Uterine Fibroids: Can We Prevent Them?

Dr. Sandler received her medical degree from NYU Langone Medical Center, where she was awarded the Frederick C. Holden Award for Excellence in Obstetrics and Gynecology. After graduation, Dr. Sandler remained at NYU to complete her Ob/Gyn residency, where she was selected as the Administrative Chief Resident and was awarded the Robert F. Porges Award for Excellence in Teaching, Research, and Patient Care. Dr. Sandler then joined NYU as a full-time Clinical Assistant Professor, during which time she was awarded the Gordon W. Douglas Faculty Teaching Award. Dr. Sandler is board certified by the American College of Obstetrics and Gynecology. She is currently in private practice at Carnegie Hill OBGYN.

What are Uterine Fibroids?

Uterine fibroids are non-cancerous, smooth muscle tumors that originate from the muscle layer of the uterus.  Certain hormones like estrogen and progesterone are believed to play a role in their development, but newer research has also linked fibroid development to chronic inflammatory states. 

Women are highly likely to encounter fibroids within their lifetime.  In fact, fibroids are clinically apparent in a quarter of reproductive-age women. Approximately a quarter of women with fibroids require treatment. By the onset of menopause, seventy percent of women are presumed to have a fibroid. 

Fibroid Symptoms and Complications

Women suffering from fibroids have a wide range of experiences. Some are entirely asymptomatic. Others experience  severe and chronic symptoms, including heavy menstrual bleeding, anemia, pelvic pain, abdominal protuberance, pelvic pressure, and bladder/bowel dysfunction.  And still, many others fall somewhere in between. 

Regardless of how a women experiences fibroids, they are also associated with reproductive problems, including impaired fertility and pregnancy complications.

Risk Factors: What Can We Change? 

Although one’s risk of developing fibroids is influenced by certain non-modifiable risk factors, like race and age, there are things we can do to reduce our risk of developing them. Several studies have shown that we may be able to reduce the risk of developing fibroids by adopting certain medical interventions and lifestyle changes.

• Oral and injectable contraception: Studies have shown a reduced risk of fibroid development in people currently using or those who have previously used hormonal contraception (i.e., oral contraceptive pills or the Depo-Provera injection) for an extended period of time. 
• Blood pressure control: Women with hypertension have a higher risk for developing fibroids than those with normal blood pressures. Appropriate blood pressure control and management has been found to reduce the risk of developing fibroids.
• Cardiometabolic Risk Factors: Obesity, diabetes and elevated cholesterol levels are not only major contributors to heart disease and stroke, but are also believed to play a role in fibroid development and growth. Studies have demonstrated that these cardiometabolic risk factors can result in fibroids because they cause both systemic inflammation and increased hormonal load. Management of obesity, diabetes, and cholesterol through medication and lifestyle changes can lead to improvements in fibroid development, growth, and symptoms.
• Exercise and Dietary Changes: There is mounting evidence in the role of cardiometabolic risk factors for fibroid formation.  Studies have also demonstrated that modifying diet and exercise can have an impact on the development of fibroids.  
• Increase vegetable and fruit consumption. Studies have demonstrated that women with diets that are high in fiber, with substantial amounts of fruits and vegetables, have a reduced overall risk and incidence of fibroids.
• Decrease red meat consumption. In studies women who ate more red meat had higher risk of developing fibroids than those with the lowest rate of its consumption.
• Decrease alcohol intake. Beer, wine, and liquor have all been shown to increase the risk of developing fibroids.
• Increase exercise: Women who engage in moderate-to-vigorous exercise routines consisting of multiple hours a week have a lower risk of developing fibroids.

Conclusion 

There are a variety of risk factors for developing fibroids—some of which we can influence, and some of which we cannot.  Due to the risks that fibroids present, women should adopt what lifestyle changes they can to reduce the risk of developing them. Once fibroids are formed, lifestyle modifications are not enough, and medication and/or surgical interventions are usually required.  

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