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In a normal menstrual cycle, following ovulation, the uterine lining thickens to facilitate the implantation of the fertilized ovum. However, if a woman fails of conceive, the thickened uterine lining is shed off during the menstruation or ‘periods’. However, occasionally there is a possibility of formation of benign tumors in the muscular walls of the uterus, which are referred to as fibroids. As per scientific studies conducted, it has been observed that the occurrence of uterine fibroids has been associated with hormonal imbalances, especially of the hormones that are meant to regulate the normal functioning of the ovaries.

What are Fibroids?

Fibroids are a fairly common occurrence among females, with one in five women in the United States developing this condition. Uterine fibroids are overgrowths of the connective tissue or the muscle mass, which may be located anywhere in the uterus. Uterine fibroids are common in women between the age group of 30 - 50 years.

They are primarily benign tumors and rarely transform into malignant tumors. Uterine fibroids can be isolated or may grow in clusters. However, if the fibroid is too big or there are multiple fibroids in the uterus, it can result in symptoms like irregular and heavy bleeding, fullness and heaviness in the abdomen, abdominal pain, endometriosis, etc. Occasionally, very large fibroids can press onto the surrounding pelvic organs and cause pressure symptoms like constipation or urinary incontinence.

The treatment may depend upon the size and complications associated with the fibroid. In most cases, women are unaware of the condition, while others may experience minor menstrual irregularities. However, in larger fibroids with several complications, surgical intervention may be required, which may either include the removal of the fibroid or removal of the uterus (i.e. hysterectomy).

Fibroids and Hormones:

There is little information available about the etiological factors that result in the formation of these benign tumors in the uterine cavity. However, there are some explanations.

Firstly, the occurrence of uterine fibroids is associated with genetics and it is found to run within the same family. This connection is attributed either to hereditary or to the similar life style patterns.

On the other hand, there is profound evidence that the occurrence of fibroids is in some way linked to the production of hormones in the body. Under normal conditions, the ovaries produce estrogen and progesterone in a cyclic pattern. Estrogen is known to stimulate cellular growth, while progesterone, counter balances the effect of estrogen by inhibiting cellular growth.

However, if the level of progesterone falls or there is an increase in the production of estrogen, the effects of the same result in the formation of uterine fibroids, due to the over stimulation of cellular growth. One of the common causes of elevated levels of estrogen in the body are “Xenoestrogens”, which are hormones that are chemically similar to estrogen and commonly found in some foods.

Further, there is adequate verification to link the incidence of uterine fibroids to stress and elevated levels of hormone cortisol in the blood.

In a study conducted in the Medical College Hospital in Iowa, it was observed that Uterine fibroids tend to disappear naturally after menopause. This clearly indicates that the occurrence of uterine fibroid was associated with the production of hormones by the ovaries, and after menopause, as the production of the hormones from the ovaries falls, so does the incidence of uterine fibroids .

This unmistakably specifies that in addition to the genetic make up of an individual, a hormonal imbalance is responsible for the occurrence of uterine fibroids in females.

Management of Uterine Fibroids:

The primary course of management of uterine fibroids is to regulate the levels of estrogen and progesterone in the body. As per several clinical studies published in the British Journal of Gynecology and the Journal of the North American Menopause Society , it has been suggested that the prescription of certain drugs like Lupron and Tribolone, reduces the production of estrogen by the body, which consequently helps regress the uterine fibroids, without causing detrimental effects on the health of the women.

An alternative use of ‘bio identical hormone therapy’ has been found to provide beneficial results. This therapy focuses chiefly on nutrition, fitness and supplementation to maintain a normal hormonal balance and avoid disturbances in the menstrual cycles. This therapy also provides a specific stress management regimen to reduce the production of cortisol, which in turn minimizes the formation of fibroids. Also, as an integral part of the therapy, the physician will suggest a list of various xenoestrogens that have to be completely avoided. The program is customized as per the patient’s requirement and the cause of the hormonal imbalance.

In cases of large fibroids, which tend to produce major complications like excessive bleeding, abdominal pain and distension, constipation or urinary incontinence due to pressure of a growing fibroid, etc, surgical intervention is inevitable. The surgical intervention may depend upon the age of the patient and the desire to bear children. Myomectomy (i.e. removal of the fibroid) or hysterectomy (i.e. removal of the uterus) may be recommended depending upon the specific condition.

Finally, diet and life style play a crucial role in the secretion of various hormones in the body. A well balanced diet rich in vitamins, minerals, anti-oxidants, proteins and carbohydrates is found to be highly effective in the management of most hormonal imbalances. Regular exercise for about thirty minutes each day has profound influence on the endocrinal glands and stimulates the production of various essential and vital hormones, which aid in maintaining good sexual and reproductive health.