Eating Saturated Fat May Reduce the Risk of Uterine Fibroids
By Alicia Armeli

SaturatedFat

Fat, especially saturated fat, is the nutrient we seem to have a love-hate relationship with. Eating a high-fat diet has been linked to increased levels of estrogen within the body—which is then thought to influence the risk of uterine fibroids. But do all fats affect fibroids in the same way?

The results of a study published by the American Journal of Clinical Nutrition1 may surprise you.

Wise and colleagues of the Slone Epidemiology Center at Boston University and the Department of Biostatistics and Epidemiology at the University of Pennsylvania Perelman School of Medicine looked at food questionnaire data, particularly fat intake, from over 12,000 premenopausal women participating in the Black Women’s Health Study from 2001-2009.

After eight years, 2,695 women were diagnosed with fibroids. Among these women, fibroid risk wasn’t noticeably affected by overall fat intake but instead was affected by consumption of specific types of fats.

Surprisingly, small but statistically significant reductions in fibroid risk were seen when women ate saturated fat—but only certain types. Butyric acid, caproic acid, caprylic acid and myristic acid made the list of possibly protective saturated fats. Food sources of these fats include coconut oil and dairy products.

On the flipside, the authors found slight increases in fibroid risk when women ate high levels of omega-3 polyunsaturated fatty acids like EPA and DHA found in fish. Omega-3s have the ability to change gene expression and cell signaling—which, the authors contend, could cause fibroid formation.

However, it was noted that the connection between omega-3 intake and fibroid risk may not entirely be due to the fat itself but instead to hormone-disrupting pollutants found in fish, like polychlorinated biphenyls (PCBs).

Of the monounsaturated fats, only erucic acid, often found in processed oils, was linked to a small increase in fibroid risk.

Due to conflicting evidence, the jury is still out when it comes to how fat intake actually affects fibroid risk in premenopausal women.

Epidemiologic studies show fat intake to be correlated with other hormone-driven illnesses like endometriosis, cancers of the endometrium, and ovarian. Given this information, it could be deduced that fibroids, another hormone-driven condition, would respond to fat intake in the same way. Yet, how dietary fat and fibroids are ultimately connected is still unclear and needs further investigation.

Until more data emerges, the guidelines listed below may be the first step to reducing your risk:

  • Daily incorporate organic low-fat dairy foods2
    Consuming dairy may lower fibroid risk due to its calcium and butyric acid content, which may inhibit abnormal cell growth and tumor activity respectively. Studies have shown that women who eat more dairy are at a reduced fibroid risk. Yogurt or milk enjoyed as part of a balanced meal or snack is a great way to get your daily intake.
  • Swap out meat at meals 
    Earlier studies suggest women who eat more meat are at a heightened risk for fibroids.3 Get creative and try low-fat meatless meals like hearty bean chili or vegetarian lasagna.
  • Fill your plate with fiber-rich fruits and veggies 
    Women who eat more fruits and vegetables are seen to have a decreased fibroid risk.4 Cruciferous vegetables like cabbage, broccoli, brussel sprouts, cauliflower, and kale contain indole-3-carbinol, a phytochemical that may protect against estrogen-related conditions.5 Citrus fruits, like oranges, contain flavonoids that effectively prevent estrogen receptor activity and abnormal cell growth.4 Including a fruit and/or vegetable at every meal and snack is a surefire way to receive these powerful compounds.

ABOUT THE AUTHOR Alicia Armeli is a Health Freelance Writer and Photographer, Registered Dietitian Nutritionist, and Certified Holistic Life Coach. She has master’s degrees in English Education and Nutrition. Through her writing, she empowers readers to live optimally by building awareness surrounding issues that impact health and wellbeing. In addition to writing, she enjoys singing, traveling abroad, and volunteering in her community.

REFERENCES

1. Wise, L. A., Radin, R. G., Kumanyika, S. K., Ruiz-Narváez, E. A., Palmer, J. R., & Rosenberg, L. (2014). Prospective study of dietary fat and risk of uterine leiomyomata. American Journal of Clinical Nutrition, 99(5): 1105-1116. doi: 10.3945/ajcn.113.073635

2. Wise, L. A., Radin, R. G., Palmer, J. R., Kumanyika, S. K., & Rosenberg, L. (2010). A prospective study of dairy intake and risk of uterine leiomyomata. American Journal of Epidemiology, 171(2): 221-232. doi: 10.1093/aje/kwp355

3. Chiaffarino, F., Parazzini, F., La Vecchia, C., Chatenoud, L., Di Cintio, E., & Marsico, S. (1999). Diet and uterine myomas. Obstetrics & Gynecology, 94(3): 395-398.

4. Wise, L. A., Radin, R. G., Palmer, J. R., Kumanyika, S. K., Boggs, D. A., & Rosenberg, L. (2011). Intake of fruit, vegetables, and carotenoids in relation to risk of uterine leiomyomata. The American Journal of Clinical Nutrition, 94(6): 1620-1631. doi: 10.3945/ajcn.111.016600

5. Parajuli, B., Shin, S., Kwon, S., Cha, S., Lee, H., Bae, I., & Cho, C. (2013). The synergistic apoptotic interaction of indole-3-carbinol and genistein with TRAIL on endometrial cancer cells. Journal of Korean Medical Science, 28(4): 527-533. doi: 10.3346/jkms.2013.28.4.527

Yale study: Few patients get ovary-sparing hysterectomies

There’s a type of hysterectomy that allows women to lower their ovarian cancer risk while preserving their hormone levels, but until recently, few were receiving this procedure.

That’s according to a new study by Yale University School of Medicine researchers, published in the February issue of Obstetrics & Gynecology.

Researchers found that, of a sample of nearly 21,000 women who received a hysterectomy for a non-cancerous condition in 2012, slightly more than 5 percent received a version in which only the fallopian tubes were removed, leaving the ovaries in place.

Click here to read the full article.

Study finds minority, poor women not getting safer minimally invasive hysterectomies

When Bonita “Bonnie” Hudak had a hysterectomy three years ago after being diagnosed with endometrial cancer, she recovered faster and suffered less pain than when she delivered a child by cesarean section many years before.

The C-section required a large cut that took weeks to heal and left an unattractive scar. For the hysterectomy, Hudak’s doctor performed a robotic surgery that required only small incisions.

“I was pretty much flat on my back for about a week and then shortly after that I was able to walk around,” said Hudak about her minimally invasive surgery. “And I was only taking Tylenol or ibuprofen for pain.”

Click here to read the full article.

Choosing the Best Fibroid Treatment Option for You
By Alicia Armeli

Choices

Being diagnosed with uterine fibroids may be overwhelming. But fortunately, you have options—and lots of them. From pharmaceutical treatments to surgery, and less-invasive options in between, a woman has much to choose from.

NON-INVASIVE TREATMENT OPTIONS 

Pharmaceutical Treatment 

Nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, can reduce menstrual flow by 25-30 percent and lessen cramping.1 Hormonal birth control options2,3 like the pill, patch, vaginal ring, injections, and intrauterine devices have also been found to reduce bleeding—but not fibroid size. Iron supplementation1 may be needed to combat anemia that can result from heavy periods. Although some of these options are available over-the-counter, use and duration of therapy should be discussed with your doctor first.

GnRH-a Therapy 

GnRH-a, or Gonadotropin-releasing hormone analogue therapy, may be used to shrink fibroids and reduce menstrual bleeding. Fibroid symptoms may cease when starting therapy but will return once treatment stops.

GnRH-a therapy preserves the uterus but has been linked to causing menopausal-like symptoms, such as hot flashes, decreased sex drive, spotting, fatigue, depression, and bone loss.4 For this reason, it’s commonly used as a short-term option to shrink fibroids before their surgical removal.2

MR-Guided Focused Ultrasound (MRgFUS) 

Also known as high intensity focused ultrasound or HIFU, this procedure uses ultrasound waves to penetrate the abdominal wall and heat fibroid tissue causing it to shrink by up to 54 percent one year after the procedure, according to research.5

This uterus and fertility-sparing option can take several hours to complete but is associated with less than one week of recovery time and minimal discomfort.

The success of MRgFUS depends on fibroid location since it’s most effective at treating small fibroids located near the uterine surface. A risk of fibroid recurrence exists and more than one procedure may be needed.

LESS-INVASIVE TREATMENTS 

Uterine Fibroid Embolization (UFE) Performed by an interventional radiologist, UFE is a minimally-invasive, non-surgical option that shrinks fibroids.

The physician makes a small incision in the upper thigh or wrist to access the arteries providing blood to the fibroids. Tiny spheres called embolics are injected into the arteries, blocking the blood flow, causing the fibroids to shrink and die. After the procedure, cramping and flu-like symptoms may occur, but can be treated and typically subside after 12 hours.6 Women can return to normal activity, on average, within 11 days. UFE has a 90 percent cure rate of symptoms7 and is effective treating fibroids of all sizes, but risk of recurrence does exist, in some cases warranting further rounds of treatment.

Endometrial Ablation 

Endometrial ablation destroys the lining of the uterus with the goal of reducing heavy menstrual bleeding. By inserting tools into the uterus through the vagina, ablation methods include radiofrequency, freezing, heated fluid, microwave energy, and electrosurgery.8 Since the lining is targeted, this option effectively treats submucosal fibroids that measure less than one inch in diameter. Since endometrial ablation doesn’t reduce fibroid size, it doesn’t treat symptoms related to fibroid bulk such as pain, pressure, or urinary incontinence.

Abnormal bleeding can recur and additional procedures may be needed. Although uterus-sparing, women who wish to become pregnant should avoid this procedure.

Radiofrequency Ablation 

Performed laparoscopically and as an outpatient procedure, radiofrequency ablation works by inserting a needle-probe into the middle of each fibroid. Heat is delivered through the probe, destroying and shrinking fibroid tissue.

Recovery time is minimal with women reportedly returning to work in less than a week. The procedure may take several hours and there’s a risk of fibroid recurrence. However, studies indicate a high rate of patient satisfaction, significant reductions in symptom severity, and an increase in quality of life.9

SURGICAL TREATMENTS 

Myomectomy 

Myomectomy, or the surgical removal of fibroids, has been considered the go-to treatment for women wanting to alleviate symptoms while still maintaining their fertility. Surgical methods include hysteroscopic, laparoscopic (including robotic), and abdominal. Risks include those associated with surgery, including extensive blood loss and scar tissue. Recovery time can last up to six weeks and fibroids may recur, requiring more surgery over time.

Hysterectomy

A hysterectomy surgically removes the entire uterus and is an option for women who no longer wish to conceive. Doing so leads to permanent symptom relief but other side effects such as pelvic and back pain, sexual dysfunction, and incontinence. Side effects may intensify with ovary removal.

As seen with myomectomy, additional risks include those linked with surgery and general anesthesia. Different types of hysterectomy are available and differ depending on whether other structures surrounding the uterus are also removed. Recovery time averages between two and six weeks.

And what if you don’t have symptoms? The best option may be to simply monitor your fibroids under the supervision of your doctor.

In the end, the best decision a woman can make regarding her fibroid treatment is one she’s made with confidence and a well-informed mind.

 

REFERENCES

1. The Centre for Menstrual Cycle and Ovulation Research. (2013). Very Heavy Menstrual Flow. Retrieved January 8, 2015, from http://www.cemcor.ubc.ca/resources/very-heavy-menstrual-flow

2. Khan, A. T., Shehmar, M., & Gupta, J. (2014). Uterine fibroids: current perspectives. International Journal of Women’s Health, 6: 95-114. doi: 10.2147/IJWH.S51083

3. Zapata, L. B., Whiteman, M. K., Tepper, N. K., Jamieson, D. J., Marchbanks, P. A., & Curtis, K. M. (2010). Intrauterine device use among women with uterine fibroids: a systematic review. Contraception, 82(1): 41-55. doi: 10.1016/j.contraception.2010.02.011

4. Magon, N. (2011). Gonadotropin releasing hormone agonists: expanding vistas. Indian Journal of Endocrinology ad Metabolism, 15(4): 261-267. doi: 10.4103/2230-8210.85575

5. Bohlmann, M. K., Hoellen, F., Hunold, P., & David, M. (2014). High-intensity focused ultrasound ablation of uterine fibroids-potential impact on fertility and pregnancy outcome. Geburtshilfe Frauenheilkd, 74(2): 139-145.doi: 10.1055/s-0033-1360311

6. Spencer, E. B., Stratil, P., & Mizones, H. (2013). Clinical and periprocedural pain management for uterine artery embolization. Seminars in Interventional Radiology, 30(4): 354-363. doi: 10.1055/s-0033-1359729

7. McLucas, B., Voorhees Iii, W. D., & Elliott, S. (2015). Fertility after uterine artery embolization: a review. Minimally Invasive Therapy & Allied Technologies, 2: 1-7.

8. The American College of Obstetricians and Gynecologists. (2013). Endometrial Ablation. Retrieved January 8, 2015, from https://www.acog.org/-/media/For-Patients/faq134.pdf?dmc=1&ts=20160114T2053317542 

9. Chudnoff, S. G., Berman, J. M., Levine, D. J., Harris, M., Guido, R. S., & Banks, E. (2013). Outpatient procedure for the treatment and relief of symptomatic uterine myomas. Obstetrics & Gynecology, 121(5): 1075-1082. doi: 10.1097/AOG.0b013e31828b796

Empowering Women One White Dress at a Time
By Alicia Armeli
Georgia Lt. Governor Casey Cagle, The White Dress Project Founder Tanika Gray Valbrun (standing to the right of Lt. Gov. Cagle), and White Dress Project supporters gather on the steps of the Georgia Capitol in celebration of July declared as Fibroids Awareness Month in the State of Georgia.

Georgia Lt. Governor Casey Cagle, The White Dress Project Founder Tanika Gray Valbrun (standing to the right of Lt. Gov. Cagle), and White Dress Project supporters gather on the steps of the Georgia Capitol in celebration of July declared as Fibroids Awareness Month in the State of Georgia.

Tanika Gray Valbrun suffered from uterine fibroids; her mother miscarried twice due to the same condition. In 2013, Gray Valbrun decided to do something about it.

“I had an epiphany while recovering from a myomectomy,” recalls Gray Valbrun, Founder and Executive Director of The White Dress Project. “I looked in my closet and realized I didn’t have any white. It hit me at that moment. For so long I had altered my life from wearing white because of fibroids.”

If you’re a woman with uterine fibroids, you can most likely relate. White and light-colored clothing are not viable fashion options due to heavy, often unpredictable periods.

That fibroid fashion dilemma provided the motivation needed for Gray Valbrun to create The White Dress Project, a national organization that builds social awareness by raising funds for fibroid research and advocating on behalf of a widespread and often silent community of sufferers.

The organization’s slogan, “We Can Wear White,” offers strength to thousands of women who are reclaiming their lives in the face of this epidemic.

Since officially becoming a non-profit in June 2014, The White Dress Project has actively followed the work of prestigious institutions like North Carolina Central University and Duke University. By attending cutting edge research conferences, Ms. Gray Valbrun has dedicated her organization’s existence to someday being a part of finding a cure for fibroids.

Not only is The White Dress Project taking the scientific community by storm; it’s creating hefty political waves as well.

“Our first piece of legislation was drafted in May 2014,” shares Gray Valbrun. “This first piece of legislation was in the Georgia House of Representatives and was a resolution that declared July Fibroids Awareness Month.”

As a part of their “16 by 2016 Campaign” (16 states declaring July Fibroids Awareness Month by 2016), The White Dress Project works with our country’s legislators to make sure July remains dedicated to fibroids now and in the future.

Thanks to their efforts, in only a year and a half, Fibroids Awareness Month is now a reality in Georgia, Florida, New York, and the city of New Orleans. “We’ve also gotten a U.S. resolution introduced in the U.S. House sponsored by Congressman David Scott of Georgia (D-GA 13th District) and Representative Donna Edwards of Maryland (D-MD 4th District)—ideally that is really what we want,” stresses Gray Valbrun. “It would then allow us to nationally declare July Fibroids Awareness Month instead of going state by state.”

But in order to maintain this type of momentum, The White Dress Project relies on you. Since fibroids affects as many as 80 percent of African American women, 70 percent of Caucasian women1, not to mention countless partners and loved ones, Gray Valbrun encourages the public to support a cause that can no longer wait, asking supporters to sign their petition or make a monetary donation, since the grass roots organization operates entirely on donations.

“We’re committed to empowering women. To do that, we need funds to continue this work and to really support research that isn’t getting dollars from NIH, Health and Human Services, or the government,” continues Gray Valbrun. “We want people to know that our funding is truly going towards research, raising awareness, and getting states to advocate for legislation.”

Another important piece of the puzzle is spreading the word about fibroids. Groups such as The White Dress Project that are built solely on the power of people can make the biggest impact.

“As soon as you start talking about fibroids, most women—especially in the African and Caribbean communities—are familiar with it. But we don’t talk about it often,” she admits. “We need to start sharing our stories. There’s a sisterhood that’s there. It really crosses socioeconomic and racial boundaries. It binds us as women.”

 

REFERENCES

  1. National Institute of Health. (2014). How many people are affected by or at risk for uterine fibroids? Retrieved December 20, 2015, from http://www.nichd.nih.gov/health/topics/uterine/conditioninfo/pages/people-affected.aspx