

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Chaste berry tincture by mouth can also be of help. Use it for two months or more.

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Soy foods can be helpful for fibroids. The most helpful form of soybeans is the whole dry bean, soaked and cooked as ordinary beans. Take about one quarter cup of the cooked beans each day.

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Hot Sitz Baths

Hot sitz baths have been used by some OB-GYN physicians in an attempt to control uterine fibroids, without surgery. The procedure for giving this treatment is as follows:

You will need

• Two tubs, perhaps your bathtub and a #2 washtub or plastic utility tub that will set in the bathtub—deep and wide enough for you to be able to sit in it
• Coarse, dry towel
• Bathrobe  or sheet for protection, while transferring to the bed and while resting after the treatments‍

Directions

• ‍‍Put hot water in the bathtub and cold water in the smaller tub.
• Sit for three minutes in the bathtub in hot water with the knees drawn up out of the water. Have the water as hot as can be tolerated.
• Then, with the feet remaining in the hot water, transfer your seat into the smaller tub, having the cold water come up over all the area where hot water touched the skin. Keep the feet in the hot water.
• Sit three minutes in the hot water and one minute in the cold water.
• Continue to add both hot water and cold water, keeping the hot water as hot as can be tolerated, and the cold water as cold as you can get it from the cold water tap, as well as adding ice from time to time to keep the water temperature around or below 45 degrees. If you positively cannot tolerate temperatures that low, raise the temperature to 65 degrees, or shorten the time in the 45-degree tub to 30 seconds.
• The entire treatment should last about 45 minutes, alternating between the hot water sitz and the cold water sitz.
• When the time is finished (the last application to the hips being the cold water), then stand in the cold water tub approximately 20 seconds. Begin to briskly dry the body with the coarse, dry towel.
• Then step directly out of the cold tub onto the floor.
• Put on the bathrobe, or wrap up in the sheet, and quickly transfer to the bed and rest at least 20-60 minutes.
• Perform the treatment five days a week for six weeks.

Tip: If the cold water tub cannot be managed easily in the bathtub, you can apply the cold part of the treatment by wrapping a slightly dripping, ice-cold towel around the waist and hips, bringing it up between the legs like panties while standing in the hot water. You will need two large, wet, and dripping cold towels, one for the first 30 seconds of the one-minute cold phase, and the second for the last 30 seconds. Make your changes quickly. Then sit again in the hot water.

Take four capsules daily for six weeks of evening primrose oil, or 400 IU of vitamin E per day, or 20,000 IU per day of vitamin A. One or all taken each day can be helpful in some cases.

A foot rub will often help, if there is pain or congestion of the fibroids.‍

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Herbal Treatments

‍Medicinal Tampons

• Cut well-washed and rinsed cotton fabric (old undershirts will be fine) in pieces about 1" x 4".
• Lay one on top of the other until you have a small pile about 1/4" high.
• Tie a string tightly around the middle, and leave the ends of the string about 6" to 8" long.
• Mix a teaspoonful of slippery elm powder and a teaspoonful of white oak bark powder with enough water and a teaspoon or more of clay (French clay recommended, but any kind can be used) to make a thin consistency, about like mustard or catsup.
• Spread this mixture on the cotton fabric layers, being generous and soaking the cotton thoroughly.
• Using the eraser end of a long but very sturdy pencil or similar sturdy instrument, insert the tampon into the vagina up to the cervix, leaving the long end of the string hanging out. The best way is to lie in a dry bathtub. Drape the prepared cotton strips over the blunt end of the pencil and push the mid-section as far into the vagina as possible. Wipe off any drips from your skin, and wash spills down the drain. (The insertion can  be done on a bed, catching spills on a towel or plastic sheet.)
• Wear a protective pad to prevent any leakage from soiling the clothing.
• Follow these instructions five nights weekly for six weeks, immediately before bed. Remove the tampon next morning by pulling firmly on the string.

Note: If for some reason the herbs are not used, Ichthammol Black Salve may be used on the cotton fabric layers, being generous. Mix it half and half with vegetable glycerin, and follow the same procedure.

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‍Herb Teas

‍We suggest you take any one of the following formulae for fibroids:

‍Recipe I‍

• Use chaste tree berries, angelica root, squaw vine, licorice root, and raspberry leaf.
• Use one tablespoon of each of the herbs except for one-quarter cup of the raspberry leaf.
• Use one quart of water.
• All herbs that are not leaves should be put in the water and set to simmer for 25 minutes. The gentlest boil you can obtain is preferable, as too vigorous boiling can damage the active ingredient. When the 25 minutes are up, set the pot off the heat and put a tablespoon of those herbs that come as leaves in the container with the first herbs and let them all steep together for 30 minutes.

This is one-day's supply. If it is slightly nauseating, you can eliminate that by putting one teaspoon of soy milk powder with each cup of the tea, dissolving it just at the time you are drinking it. That should eliminate any nauseating effect from the herbs.‍

Recipe II‍

• One part licorice root
• One part false unicorn
• Two parts chaparral
• Three parts red clover
• One part cramp bark

Directions: Powder the mixed herbs in a dry blender. Put one teaspoon of the powder in a cup of boiling water. Cool, and while keeping the powdered herbs stirred up from the bottom, drink both the liquid and the powder. Use one cup four times a day. Continue the herbs for six to ten weeks. This mixture is said also to shrink ovarian cysts, and endometriosis, as well as uterine fibroids. It will often abolish chronic vaginitis and other vaginal and uterine infections.

Recipe III‍

Another mixture you will find helpful for fibroids is chastetree and milk thistle. Gently simmer one tablespoon of chaste tree for five to ten minutes in one quart of water. Remove from the heat and add one heaping tablespoon of milk thistle, and steep for half an hour. Take one cup four times a day for three to six months. This mixture can be taken with the previous recipe.

You may also find benefit from wild yam gel, available from an herbal company called Born Again.

Ginseng can be used for fibroids—one cup four times daily for at least eight weeks. Take it at least 40 minutes after eating, and never with food.

Butcher's broom can also be used for fibroids—one cup four times daily.

For uterine hemorrhaging, a tincture of fresh trillium and shepherd's purse can be taken to stop hemorrhaging. Cinnamon tincture, peony tincture, chaste tree, and verbena should be taken throughout the bleeding episode. No plastics should be used for your food, as they contain zenoestrogens. Follow the eight natural laws of health very carefully. (See separate Counseling Material) Glycyrrhiza from licorice root may also be taken. Kudzu leaf can also be taken for high blood pressure, which may encourage uterine bleeding.

A patient told one of our doctors at Uchee Pines Institute about a treatment she used for fibroids, which she said was very successful in helping her to control bleeding. She used two garlic capsules two times a day for six weeks; then once a day for six months; one-quarter teaspoon of cayenne pepper mixed in water with one teaspoon of golden seal powder two times a day; and one cup of echinacea tea twice daily for six weeks. While we do not usually recommend the long-term use of cayenne pepper, internally, in this case, if other remedies are not effective, it should be tried to see if surgery can be avoided.‍

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Dietotherapy

‍With the treatment for fibroids, use a one- to three-day fast, if you have good nutritional reserves. Avoid permanently all beverages such as coffee, tea, colas, chocolate, beer, wine, mixed alcoholic drinks, etc., and avoid temporarily all drugs, unless essential, such as insulin in Type I diabetes, epilepsy medication, or blood pressure pills. Check with your doctor, if you are not certain you can leave off your medicine during a fast. This portion of the treatment is very important.

In addition, you should begin planning to eat a diet, which has been recognized to be associated with a much lower incidence of fibroids —a totally vegetarian diet—no meat, milk, eggs, or cheese. All free fats (margarine, butter, mayonnaise, fried foods, cooking fats, salad oils, and peanut butter)should be removed from your diet during the treatment period. You may have some nuts, seeds, olives and avocado, but no oil made from any of these foods, as the extracted oils are chemically different after extraction and tend more to promote tumor growths. No free sugars should be used during the treatment period such as sugar, honey, fructose, syrup, malt, etc. Be careful to avoid very salty foods.‍

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Weight Control

‍If you are overweight, you are more likely to develop fibroids and to have complications from them. Follow the instruction on Weight Control from our Counseling Material. Also, avoid eating anything between meals or after 3:00 p.m. as food eaten then is more likely to be put on as fat than food taken at mealtimes. Be regular in mealtimes.

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‍Fasting

‍Fasting will temporarily shrink a fibroid. Start your fasting program with a three-day fast. Then, fasting a day or two each week will be very helpful, if the nutrient reserves are adequate—that is, you are not severely thin or very run down.‍

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A Case History‍

A 39-year-old white woman suddenly began having bleeding at 2:00 a.m. She felt full in the abdomen; when she got to the bathroom she passed a number of large blood clots and some liquid blood. She recognized that this was not a menstrual period, but she had cramps with the bleeding. She saw her doctor the next day and a grapefruit size fibroid was found, which was doubtless the cause of the heavy bleeding. Her periods had been prolonged and more frequent and, at times, her hemoglobin level would drop down to around ten grams, while usually running around 12.3 grams.

At this point, she had a D. & C. and the surgeon recognized the presence of small fibroids just under the lining of the uterus, and suggested a hysterectomy. The patient postponed the surgery and began trying several types of home remedies.‍

‍Her treatment was successful, as follows: Six weeks of large garlic capsules followed by the odorless tablets in a concentrate on the following dosage schedule: two of the large capsules twice a day for six weeks, but switched to four tablets twice a day for six weeks, and later cut down to two tablets a day. She found a preparation in the health food store of cayenne pepper mixed with golden seal. She took two capsules of the mixture four times a day, along with rose hip tea, two cups per day; echinacea tea, one cup two times a day; and burdock tea, one cup two times a day.

She emphasizes that she prayed to the Lord for assistance in successfully treating her fibroids. Within six weeks, the grapefruit size fibroid was "down to barely detectable size" by the gynecologist. Her bleeding had greatly diminished, and within a year, was back to the level of bleeding she had had before her trouble began. (September 2007)