Iwona Szydłowska, MD, from the Department of Gynecology, Endocrinology and Gynecological Oncology, Pomeranian Medical University in Szczecin, Poland, and colleagues used PubMed and Medline to conduct the literature review. The researchers reviewed 272 full-text articles in English from 120 publications and assessed the correlation between diet and the risk and treatment of uterine fibroids (UF).
“The purpose of the review was to assess the evidence on natural, non-hormonal, effective and safe treatment options for the treatment of this disease,” the authors said. They used a collection of combined keywords: leiomyoma, uterine fibroids, uterine myoma, curcumin, milk products, diet, fruits, plants, Vegetables, turmeric, green tea, selenium, carotenoids, Vitamin A, Vitamin C, Vitamin D, Vitamin E, dysbiosis and intestinal microbiota. The results of the literature analysis revealed statistically relevant effects of certain vitamins, plant compounds and 1 trace element.
After analyzing the study, they reported a strong link between vitamin D deficiency and UF. They recommended 25-hydroxyvitamin D3 analogs as therapy because tissue 24-hydroxylase is unable to break it down. “Vitamin D3 may be a promising option in the prevention and treatment of UF. The majority of the studies presented consider vitamin D3 treatment to be safe and effective,” the authors said.1 Physiological vitamin D concentrations prevent fibroid growth, especially in women with vitamin D deficiency, the researchers said.
While previous vitamin A research contradicts each other, synthetic retinoid analogs in addition to a vitamin A-rich diet can prevent tumor growth, Szydłowska and colleagues explained. Vitamin A “reduces cell proliferation and extracellular matrix formation and increases fibroid apoptosis,” they noted.1
Szydłowska and colleagues reported little data on vitamin E, and the results of existing studies they found were conflicting. In fact, high concentrations may contribute to the growth of fibroids, especially in Caucasian women.2 “Vitamin E, despite its antioxidant properties, does not appear to demonstrate proven beneficial effects in terms of the prevention and management of leiomyomas,” the authors reported.
Vitamin C also did not have much data on its role in UF, with researchers reporting a non-statistically significant association with an increased risk of UF.
COMPOUNDS IN PLANTS
“A diet enriched with fruits and vegetables, as sources of carotenoids, polyphenols, quercetin, and indole-3-carbinol, is an easily modifiable lifestyle item with beneficial results in patients with UF. “, said the researchers. However, the researchers added that there were caveats. For example, high intake of β-carotene combined with cigarette smoking actually increased the risk of uterine fibroids.3 The role of polyphenols in preventing UF depended on the type chosen by the patient, the dose and the duration of use. Curcumin/turmeric has anti-inflammatory properties and the researchers said it appears to be a good choice for women at risk of developing UF in addition to women who have already been diagnosed.
MICRO AND MACRO ELEMENTS
Szydłowska and colleagues reported that the analysis showed selenium may play a role in preventing and treating UF, but did not affect tumor counts. No other trace minerals have been shown to be beneficial. The role of probiotics has not been fully studied, but dairy products such as yogurt may also play a protective role, the authors said.
In addition to genetic predisposition, substances associated with UF formation included heavy metals, endocrine disruptors (EDCs), and cigarettes. A diet low in antioxidants and fiber is also correlated with UF growth. Researchers have stated that EDCs can bind to hormone receptors and stimulate them to alter hormone production and/or function. “Induction of genomic and non-genomic signaling and pro-inflammatory effects of EDCs increases the risk of UF,” they said.
Szydłowska and her colleagues concluded that vitamins, plant compounds and selenium are useful in the treatment and prevention of UF. “Natural compounds present themselves as an alternative route in the treatment of UF, especially in patients with contraindications to hormone therapy,” they said. They highlighted the usefulness of this therapy and stated that even for conventional treatment of UF, the therapeutic effects can be enhanced by these compounds.
- Szydłowska I, Nawrocka-Rutkowska J, Brodowska A, Marciniak A, Starczewski A, Szczuko M. Natural dietary compounds and vitamins as potential cofactors in the growth and development of uterine fibroids. Nutrients. 2022;14(4):734. Published February 9, 2022. doi:10.3390/nu14040734
- Ciebiera M, Szymanska-Majchrzak J, Sentkowska A, et al. Serum alpha-tocopherol levels are increased in Caucasian women with uterine fibroids: a pilot study. Biomed Res Int. 2018;2018:6793726. Published July 24, 2018. doi:10.1155/2018/6793726
- Terry KL, Missmer SA, Hankinson SE, Willett WC, De Vivo I. Intake of lycopene and other carotenoids in relation to the risk of uterine leiomyomas. Am J Obstet Gynecol. 2008;198(1):37.e1-37.e378. doi:10.1016/j.ajog.2007.05.033