The standard treatment of fibroids is surgical removal by myomectomy or total hysterec-tomy (removal of the entire uterus), but both operations are associated with numerous risks-from wound infections and internal scarring to incontinence and vaginal prolapse (JAMA, 2009; 301: 82-93). For this reason, a number of researchers are looking for alternative ways to manage
Green tea goodness
The green-tea discovery was made by a team of scientists at Meharry Medical College in Nashville, TN-Dong Zhang and his colleagues- who injected 20 mice with fibroid cells, then gave half of them epigallocatechin gallate (EGCG) mixed with water, while the remaining mice were given just plain water. EGCG is a bioactive polyphenol in green tea, known to be a potent antioxidant.
The mice were observed for up to eight weeks. The results showed that EGCG dramatically reduced both the volume and weight of tumours at both four and eight weeks after treatment.
The researchers also noted that one mouse in the EGCG group had no visible tumour by the end of the eight-week period of observation (Am J Obstet Gynecol, 2010; 202: 289).
These results were in animals and, so, may not apply to humans. Nevertheless, the same research-ers followed-up their study with a test-tube investigation into the effects of EGCG on human fibroid cells. They found that the green tea extract inhibited cell growth and even induced cell death-and the higher the dose, the better the effect.
"These results suggest that EGCG may be a potential anti-uterine fibroid agent acting through multiple signal trans-duction pathways," the scientists said (Fertil Steril, 2010; 94: 1887-93).
The team has now received permission to start human trials to find out whether EGCG is an effective treatment for people with fibroids. For this study, 80 women are being recruited. Forty will be given a concentrated amount of the extract, while the other 40 will be given a placebo to allow the results to be compared.
If the trial proves positive, EGCG could become a valuable treatment for many fibroid sufferers, particularly those in the early stages of the disease. It could also potentially prevent the need for major surgery.
Other promising remedies
Besides EGCG, a number of other natural compounds as well as popular supplements are showing promise in the treatment of fibroids.
u Curcumin, the yellow pigment in the spice turmeric, has been reported to prevent various diseases, such as cancer, diabetes and obesity. Now, preliminary research suggests that the compound might be useful for fighting fibroids. Test-tube studies have shown that curcumin can reduce the growth and increase the death of fibroid cells from both animals and humans (Gynecol Endocrinol, 2010 Jul 30; Epub ahead of print; Fertil Steril, 2009; 91 [5 Suppl]: 2177-84).
u Lycopene, a carotenoid anti-oxidant found primarily in tomatoes, reduced the size and incidence of fibroids in Japanese quails, a species prone to fibroids of the oviduct (Nutr Cancer, 2004; 50: 181-9). Likewise, tomato powder has demonstrated the same effect (Nutr Cancer, 2007; 59: 70-5).
u Selenium and zinc have also been tested (separately) on Japanese quails. Both of these supplements had no effect on the number of fibroids in the birds, but they did significantly reduce the size of the fibroids compared with controls (J Med Food, 2009; 12: 1368-74; Nutr Cancer, 2010; 62: 495-500).
u Vitamin D, used in another laboratory study, was recently found to inhibit the growth of human fibroid cells by 47 per cent. The researchers also commented that vitamin D deficiency "might conceivably be a risk factor for the initiation and progression of uterine fibroids", and may explain why African-American women are more likely to have fibroids than other ethic groups, as around 40 to 45 per cent of African-Americans are deficient in vitamin D compared with only 4 per cent of European Americans (Fertil Steril, 2011; 95: 247-53).
Although studies are still in the early stages and clinical trials are yet to be done, the evidence so far suggests that supplementing your diet with the above nutrients may help to slow fibroid growth and may possibly even reverse it to some extent.
Sadly, human trials of alternative therapies for fibroids are, as yet, few and far between. However, based on the available evidence, the following may be beneficial.
u A change of diet. A large Italian study found that women who often ate ham, beef and other red meats were more likely to develop fibroids than those who did not. Also, high intakes of fish, green vege-tables and fruit appeared to be protective (Obstet Gynecol, 1999; 94: 395-8).
Other studies suggest that soy products might be contrib-uting to fibroids due to soy's oestrogenic effects (Complement Ther Clin Pract, 2008; 14: 132-5), although the evidence has been conflicting (Eur J Clin Nutr, 2001; 55: 773-7).
Recently, a diet with a high glycaemic index (GI) and glycaemic load (GL) was linked to a higher risk of fibroids (Am J Clin Nutr, 2010; 91: 1281-8). Following a low GI/GL diet may, therefore, be helpful.
u Avoiding heavy metals. Exposure to heavy metals could be linked to fibroids. One study found that women with fibroids and infertility tended to have higher levels of cadmium, found in enamelled cookware, cigarette smoke and heavily polluted environments (J Toxicol Environ Health A, 1998; 54: 593-611).
u Chinese herbs. It may be worthwhile seeing a qualified Traditional Chinese Medicine practitioner. In one study of more than 100 premenopausal women, kuei-chi-fu-ling-wan (keishi-bukuryo-gan, KBG)-a compound made up of the bark of Cinnamomum cassia, roots of Paeonia lactiflora, seeds of Prunus persica, pistils of Poria cocos and root bark of Paeonia suffruticosa-improved the clinical symptoms of fibroids
in more than 90 per cent of cases. What's more, around 60 per cent of the women saw their fibroids shrink with this remedy (Am J Chin Med, 1992; 20: 313-7).
In a study using lei gong teng (Tripterygium wilfordii Hook f, or common broad lily root), 70 per cent of women had smaller fibroids after five or six months of using the remedy (Zhonghua Fu Chan Ke Za Zhi, 2000; 35: 430-2). Both studies, however, had no control groups for comparison.
u Mind-body medicine. Stress has recently been linked to fibroids (Stress Health 2010, Nov 17; Epub ahead of print), so mind- body therapies may be helpful. Indeed, body therapy (somatic therapy, body work), guided imagery and weekly Traditional Chinese Medicine (TCM) was more effective than conven-tional care in treating fibroids in a controlled study of 74 American women (Altern Ther Health Med, 2002; 8: 34-6, 38-40, 42, 44-6).
u Homeopathy. Remedies known to slow or halt the growth of fibroids are Thuja Occidentalis, Conium Maculatum, Ustilago Maydis and Silica. For relief of symptoms, try Thlaspi Bursa Pastoris, Cimicifuga Racemosa and Magnesium Phosphoricum (J Comp Med, 2005; 4: 87-90, 92). However, it's better to see a qualified homeopath for an individualized prescription.
u Acupuncture. On comparing this form of TCM with other medical treatments, acupunc-ture achieved a total rate of effectiveness in 98 per cent of cases, with a cure rate of 73 per cent (Zhen Ci Yan Jiu, 1994; 19: 14-6).
u Exercise. Obesity and low levels of physical activity have been linked to fibroids (Wiad Lek, 1993; 46: 592-6). In one study, women who were active for seven or more hours a week were significantly less likely to have fibroids compared with those who did less than two hours of physical activity a week (Am J Epidemiol, 2007; 165: 157-63).
u Vitex agnus-castus (chaste-berry) is a tried-and-true remedy for fibroids, according to medical herbalist and WDDTY columnist Dr Harald Gaier. In his own practice, he's observed that an extract made from these fruit (extract of agnus castus, EAC), taken every day for at least seven months, can halt the growth of, and even shrink, uterine fibroids, as confirmed by regular ultrasound scans. It should, however, be taken only under the supervision of a qualified herbalist, who can select the appropriate dosage and monitor your condition.
Factfile: Conventional alternatives
u Uterine artery embolization (UAE). This operation uses radiological techniques to block blood flow to the main artery supplying the uterus, resulting in fibroid shrinkage, and has been successfully used in postmenopausal women (J Vasc Interv Radiol, 2007; 18: 451-4). However, a recent study reported that, five years after UAE, around 30 per cent of patients had to undergo hysterectomy because of insufficient improvement of their symptoms (Am J Obstet Gynecol, 2010; 203: 105).
u High-intensity focused ultrasound (HIFU). This technique uses focused HIFU waves in conjunction with magnetic resonance imaging (MRI) to destroy fibroids with pinpoint accuracy (Srp Arh Celok Lek, 2008; 136: 193-5). Although generally successful, the potential complications include abdominal, leg and buttock pain, bloody vaginal discharge and skin blisters (Zhonghua Fu Chan Ke Za Zhi, 2010; 45: 913-6).
u Drug therapy. Hormone therapies and gonadotropin-releasing hormone agonists have proved effective in some women with fibroids (Acta Obstet Gynecol Scand, 2008; 87: 812-23). However, the possible side-effects limit their long-term use (Orv Hetil, 2010;
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