Big Uterus Energy

What is the state of fibroid awareness? In March of this year The Fibroid Foundation (patient advocacy group), posted to social media a game board style illustration mapping out the path to find a cure for fibroids. The second “space” on the game board is “Awareness through Media and Influencers.” What information are patients getting about fibroids through social media?

I have long known the importance of social media to my fibroid patients. Often, they find me via Reddit or a Facebook group. Then after surgery they return to those groups to post their carefully curated surgical fibroid photos (credit to my medical students for making a pile of morcellated fibroids into something worthy of posting).

On my own social media accounts, I generally try to stay away from anything work related, but in the spirit of fibroid awareness, I went to the search bar on Instagram (I am a millennial – I don’t Tik Tok), typed in “fibroids,” hit the blue arrow and let the algorithms get to work. In full disclosure, Meta must know that I am a doctor based on some of the targeted content I see. So, I was surprised that I got very few medical posts and quite a lot of posts about how to treat fibroids without ever seeing a doctor.

Veganlifemoss recommends the best herbs for fibroids in order to balance hormones for fibroid shrinkage. Yamayasgiftllc promotes their Fibroid Finisher Herbal Infusion to “nourish the uterus by naturally shrinking uterine fibroids.” Fine print states their claims have not been evaluated by the FDA. Madam_consolantha promises to shrink fibroids and end all traces of infertility in four weeks. Fibroidqueen sells a coaching program to those with fibroids to address “hidden factors feeding fibroids” and refers to hysterectomy as a “temporary fix.”

Again, and again the idea of “estrogen dominance” as the root cause of fibroids comes up. Of course, the relationship between fibroids and estrogen is not so straight forward as it is made out to be. Pippa Campbell Health shares that the signs of estrogen dominance are headaches, irritability, PMS, bloating, anxiety, fibroids, painful periods, breast tenderness, and acne. Who doesn’t have a few of those? Legendairymilk sells a supplement of Myo & D-Inositol to “support hormone health.” The bottle has a cartoon uterus winking with the caption, “Big Uterus Energy.” They do provide links to data (with PMIDs) supporting their supplement’s use in PCOS rather than fibroids.

I confess that I am a social media novice, but I have concerns about what I see. I don’t doubt the value in natural medicine and neither does the NIH. However, some of these posts promote modern day snake oil. Patients want more non-surgical options for fibroids and unfortunately, birth control has been tried in the court of public opinion online. Why take more estrogen when I already exhibit signs of estrogen dominance?

We may not have the miracle cure for fibroids in four weeks, but we do have some non-surgical and non-hormonal options with RCTs supporting them. Vitamin D supplementation (in those with a deficiency) has been shown to inhibit fibroid growth in comparison to controls in an RCT. [3] Tranexamic Acid significantly decreases menstrual blood loss compared to placebo in patients with fibroids. [4]

There is data supporting the therapeutic effect of an antioxidant compound found in green tea, Epigallocatechin-3-gallate (EGCG). In a pilot RCT women with symptomatic fibroids were given 800 mg of EGCG daily for four months and had a 32% decrease in fibroid volume and symptom severity compared with the placebo group. [5] In all these RCTs adverse effects were minimal.  

Surgery and hormonal therapy still work great for those patients who are willing to try them. But let’s meet people where they are if they are not willing to accept these options.

Also, is there an FMIGS fellow who wants to be a fibroid Tik Tok star? We need one.

References

1. Kalmowitz, Dan. “Clarke Introduces the Stephanie Tubbs Jones Uterine Fibroid Research and Education Act.” Congresswoman Yvette Clarke, 17 July 2023, clarke.house.gov/clarke-introduces-the-stephanie-tubbs-jones-uterine-fibroid-research-and-education-act/.
2. “Congresswoman Brown Introduces U-FIGHT Act to Promote Early Detection, Treatment, and Research on Uterine Fibroids.” Representative Shontel Brown, 16 May 2024, shontelbrown.house.gov/media/press-releases/congresswoman-brown-introduces-u-fight-act-promote-early-detection-treatment.
3. Arjeh S, Darsareh F, Asl ZA, Kutenaei MA. Effect of oral consumption of vitamin D on uterine fibroids: A randomized clinical trial. Complementary therapies in clinical practice. 2020 May 1;39:101159.
4. Eder S, Baker J, Gersten J, Mabey RG, Adomako TL. Efficacy and safety of oral tranexamic acid in women with heavy menstrual bleeding and fibroids. Womens Health (Lond). 2013 Jul;9(4):397-403. doi: 10.2217/whe.13.28. Epub 2013 May 9. PMID: 23656203.
5. Roshdy E, Rajaratnam V, Maitra S, Sabry M, Allah AS, Al-Hendy A. Treatment of symptomatic uterine fibroids with green tea extract: a pilot randomized controlled clinical study. International journal of women’s health. 2013 Aug 7:477-86.