The Christmas and New Year break are over and although I enjoyed it, I felt strangely relieved.  I think that’s because although it’s normally a really enjoyable time of year- it can also be highly stressful.  We know stress has an effect on general health. But how much do we know about how stress affects particular conditions associated with the Black community?  Black women have the highest risk of developing fibroids (non-cancerous growths in or around the womb). They can lead to heavy periods, period pain and pregnancy challenges (amongst other things). It is useful to know if stress plays a part in the existence of fibroids since we can control the way we handle stress.

A basic search of the literature doesn’t reveal many studies focused on the link between stress and fibroids.  One study did note that the increase in stress hormone cortisol can cause fluctuations in oestrogen and progestogen. Low levels of these hormones are linked to a reduction in fibroid growth.  This particular US study actually investigated the links between major-life event stress and fibroids in both Black and White women.  The authors reported  that the greater the number of ‘major life events’ the female experienced, the more likely she was to have fibroids. The pattern was evident among white women who had experienced all levels of stress yet only obvious  among  very highly stressed  Black women.  The authors of another study looked at 22,002 premenopausal  US Black women.  They reported that high levels of self-reported racism increased the risk of fibroids.  However, a study on Chinese women did not find any link between stress and the presence of fibroids. You can find out more about these studies here, here andhere.

Due to the small number of studies which investigate the link between fibroids and stress, it is difficult to say whether there is a true link- more work needs to be done in this area.  However, some people do find that they discover their fibroids after a period of stress in their lives. Have any of you had this experience?

We get a lot of questions about natural ways of treating and managing fibroids and in this week’s blog post we take a look at what the research tells us about the effectiveness of complementary medicine in treating the symptoms of fibroids.

Fibroids are non-cancerous growths that develop in or around a woman’s womb. They can cause a number of symptoms including pelvic (tummy) pain, infertility, heavy and/or painful periods, back pain, anaemia, constipation, frequent urination and pain during sexual intercourse.

The exact cause of fibroids is unknown but research does suggest that fibroids are caused by a combination of genetic, lifestyle and hormonal factors.  Those most at risk of developing fibroids are: black women, those who are overweight, women of child bearing age (particularly women who are 25-45 years old), those with a family history of fibroids and women who haven’t given birth.

There are several treatment options for fibroids these include a hysterectomy, myomectomy, embolization, endometrial ablation and new MRI-based treatments. Some of these treatments such as a hysterectomy and endometrial ablation result in infertility and because of this as well as unease with medical procedures, many women are exploring less invasive more “natural” options for managing their fibroids, but are these effective. What does research tells us about “natural” methods, more formally known as complementary and alternative medicine (CAM), for treating fibroids?

What Does the Research Tells Us?

To explore this area we’ll look at one recent research paper which was published in 2014 in the European Journal of Obstetrics & Gynaecology and Reproductive Biology and is entitled ‘Use of Medicine, Surgical and Complementary Treatments among Women with Fibroids’.  This paper summarised a study of 933 premenopausal women aged 31 to 54 with symptomatic fibroids. In this study women took part in face-to-face interviews every year for up to eight years to assess their symptoms following use of the treatment they opted for.

Researchers explored and compared the effect of CAM, Western Medicine and uterus-preserving surgeries. They classified CAM as the use of exercise, herbs, diet, acupuncture and physical therapy; Western medicine included hormonal contraception, analgesics and narcotic pain medicine; and uterus-preserving surgeries included myomectomy, embolization and endometrial ablation.

The majority of women in this study, 57%, didn’t have a hysterectomy or uterus-preserving surgery. The majority of these women used Western medicine to treat their symptoms and the most commonly used type of Western medicine used was anti-inflammatory analgesics followed by narcotic pain medicine.  Fifty percent of women who used the anti-inflammatories said it made their symptoms “a lot” better, but 10% were bothered “a lot” or “some” by the side effects. For women who used narcotics, 60% said it made their symptoms “a lot” better but 30% were bothered “a lot” or “some” by the side effects. Fifty-five percent of women who used the combined hormonal contraception said it made them feel “a lot” better, but 22% were bothered “a lot” or “some” by the side effects. Finally, the progestin IUD was the most effective with 71% of women who used it saying it made them feel “a lot” better, but 24% were bothered by the side effects.

CAM was used by a significant number of women to treat their fibroid-related symptoms. The most common methods used were exercise, herbs and diet. Improvements in symptoms were lower than that observed for Western medicine with 39% of women trying exercise, 38% of women trying herbs, 43% of those trying dietary changes, 45% trying acupuncture and 41% trying physical therapy  saying it made their symptoms “a lot” better, and as expected bothersome side effects were rare, less than 5% in all CAM therapies.

When looking at surgery, women who underwent uterus-preserving surgery had a greater improvement of pelvic symptoms compared to women who used Western medicine or CAM, but the researchers noted that despite this observation women who used Western medicine or CAM“observed significant improvements in pelvic problems as well as dyspareunia (pain during sex), pelvic pressure, bladder pain and menstrual cramps.”

In explaining how CAM works in improving symptoms, it was stated that some foods, vitamins and minerals can decrease the production of prostaglandins which cause a number of fibroids-related symptoms.

Based on their  finding the researchers concluded that “uterus-preserving fibroid surgery is effective, but many symptomatic women can be successfully treated with non-surgical management, including complementary and alternative therapy”

From this research study we can see that diet, exercise, acupuncture, herbs and physical therapy may be effective in some women at treating fibroid-related symptoms. Women wanting to explore any of these as an option should have a discussion with their doctor.

We do recognise that what’s missing from this study is the detail around what herbs and dietary changes women tried and we’ll be contacting the researchers to get some more information about this.

You can read the full paper by downloading it below.

We recently helped organised a fibroids awareness event and one issues that was raised at this event was that many women aren’t aware of the various treatment options available and in this week’s blogs we  provide an overview of treatment options.

It is first important to note that the treatments offered for fibroids depend on the size of a woman’s fibroids, the symptoms they are causing, and if they are likely to affect her fertility. Most women with fibroids will not have symptoms, or the symptoms may be very mild and therefore no treatment may be required.  However, a significant number of women with fibroids will need treatment because they have severe symptoms and/or their fibroids may interfere with pregnancy or fertility.

Treatment options for fibroids may include:
· Watchful waiting
· Medication to treat symptoms
· Medication to shrink fibroids
· Surgery or medical procedures

Watchful Waiting

A woman may not realise that she has fibroids until her doctor detects them after a routine pelvic exam. Therefore she may have no symptoms or very minor symptoms. Or her minor symptoms may have led her to visit her doctor who then went on to diagnose her fibroids. Either way, if a woman has no symptoms or mild symptoms that are not a major problem, her best option is ‘watchful waiting’. This may involve her:
· Keeping an eye on her symptoms and if they get worse or new symptoms develop then the next step will be a visit to her doctor.
· Being regularly monitored by her doctor. This may involve having regular (yearly) ultrasound scans to keep an eye on the size of the fibroids.

It is hard to predict if the fibroids will grow or whether symptoms will develop. It is only through watchful waiting that this can be determined. The benefit of watchful waiting is that unnecessary treatment can be avoided or delayed. Delaying treatment may allow a woman to start her family before having treatment which may affect her fertility.

Women nearing menopause may consider watchful waiting until after menopause as fibroids tend to shrink after menopause and symptoms may ease or disappear completely on their own after menopause.  If symptoms don’t improve after menopause then a woman can speak to her doctor about other options.

Medication to treat fibroid symptoms

Some of the symptoms of fibroids may be treated with over-the-counter or prescription drugs. Women should speak to their doctors before taking any medication, and make sure that they are aware of any side effects.

If fibroids are causing pelvic or abdominal pain, pain-killers may be an effective way to treat that. Or, if fibroids have caused severe period pain, anti-inflammatory drugs such as ibuprofen and mefanamic acid can be effective at easing period pain.

Sometimes fibroids can cause heavy flow during periods. If this is the case, a woman can speak to her doctor about the contraceptive pill.  This can make periods lighter and also ease period pain. An alternative to the pill for treating heavy periods is tranexamic acid, a drug that is used in many different conditions to control bleeding.

Medication to shrink fibroids

There are treatments available that may be effective at shrinking fibroids. These types of drugs are usually used before surgery, meaning that less extensive surgery may be required because they make it easier for fibroids to be removed.  These are hormonal drugs that reduce a woman’s hormone levels. This means that there will be less hormones available in a circulation to stimulate the growth of fibroids, causing them to shrink.

Drugs that can shrink fibroids include goserelin (Zoladex®) or leuprorelin acetate (Prostap® SR).  They reduce oestrogen levels, and can cause menopause symptoms, so sometimes patients are given Hormone Replacement Therapy (HRT) to combat any menopause symptoms. The patient will be started on a course of treatment three to four months before surgery.
Another drug that may be offered is ulipristal acetate (UPA or Esmya®), which lowers progesterone levels. Typically, if this drug is prescribed, it will be given to the patient before surgery and it can be taken for a maximum of up to three months.

Surgery or medical procedures

In many cases, women with symptoms will need some form of surgery or a medical procedure to treat their fibroids. The options here include:
· Hysteroscopic Resection
· Myomectomy
· Hysterectomy
·  Endometrial Ablation
·  Embolisation
·  MRI treatments

Hysteroscopic Resection

A hysteroscopic resection (transcervical resection of fibroids) is a procedure that removes fibroids that develop on the inside of the womb (submucosal/intracavity fibroids).  It is usually performed under general anaesthetic (where a woman is put to sleep for the entire procedure). A small device with a camera and a light on the end of it (a hysteroscope) is inserted through the vagina, past the cervix and into the womb. The camera allows the doctor to see the womb on a video screen. On the end of the hysteroscope is a device that allows the doctor to remove the fibroids.

A hysteroscopic resection takes 20 to 80 minutes and is likely to be a day-case or one that might require an overnight stay in the hospital. Recovery time will be 1 to 2 weeks. After-care advice is given to prevent infection, and to help with any pain that a patient may experience.  Within a couple of months, there should be improvements in the symptoms that were caused by the fibroids, such as heavy bleeding or irregular periods.

This procedure is a good option as it avoids the removal of the womb and allows a woman to preserve her fertility. As with any medical procedure, there is a small risk of complications

Myomectomy

A myomectomy is a surgical procedure used to remove fibroids without removing the womb, and therefore helps to preserve fertility. A myomectomy can be carried out in two ways; either via keyhole surgery (laparoscopic myomectomy) or an abdominal myomectomy (laparotomy).

Keyhole surgery is usually performed when you have one or two fibroids that are five centimetres or smaller that grow on the outside of the womb (pedunculatedand subserosalfibroids). It involves a small hole being made in or near the belly button and then a narrow tube with a camera (laparoscope) is inserted into the abdomen. Through this hole, and other holes in the abdomen, a surgeon is able to cut the fibroids into small pieces and then remove them through the holes.

The benefit of keyhole surgery is that because the operation occurs via the small holes, it is less invasive. This means that there is less blood loss and pain, and recovery is quicker than a full-blown operation – 1 to 2 weeks. It also requires minimal stay in the hospital (either a day case or for one night).

Despite this, there is a small risk of developing complications. These include: excessive bleeding, an adverse reaction to the anaesthetic, a puncture to the womb, blood clots and infection. And, there is a 40% chance that fibroids will re-grow within five years of the keyhole surgery.

An abdominal myomectomy is performed under general anaesthetic. A surgeon will make a fairly large incision in a woman’s abdomen in order to gain access to the womb and will then remove the fibroids. This procedure is used to remove large fibroids from the wall of the womb and may require a 2 to 4 day stay in hospital and takes anywhere from 4 to 6 weeks to recover.  There is a small risk of complications which include infection, damage to internal organs like the bowel, and weakening of the womb. There is also a 10 to 50% chance that fibroids will re-grow.

Hysterectomy

A hysterectomy is a surgical procedure to remove the womb. It is performed under general anaesthetic and is a permanent solution to resolving any symptoms which are caused by fibroids. Removal of the womb means that a woman will not be able to have children, making this option best for women who have completed their families. If the ovaries are also removed during the hysterectomy, a woman will go through menopause immediately. But if the ovaries are not removed, then a woman may go through the menopause within five years of having her womb removed.

Depending on the size of the fibroids, a hysterectomy can be conducted in three different ways. Smaller fibroids can be removed by a vaginal hysterectomy (the womb is removed through the vagina via a small cut at the top of the vagina), or by a laparoscopic hysterectomy (where the womb is removed through small holes in the abdomen). Alternatively, for larger fibroids, an abdominal hysterectomy can be performed where a fairly large incision is made in the abdomen and the womb is removed through the incision.

A hysterectomy is considered to be major surgery and as such takes longer to recover from than other procedures. It takes about 6 to 8 weeks and requires about 1 to 7 days stay in hospital depending on the way in which the hysterectomy was performed.

A woman will be given an after-care plan on how to care for her wounds and will have a follow up appointment to ensure that she is healing properly.
As with any surgical procedure there is a small risk of complications

Endometrial Ablation

Endometrial ablation is a procedure that is used to address heavy menstrual bleeding caused by fibroids or to remove small fibroids (less than 5cm) that have formed in the lining of the womb. This procedure removes the lining of the womb using either a laser beam, radiofrequency waves, microwaves, hot saline, electrical current or freezing.
A small device with a camera and a light on the end of it (a hysteroscope) is inserted through the vagina, past the cervix and into the womb. The camera allows a doctor to see the womb on a video screen. The doctor will then use specialist instruments to remove the lining of the womb by one of the methods described above (i.e. either laser beam, radiofrequency waves etc.).
Because the lining of the womb is removed it is highly unlikely that a woman will be able to get pregnant after this procedure. However, even if her periods stop, there is a small chance that she may become pregnant. And, because of the removal of the lining of her womb, her pregnancy is likely to be a risky one for both her and her baby, and she will probably be advised to use birth control after her endometrial ablation.

An endometrial ablation takes 20 to 45 minutes to perform, and is performed either under local or general anaesthetic. Patients are usually discharged from hospital on the same day and take about 2 weeks to fully recover.

There is a small risk of complications, these include: burns to the womb and surface of the bowel, fluid build-up in the lungs, tearing of the cervix, a womb puncture and a blockage of the major blood vessel in the lung (pulmonary embolism).

Embolisation

Embolisation, or Uterine Artery Embolisation (UAE), is a procedure that blocks the blood vessels (uterine arteries) to the fibroids, starving them of oxygen and therefore causing them to shrink.  This procedure is carried out by an interventional radiologist who makes a small cut in the groin area and then inserts a tube (catheter) through the cut, using live x-ray images on a monitor to guide the tube into the uterine arteries. Tiny plastic beads (the size of fine sand particles) are then injected into the artery supplying the fibroid and these tiny embolic particles block the artery.  Over the next few hours, the fibroids ‘die’ and then shrink over the next few months and years.

An embolisation is carried out under local anaesthetic and patients will have to stay in hospital for 1 night and recovery will take 1 to 2 weeks.

Complications from embolisation are rare and tend to be fairly minor, for example: bruising, pain, fever and vaginal discharge.  Submucosal and particularly intra cavity fibroids can become detached. These can either pass through the cervix and vagina on their own or, if they get stuck, can rarely require a hysteroscopic removal by a Gynaecologist.

Fertility after embolisation has been maintained in many women, and premature menopause is very rare. Recurrence rates are low, being around 15% by 5 to 10 years.

UAE can be used in combination with various forms of myomectomy to get the best of both treatments and maintain fertility.

MRI Treatments

There are two fairly new procedures that may be considered to treat fibroids which make use of MRI (magnetic resonance imaging).  These are:

• MRI-guided percutaneous laser ablation
• MRI-guided transcutaneous focused ultrasound

These treatments are not widely available in the UK and only a handful of specialist centres perform these procedures.

In MRI-guided percutaneous laser ablation, an MRI scan is used to locate the exact location of fibroids and fine needles are inserted through the skin and into the fibroid. A cable is then passed through the needle and light is targeted at the fibroids. The heat from the light shrinks or destroys the fibroids. MRI-guided transcutaneous focused ultrasound also uses MRI to find fibroids, but uses ultrasound energy to target them.

Both of these procedures take 3 to 4 hours to perform and requires only about a two hour stay in hospital after the treatment. Recovery should take a few days during which the patient may experience some pain and nausea.  There are rarely any complications in the short-term. However, the long-term effects and risks are unknown, as are the effects on fertility.

Conculsion

We hope that above has been useful to providing a summary of the various treatments that are available for fibroids. Again, it’s important to note that the treatment a woman receive will depend on various factors. We encourage women who have to have treatment for their fibroids to have an informed discussion with their doctor.

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This blog is based on our fibroids booklet which was reviewed by experts in the field.

On 30^th September we teamed up with Black History Walks to help organise a Queen Nzingha Lecture on fibroids.  The Queen Nzingha lecture series is a regular event developed by Black history Walks and is a series  of lectures  delivered by black women  with expertise in a particular topic. It aims to achieve three things: give black professional women a platform to discuss their area of expertise;  give audiences the opportunity to learn about a specific topic; and provide a forum to debate topical issues.

We were delighted to be asked to help organise the most recent event which focused on fibroids. This was a great opportunity to raise awareness and also give women affected by fibroids the opportunity to learn more about this condition, share their experiences and meet other women with fibroids.

On the day we were delighted to have an interesting agenda which included an overview of fibroids by Abi Begho of The Lake Foundation, a really inspiring presentation by Amanda Epe on her personal experience of fibroids and finally a presentation by Dr Sydney Dillard on treatment options.

Lifestyle, this word brings thought to mind of daily tasks, particularly professional and pastimes, hobbies, activities or lack of them. As a former Cabin Crew member the work had a strong influence and was my lifestyle. I was a long haul stewardess, which entailed trips to far distance lands for a few days at a time or a week. My whole life activities were based on where I was going and for how long. I had wonderful opportunities for sight seeing, exploration, shopping or relaxation.  At times though, my peers and I weren’t motivated to go out or it was mundane to re-visit some locations. It became standard to stay in the hotel and meet for a drink or two with my peers. I had to keep myself motivated to use the gym and spa facilities, which were the perks of lodging in five star hotels. My health had deteriorated as A Fly Girl and prior to leaving the job I had a surgical removal of a uterine fibroid.

I had uterine fibroids since I was in my early twenties, prior to working in the airline, and have no history of fibroids in the family. I was also raised on a diet which was balanced and healthy; minimal dairy and red meat. During my twenties my lifestyle had changed and when I reflect back to this I can pick out the decline in a totally healthy lifestyle, it was not drastic however it may have been significant to the cause.

Some key points that I should mention are that in my twenties, and since childhood, I craved sugar and water was not a friend of mine. Until recently I admit water isn’t medicine, but in my twenties instead of water I increased my daily dinner red wine with red meat.

During my youth my menstruation was a curse on my well-being. It came with severe dysmenorrhea, nausea and occasional vomiting. No matter what pain killing medication the doctor prescribed, nothing worked, my stomach looked enlarged on my small and athletic frame. The appearance was a minor, the pain was major.

Although my fibroid was present before being a cabin crew member, my new lifestyle fed the fibroids, my symptoms worsened and my distended stomach gave me the appearance of a second trimester pregnancy.

In my memoir, A Fly Girl, there are many incidences in my tales that reflect on the toxic lifestyle.

Just before leaving the airline I had a myomectomy, the surgical removal of fibroid through an intense operation. It was intense compared to today’s procedure as I had an incision whereas technology now uses laser surgery. It was done privately as I had waited for this operation since my initial diagnosis on the NHS for several years.

I was driven to have the operation because of various new symptoms which accompanied my period; the abdomen swelling was severe and I suffered with menorrhea, the haemorrhaging  would leave me extremely weak and anaemic. I felt quite emotional after surgery however I recovered well and speedily. I became fully conscious from then as to what triggers fibroid growth from a holistic perspective, nutrition, spiritual and physical.

I began to write poetry as a means of self- expression, my diet improved and water became my friend again. I eliminated a lot of foods and it was a turning point in building self-esteem and self-expression. Spiritually I was more expressive as the true me, and being a writer has aided this. I engaged in a lot more exercise, road running, and for a year I was training in Thai boxing to release anger, energy and develop mental strength and finally relaxation in the spa with sauna and steam to eliminate further toxins. I started to enjoy being a creative cook so that my dinners where healthy and whole.

The complete change, spiritual, nutritional and physical was agreeing with me and my body was in balance with no extraordinary monthly pain. Over the years and I started to slip, unconsciously, old habits die-hard and gradually unsavoury patterns took hold. Many years later the fibroid growth returned with vengeance, it came with not just swelling of the abdomen but when menstruating many parts of my body would swell including my face and eyelids. I also experienced restless leg syndrome. I was haemorrhaging and clotting heavily and it had an affect on my work life, I couldn’t commit my presence at work, neither guarantee attending social events and I was fully exhausted because of anaemia. It got to the point where I was emotionally drained and hit rock bottom. I had tried again over the last few years several remedies of natural treatments and some therapies had adverse affects. However determined not to give up, neither to go back to the medical approach, I had a vision that the pain at least should be over and started a six month change programme this year.

I worked on the spiritual and nutritional aspect alone, and I am currently getting back into the physical component. It was a worthy sacrifice to officially eliminate specific foods in my diet for the last six months and gradually experiment with herbs that balance the hormones and strengthen the womb. It has been the best introduction to well being adding herbal remedies to a wholesome diet. Also the spiritual freedom of expression this year has given me joy as I spoke from the heart being part of a national book tour. Having a 90% reduction of symptoms that over the years have accompanied my menstruation and now have disappeared is an amazing testimony, it verifies that there are options for healing in this earth, one must have resilience to overcome and to know that healing isn’t a linear progression.

I am thankful for my diverse experiences in life and I can say that having the fibroid has been a catalyst for my behaviour change. To focus on holistic health can be one of the most self-loving expressions a human can do.

I will update my progress in another six months with the inclusion of physical activity, and this can be found on my blog at www.msroseblossom.org

My experience in treating and healing fibroids or to prevent the onset of them begins with living a spiritual fulfilled life, and includes ways to balance health holistically, along with help from experts and support networks.

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Amanda Epe is a health promotion coach and author.

The Lake Foundation would like to thank Amanda for helping us raise awareness of fibroids and its challenges by sharing her story through this blog piece.

We are delighted to announce the launch of our new fibroids booklet. This booklet was developed in response to our fibroids survey which  showed that:

• There was a general low level of awareness of fibroids amongst participants prior to their diagnosis
• There was a good level of awareness of the main symptoms of fibroids but a low level of awareness of other symptoms.
• Participants were aware that ethnicity was a risk factor for fibroids but less aware of other risk factors.
• 80% of participants stated that they needed information but only 53% said that this was available to them.
• 63% of women said they didn’t feel that they had enough information to make an informed decision about their treatment

In addition to the above some participants stated that their biggest challenge in managing their condition was the lack of information and conflicting information about fibroids. For example, one participant said, “there is not enough information, particularly with regards to surgery alternatives and diet changes.”

What the booklet covers

Our booklet provides much-needed information on all aspects of fibroids from symptoms and risk factors to treatment and prevention. It aims to ensure that women have accurate, reliable information about this condition and importantly discusses the treatment options available. We hope this booklet will be a one-stop-shop for anyone with questions or concerns about fibroids.

We appreciate all those who have helped us

We’re delighted to have had some excellent reviewers work with us. We would like to say a big thank you to Dr Nigel Hacking, Consultant Interventional Radiologist at Southampton University Hospital and Miss Rosol Hamid, Consultant Obstetrician & Gynaecologist and Head of Women Services at Croydon University Hospital for providing very helpful comments and suggestions.

We would also like to thank Celia Osu and Tenequa Wildy for their useful feedback and  our case studies for their willingness to share their experience and raise awareness. Finally, we are grateful to The Brielle Agency for proofreading our work and to Adrinqa for their creativity in designing the booklet.

You can download a pdf below and hard copies will be available soon.

Fibroid_LF_booklet_v0.4

We’re currently working on developing a fibroids booklet to address some of the issues that came out of our fibroids survey last year. From the survey we found that:

• There was a general low level of awareness of fibroids amongst participants prior to their diagnosis.
• There was a good level of awareness of the main symptoms of fibroids but a low level of awareness of other symptoms.
• Participants were aware that ethnicity was a risk factor for fibroids but less aware of other risk factors.
• 80% percent of participants stated that they needed information but only 53% said that this was available to them.
• 63% of women said they didn’t feel that they had enough information to make an informed decision about their treatment

In addition to the above some participants stated that their biggest challenge in managing their condition was the lack of information and conflicting information about fibroids. For example, one participant said, “there is not enough information, particularly with regards to surgery alternatives and diet changes.”

What our booklet will cover

Our booklet will provide much-needed information on all aspects of fibroids. It will cover the symptoms of fibroids allowing women to quickly pick up on the possibility that they might have fibroids ensuring an early diagnosis which may mean less invasive treatment, the prevention of unnecessary pain and avoiding loss of fertility. It will also raise awareness of the risk factors and provide information on what changes women can make to their lifestyle to reduce their risk of developing fibroids and it will help women identify whether they are at a high risk of developing fibroids and therefore whether they should be more vigilant about recognizing symptoms and changing their lifestyle to reduce their risk. Finally, it will also cover treatment options so women are aware of what options are available to them.

We appreciate all those who have helped so far

We’re delighted to have had some excellent reviewers work with us. We would like to say a big thank you to Dr Nigel Hacking, Consultant Interventional Radiologist at Southampton University Hospital and Miss Rosol Hamid, Consultant Obstetrician & Gynaecologist and Head of Women Services at Croydon University Hospital for providing very useful and helpful comments and suggestions.  Additionally we’d also like to thank The Brielle Agency for proofreading our work .

We need your help for the final review

Now we are looking for members of the public to read the final draft before it goes off to our wonderful designers, Adinqra, and provide us with feedback on what needs to be improved. If you’d like to help please contact us on info@thelakefoundation.com

On Saturday, we attended the Croydon Tabernacle Women’s Breakfast to deliver presentations on both breast cancer and fibroids.  This was a lovely event that brought together the women of Croydon Tabernacle to discuss important health issues over a delicious breakfast.

We were given a one hour slot to discuss two important health conditions. We started with breast cancer and gave attendees some background discussing what is cancer, what happens in breast cancer, the different types of breast cancer, stages, diagnosis, treatment, risk factors and current statistics.  Once we had set the scene with a bit of background we then provided attendees with information on what they can do to prevent breast cancer or ensure an early diagnosis. Here we focused on three areas, understanding the signs and symptoms, taking part in breast cancer screening and adopting a healthy lifestyle.  We finished the breast cancer session with a lively Q&A and then moved on to fibroids.

Wonderful programme. Very educational, informative and interesting. I learnt a lot – Bosola

For our fibroids session we covered what are fibroids, the types of fibroids, causes, risk factors, symptoms, diagnosis, treatment, facts and figures and prevention. It was stressed that fibroids are not usually life-threatening but can be very painful and affect fertility. We discussed the importance of understanding the risk factors and symptoms and that if they have symptoms they should visit their doctor. Information was also given on the lifestyle changes that women can make to reduce their risk of developing fibroids – being more active and eating a healthy diet.  Furthermore we noted that fibroids are more common in black women and when black women develop fibroids they tend to be more aggressive, bigger, multiple and develop at a younger age than their white counterparts.

We finished off our presentation by stressing that if women are diagnosed with fibroids they should ensure they have enough information to make an informed decision about how they’d like to manage and treat their fibroids. Women were advised to speak to a gynaecologist who specialises in fibroids to get the best possible advice.

After our session, Pastor Yinka Ayeni gave an excellent, inspiring presentation on self-esteem.

We thoroughly enjoyed this event and would like to thank Croydon Tabernacle for inviting us to attend and for their very warm welcome.

In October, we launched our Fibroids Ask the Expert, a resource that aims to provide anyone with a question or concern about fibroids with accurate reliable information from an expert in the field. Since its launch, we have received a number of really interesting questions which our experts have been delighted to answer. We thought it would be useful to share some of the questions and the answers with you.  So, this week’s blog is a fibroids Q&A.

Question: “How much are fibroids are likely to shrink after menopause?”

Answer:  “Fibroids may shrink after menopause, but not always.  There have been reports of fibroids shrinking by 50% after menopause and that symptoms improve or disappear completely after menopause.  This isn’t an instant process though and our understanding is that if shrinkage occurs it is usually gradual.”

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Question: “My sister was diagnosed with fibroids one being 11cm, is that large?”

Answer: “A fibroid of 11cm is on the large side. Fibroids can vary in size from as small as a coin (about 2cm) to as large as a watermelon (about 19cm).”

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Question: “Would Doctors consider the use of proteolytic enzymes as a part of the fibroid shrinking protocol?”

Answer:  “Proteolytic enzymes have the potential to “shrink” fibroids, however, to answer your question, a doctor’s protocol is relative to his/her academic training.  If the physician has been trained in biomedical sciences, he/she are less likely to promote this approach, unless perhaps to assist in decreasing the fibroid size prior to surgical intervention.  Nonetheless, there have been no major studies conducted that support a significant impact between proteolytic enzymes and fibroid shrinkage.  This is just another reason medical doctors may be less likely to support this protocol.  Naturopathic or homoeopathic doctors would be more inclined to consider proteolytic enzymes in addition to other forms of treatment to address fibroids, however, this decision needs to be made in consultation with your selected physician.”

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Those are just a selection of some of the questions we have received. If you have a question about fibroids, no matter what, please do submit it  here or email us

We get a lot of questions from women about what they can do to prevent fibroids. This week’s blog post follows our recent post on exercise and fibroids prevention. Today, we’ll look at diet.

Fibroids are non-cancerous tumours that develop in or around a woman’s womb. They can cause a number of symptoms including pelvic (tummy) pain, infertility, heavy and/or painful periods, back pain, anaemia, constipation, frequent urination and pain during sexual intercourse.

The exact cause of fibroids is unknown but research does suggest that they are caused by a combination of genetic, lifestyle and hormonal factors.  Those most at risk of developing fibroids are black women, those who are overweight, women of childbearing age (particularly women who are 25-45 years old), those with a family history and women who haven’t given birth.

Diet and Risk Reduction

When trying to understand what we can do to reduce our risk of developing fibroids diet is an interesting and important factor.  As obesity is a major risk factor then logically if we adopt a healthy lifestyle and lose weight then we can reduce our risk of developing this condition. But, are there particular foods that contribute to fibroids development and are there foods that are protective? Let’s take a look at what the research tells us about this.

Red Meat 

When it comes to foods that increase a woman’s risk of developing fibroids, research suggests that red meat plays a major role. One research study has shown that frequent consumption of beef and other red meat increases a woman’s risk of developing fibroids by 70%. This finding is similar to a study conducted in India which found that women who consume red meat are three times more likely to develop fibroids compared to vegetarian women or women who are mostly fish eaters.  This is in stark contrast to a recent study that found no association between meat consumption and fibroids, although in this study researchers looked at all meat and didn’t look specifically at red meat.

Fruit and Vegetables 

The Black Women’s Health Study conducted in the US explored the impact of fruits and vegetables on a woman’s risk of developing fibroids. In this study, 22,583 black women were monitored from 1997 to 2009 and their food intake monitored.

This study found that overall fruit and vegetable intake was associated with a reduction in risk and the strongest reduction in risk was associated with a high intake of citrus fruit.  Additionally, they found that vitamin A from animal products (liver and dairy) was linked to a reduction in risk too.

These findings were similar to that of a small Chinese study which explored the association of fibroids with diet, physical activity and stress.   This study took place between 2009 and 2011 and researchers found that fruits and vegetables significantly reduced risk of developing fibroids with women consuming the most fruits and vegetables (eating fruit and vegetables more than three days a week) being 60% less likely to develop fibroids.

Finally, a study conducted in 2009 found that a high intake of green vegetables reduced the risk of developing fibroids by 50%  and fruit consumption reduced risk by 20%.

Vitamin D 

In 2013, one of the first studies looking at whether vitamin D is linked to fibroids was conducted and this study found that women with sufficient levels of vitamin D were 32% less likely to develop fibroids than women who are vitamin D deficient. Furthermore, another study published in 2013 found that women with fibroids had significantly lower levels of vitamin D compared to women not affected.  These studies suggest that vitamin D is protective.

Conclusions

It is clear that diet is very important in the development of fibroids. By adopting a healthy diet we can reduce our risk and women should pay attention to their fruit and vegetable consumption, reducing their red meat intake and making sure they have enough vitamin D.

It’s important to note that surveys conducted in the US have found that African Americans consume fewer fruits and vegetables than their white counterparts, it is important that we change our lifestyles and work on increasing our fruit and vegetable intake, our health depends on it.