On Saturday 24th July 2021, we hosted a webinar on fibroids and exercise. This webinar was part of our Fibroids Awareness Month event series which aims to empower women living with fibroids with information on the lifestyle changes that may alleviate their symptoms and improve their overall health and wellbeing.
In this session, we explored the power of exercise in managing fibroids symptoms. We discussed whether exercise can be beneficial in managing fibroids symptoms and we looked at some simple, low-impact exercises that women can easily try at home through fun demonstrations of barre, yoga and other exercises.
Speakers included:
Abi Begho, Founder, Lake Health and Wellbeing;
Davina Baptiste, Certified Wellness Coach;
Jayshree Thokal, Qualified Yoga Instructor; and
Michelle Sutton, Health and Wellness Specialist.
If you missed this webinar, you can watch the recording below.
Our next webinar will be held on Saturday 31st July 2021 at 11am AST. This webinar will focus on fibroids and mental health.
In this webinar, Olivia Haltman, an accredited counsellor, will help women identify, understand and address the many ways that fibroids can affect a woman’s mental health.
We’ll empower women with the tools they need to improve their emotional wellbeing and successfully navigate the challenges that living with fibroids may present – these include managing and dealing with debilitating symptoms, fertility issues, tensions within relationships and the challenges that having fibroids may create in work, home and social settings.
July is Fibroids Awareness Month and we’re delighted to be hosting a series of webinars especially for women in St Kitts and Nevis. These events are aimed at informing and empowering women affected by fibroids by providing practical and useful guidance to enable women to take control of their health and wellbeing.
Our series includes three webinars focusing on diet, hormones, exercise and emotional wellbeing.
On 17th July, we were delighted to host a webinar on fibroids, diet and hormones. Led by Davina Baptiste, a Certified Wellness Coach, this webinar explored the role that hormones play in the development of fibroids and how by making simple changes to their diet, women with fibroids may be able to alleviate their symptoms and thus improve their health and wellbeing.
This was a very comprehensive and informative webinar and if you missed it, you can watch the recording below.
As we begin our work to support women in St Kitts and Nevis who have been affected by fibroids, it has been interesting to explore what is happening on the global scene. When we take a closer look, we see that there are organisations working tirelessly in their jurisdictions to highlight this neglected woman’s health issue.
Today, we’re going to look at Fibrome Info France’s campaign which was launched in March 2021. As part of this campaign, Fibrome Info France partnered with the Women’s Right Ministry in France to raise awareness of menstruation and fibroids. Their campaign aimed to use a variety of communication platforms to empower women with information about fibroids that would empower women to take control of their health. Their campaign focuses on the health and societal challenges associated with fibroids such as the huge burden fibroids place on women’s quality of life and women’s sexual and reproductive health and the action that is required to address these issues.
In April, their campaign rolled out in hospitals, clinics and medical practices and they utilised printed material including posters and leaflets which were distributed across 550 relay points. Furthermore, this month (June 2021) their campaign moved into another phase where they will host a series of webinars in partnership with medical experts and these webinars will continue until October 2021.
This is a great campaign that provides much-needed information around fibroids and we’re sure it will make a significant difference by highlighting this important women’s health issue, empowering women with fibroids and providing women with access to the support that they need to manage fibroids.
More Information
To find out more about Fibrome Info France you can visit their website here or follow them on social media:
We were absolutely delighted to learn that the term menstrual health now has an official definition. This is a huge achievement and will be of significant benefit to organisations, like us, working on health issues that impact menstrual health. Specifically, this will enable us to provide more clarity and structure around the work we do on fibroids.
Ensure menstrual health is recognised as a significant global health issue
Highlight the multi-faceted nature of menstrual health
Facilitate a shared language when discussing menstrual health issues
Important points to note about this definition are that it:
Considers mental, social and physical wellbeing
Highlights the need for age-appropriate education
Highlights the right for women to take care of themselves during menstruation and be able to access timely diagnosis, treatment and care for menstrual health-related issues
Recognises the need for women to be treated with respect, dignity and sensitivity when it comes to issues related to their menstrual cycle
Stresses that women should have a choice as to when and how they participate in all areas of society during the different phases of their menstrual cycle
Recognises that menstrual health is not just limited to women’s periods
For us, this definition will be instrumental as we take forward the findings of our fibroids qualitative research project. Now that we have a formal definition for menstrual health, we can apply this to the menstrual health challenges that women with fibroids experience. This will create more structure around our future policy, advocacy, research and public health interventions aimed at improving the health and wellbeing of women living with fibroids.
More Information
For more information, you can read the journal article published by the Global Menstrual Collective here
March is designated as “Endometriosis Awareness Month.” Endometriosis is a serious medical disorder which affects women of any age. It occurs when tissue resembling the lining of the uterus (endometrium) grows outside of the uterus, on organs and structures both in the pelvic region (ex. ovaries) and outside of the pelvic region (ex. lungs). This tissue behaves just like endometrial tissue would and responds to monthly fluctuations in hormones during the menstrual cycle, building up and attempting to shed but with no exit path. The condition often causes debilitating pain, heavy and painful menstrual periods and mental health distress. Organizations across the Caribbean region who have taken up the mantle in advocating for greater awareness of women’s health issues joined their voices on the evening of March 31st 2021 to shine a much needed light on endometriosis and the current needs of the region in that regard.
The regional collaborative effort manifested itself in the form of a webinar, with presentations on different aspects of endometriosis and its management from each women’s health advocate. The panellists touched on the symptoms of endometriosis and barriers which may exist to diagnosis and treatment. Some of the focus of the discussion was on the mental health implications of endometriosis and how patients can self-advocate and empower themselves when facing the disease. The essential nature of early intervention and the need to approach endometriosis with a multidisciplinary approach was also highlighted.
Trudy Christian, founder of the Dominica PCOS Association moderated the panel and presentations were made by Abi Begho, founder of Lake Health and Wellbeing in St. Kitts, Julia Mandeville, co-founder of the Barbados Association of Endometriosis and PCOS, Odelia Thomas, founder of She is Lotus of St. Vincent and the Grenadines, Rovin Fevrier, founder of the St. Lucia Endometriosis, PCOS and Adenomyosis Support Group and Abeesha Toussaint, founder of the Trinidad & Tobago Endometriosis Association. Sandrina Davis of Jamaica, who is the Country Director of International Samaritan, shared her lived experience with endometriosis with the audience. She gave the story of her journey with the dreadful disease and ended with a message of hope and empathy.
The virtual event was an immense success, receiving positive feedback and healthy interaction from those who were in attendance. Several women voiced their concerns over aspects of handling endometriosis such as the availability of specialists for quality interventions, the impact of diet on the condition and the options as it relates to fertility. The panellists hope to continue in their quest of regional communication and collaboration in dealing with women’s health concerns. In minimal resource settings of individual Caribbean islands, it was wholeheartedly agreed upon that collaboration is the best way forward. One region with sisters united in advocacy, awareness and focus. Endometriosis and other female pelvic disorders should be scared.
If you missed this event, you can watch a recording of the session below.
Today’s blog post comes from Andrea Kallumadyil. Andrea is from Ontario, Canada and is a medical student from UMHS. She is currently the president of Because We Care and the vice president of the American Medical Student Association at UMHS.
In this post, Andrea bravely shares her journey with PCOS and the life lessons it has taught her along the way.
One of my earliest memories as a child is standing in the hallway with my Grade 3 teacher as I chugged three boxes of apple juice. My Mom picked me up soon after, and I was to have my first ultrasound in a nearby city later that day. The week before, I had my first period. Being of South Asian descent, my family was beyond excited that I had “become a woman” at 8. We spent the afternoon, to my embarrassment, calling up relatives in India announcing the good news. My parents took me out to a nearby convenience store, where I picked out a gift to celebrate the big day. On our way home, we stopped at the walk-in clinic to make sure everything was okay. Practising in a small town with predominantly white patients, my doctor had never had a patient have their period so young. She assumed it could be explained by my South Asian background but decided to run some tests just in case it was something else. The healthcare staff poked and prodded me, only for the tests and ultrasound to come back normal. I was sent home and did not have another period for four years.
I got my period again when I was 12 years old. My periods seemed to have a mind of their own. They would come and go as they please – but they were consistently heavy, caused me a lot of pain, and lasted at least a week. A few months into this unpredictable cycle, I had a period that was more than 30 days long. I was pale, and my hands and feet were freezing in the middle of the summer. They ran some blood tests and referred me to a gynaecologist. I was not only anaemic but also had high levels of free testosterone in my system. Given my lab values and symptoms, the gynaecologist had said it was a straightforward diagnosis: PCOS.
What is PCOS? What are the Symptoms?
Polycystic Ovarian/Ovary Syndrome is an endocrine (hormonal) disorder that affects the normal functioning of your ovaries. The three main features are
Ovary Dysfunction: Presents as irregular periods, including infrequent periods, prolonged periods, and an absence of periods.
High levels of androgen: Determined either with a blood test or via symptoms of hirsutism (excess body/facial hair) or acne. Androgens, although referred to as male sex hormones, are naturally occurring hormones at low levels in females.
Cystic Ovaries: The collection of fluid in follicles preventing the release of an egg during your menstrual cycle (ovulation).
A patient usually requires at least two of the three main features to be diagnosed with PCOS. The different combinations give rise to 4 distinct PCOS phenotypes:
Phenotype A: High levels of androgen, ovary dysfunction, and cysts.
Phenotype B: High levels of androgen and ovary dysfunction
Phenotype C: High levels of androgen and cysts.
Phenotype D: Ovary dysfunction and cysts.
In my case, I had irregular periods and high levels of androgen shown both in my blood tests and excessive body and facial hair (hirsutism): Phenotype B. During your diagnostic process, your health care provider may also order an ultrasound and gynaecological exam to rule out other potential causes for your symptoms.
Hirsutism is hard to assess, especially since many populations – Middle Eastern, South Asian and Mediterranean – have more body/facial hair than other ethnic groups, despite having normal androgen levels. Being of South Asian background myself, and the only South Asian family in a then-predominantly white community, my hirsutism was initially overlooked. For many young persons with PCOS, including myself, this continues to be one of the most challenging symptoms to manage.
Outside of the 3 diagnostic features, PCOS has many other symptoms and complications, including:
Infertility: PCOS is one of the most common causes of infertility due to less frequent ovulation. It can also increase the risk of pregnancy complications like gestational diabetes and miscarriage.
Weight Gain and Trouble with Weight Loss: Almost 80% of persons diagnosed with PCOS are overweight. Additionally, being overweight can make other PCOS symptoms even worse.
Metabolic Syndrome: Those overweight and those with PCOS are at risk for insulin resistance leading to diabetes, high blood pressure, and high cholesterol levels. This puts those with PCOS at risk for developing heart disease – as many as 50% of persons with PCOS will have insulin resistance.
Androgenic Alopecia: Excess androgen can cause hair loss on the head. Resembles male pattern balding.
Acanthosis Nigricans: Dark and thick skin around the neck, breasts, armpits, and groin area
Sleep Apnea: The risk is about 5-10 times higher for those with PCOS. This is primarily because those with PCOS are likely to be overweight.
Depression, Anxiety &Disorders: Hormonal changes along can increase the likelihood of experiencing depression. Symptoms like hirsutism can increase this risk.
Endometrial Cancer: The lining of the uterus (endometrium) is at risk of developing cancer if you are insulin resistant, overweight or have trouble ovulating – all of which are PCOS features.
Treatment
With each additional symptom, my doctor explained, I felt myself becoming more and more ostracized, imagining all the new ways I’d look even more different from my friends in my hometown. The racing images came to a halt when I heard the word infertility. I was too shocked to process the rest of the information I received and was frankly too embarrassed to ask any questions about what I did hear. I was prescribed an oral contraceptive for my irregular cycles and Vaniqa (a topical hair growth inhibitor) for my hirsutism and left the office. When we got in the car, my Mom asked if I was okay, and in response, I cried the entire 45 minutes home.
I wish I knew that although PCOS is one of the most common causes of infertility, it is also one of the most treatable. There are many options available to manage the symptoms of PCOS.
Oral Contraceptive Pills: OCPs help regulate hormone levels and foster regular, predictable periods that are shorter in duration with a lighter flow.
Metformin: A diabetes drug that improves insulin resistance, can promote weight loss, reduces the rate of miscarriage, and promotes regular menstrual cycles.
Spironolactone: An androgen medication that can be used to lower androgen levels in your body. This will improve symptoms of androgenic alopecia, hirsutism, and hormonal acne.
Hair Removal: Once hormone levels are managed, many people have success with electrolysis – the only truly permanent hair removal solution. A probe is inserted into each hair follicle to destroy each hair’s growth centre. Other less permanent methods include laser hair removal, epilation, threading, sugaring/waxing, or depilatory creams. A hair growth inhibitor like Vaniqacan also be used, but the hair will resume growth if you cease usage.
Weight Loss: Losing up to 5-10% of your body fat can be enough to kick start ovulation. There is also some evidence that a low carb diet may improve your hormone levels and increase fertility. A healthy lifestyle consisting of nutritious foods and exercise will enhance fertility treatment effectiveness regardless of weight loss – remember, it is highly recommended to consult a health care provider before making any significant lifestyle changes.
Acupuncture: There is some emerging evidence that acupuncture procedures restore LH and FSH hormone ratios and promote regular menstrual cycles in those with PCOS.
Surgery: A laparoscopic procedure that involves destroying a part of the ovary with an electric current. This can stimulate ovulation and decrease androgen levels. The results last for a few months.
For those trying to get pregnant, additional treatment options include:
Fertility Drugs: Clomid is a fertility drug that triggers ovulation and is often used in combination with metformin. Although some persons can become resistant to the drug, Letrozole (a cancer drug) has shown to be effective in stimulating ovulation in such situations. Injectable gonadotropins are also available under different brand names to stimulate ovulation. However, those with PCOS are at a high risk of developing ovarian hyperstimulation syndrome. Furthermore, you are also at increased risk for multiple pregnancies.
Intrauterine Insemination (IUI): A process involving sperm placement in the uterus with a catheter. This process is known to increase the total number of sperm that reach the fallopian tubes.
In Vitro Fertilization (IVF): After stimulation of egg production, multiple eggs are removed and inseminated in a lab dish. Multiple embryos are transferred a few days later back into the uterus.
There is also evidence that the following supplements can relieve some symptoms of PCOS. They include:
Myo-inositol: Reduces the risk of gestational diabetes
Inositol: Increases the number of ovulations, thereby leading to a higher chance of successful conception.
Omega-3 Fish Oils: Lowers total cholesterol levels.
Co-Supplementation of Magnesium, Zinc, Calcium, and Vitamin D: Provides beneficial effects on hormone levels while reducing inflammation and oxidative stress caused by PCOS.
Living With PCOS
Being diagnosed and starting treatment at a very young age, I was fortunate to not have to deal with the unpredictability of irregular periods. However, I did struggle with managing my hirsutism. I started laser hair removal almost immediately after my diagnosis and embarked on a process that would last several years. I bleached most of my body hair to feel comfortable wearing revealing clothes. I eventually switched to electrolysis, which did reduce the amount of hair grown by 30% but was incredibly painful and time-consuming. I considered myself a very anxious person but was officially diagnosed with anxiety and depression at the beginning of my undergraduate degree. I quickly gained a lot of weight following a high-stress period and my hirsutism got much worse as a result. I went on the keto diet to lose it and obsessively worked out.
However, a restrictive lifestyle like that was not sustainable for me and did not promote good mental health. I was still terrified that I would never have kids and am to this day very set on a specific timeline in my head. I initially set aside my career goals of becoming a physician for something attainable in a shorter period. I bounced from counselling to nursing to speech-language pathology. I did every possible prerequisite during my bachelor’s degree to keep all of my options open. I read countless blogs and videos of what other persons with PCOS did for family planning, careers, and managing their symptoms. I realized that everyone had their own unique story and that the only commonality is that they all did what made them happy. Those that wanted to start a family were able to do so without compromising their career goals. From then on, I began to focus on what I wanted instead of letting my PCOS control every little detail of my life. I stopped being so hard on myself for having symptoms. I started to wear short sleeves without bleaching, I got into the program I wanted to get into, and most importantly, I began to accept myself for who I am. It has been such a freeing experience.
For those currently struggling with PCOS right now:
Try not to compare yourself to anyone else.
Work on what is best for you, given your own story.
Learn to be comfortable in your skin.
Talk to your health care provider to figure out the best way to manage your symptoms.
And most importantly: do not let anyone convince you that your PCOS can stop you from doing whatever you set your mind to.
****
We would like to say a big thank you to Andrea for being so open and bravely sharing her PCOS story. If you’d like to ask her a question, please leave it in the comments section below or you can email your question to info@lakehealthandwellbeing.com
Sources
D’Anna, R., Di Benedetto, V., Rizzo, P., Raffone, E., Interdonato, M. L., Corrado, F., & Di Benedetto, A. (2012). Myo-inositol may prevent gestational diabetes in PCOS women. Gynecological endocrinology : the official journal of the International Society of Gynecological Endocrinology, 28(6), 440–442. https://doi.org/10.3109/09513590.2011.633665
Alois, M., & Estores, I. M. (2019). Hormonal Regulation In Pcos Using Acupuncture And Herbal Supplements: A Case Report And Review Of The Literature. Integrative Medicine (Encinitas, Calif.), 18(5), 36-39.
Arentz, S., Smith, C. A., Abbott, J., & Bensoussan, A. (2017). Nutritional supplements and herbal medicines for women with polycystic ovary syndrome; a systematic review and meta-analysis. BMC complementary and alternative medicine, 17(1), 500. https://doi.org/10.1186/s12906-017-2011-x
Lizneva, D., Suturina, L., Walker, W., Brakta, S., Gavrilova-Jordan, L., & Azziz, R. (2016). Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertility and sterility, 106(1), 6–15. https://doi.org/10.1016/j.fertnstert.2016.05.003
Maktabi, M., Jamilian, M., & Asemi, Z. (2018). Magnesium-Zinc-Calcium-Vitamin D co-supplementation improves hormonal profiles, biomarkers of inflammation and oxidative stress in women with polycystic ovary syndrome: a randomized, double-blind, placebo-controlled trial. Biological trace element research, 182(1), 21–28. https://doi.org/10.1007/s12011-017-1085-0
Polycystic Ovary Syndrome (PCOS). (2020). Retrieved 16 October 2020 from https://www.mayoclinic.org/diseases-conditions/pcos/symptoms-causes/syc-20353439
Polycystic Ovary Syndrome. (2012). Retrieved 16 October 2020 from https://americanpregnancy.org/womens-health/polycystic-ovary-syndrome-70990
Polycystic Ovary Syndrome. (2019). Retrieved 16 October 2020 from https://www.womenshealth.gov/a-z-topics/polycystic-ovary-syndrome
Polycystic Ovary Syndrome. (2019). Retrieved 16 October 2020 from https://www.healthlinkbc.ca/health-topics/tw9103
Over the past month, as we have been conducting our regular monitoring of the traffic to our website, we have noticed a lot of visitors are coming to our website to find out whether soursop or guava are beneficial for fibroids. So, today, we will visit published research to see if we can answer this question.
How We’re Going to Approach This Question
The first thing to say about this topic is there isn’t a lot of evidence-based information out there. What we found were discussions by scientists about the possibilities, there wasn’t any concrete data that could definitively answer this question.
To explore whether guava and soursop may be beneficial in treating fibroids, we will focus on one scientific paper, which was the only one we could find that was related to this topic.
This paper was published by the Department of Experimental and Clinical Medicine at the Polytechnic University of Marche in Italy, in 2014.
This paper is important in our exploration because some of the phytochemicals included in the researchers’ review are found in soursop and guava.
Some Background: What are Phytochemicals?
Before we summarise the relevant information provided in this paper, we thought it would be useful to define the term phytochemical. Harvard University describes phytochemicals as:
”…plant (phyto) chemicals: compounds in plants (fruits, vegetables, whole grains, nuts, seeds, and legumes) that contribute to their color, taste, and smell.”
Some commonly known phytochemicals are carotenoids, found in carrots, pumpkin, corn and tomatoes; flavonoids, found in citrus fruits, berries, apples and legumes and anthocyanins, which are found in berries, eggplant and red cabbage.
It is widely known that phytochemicals have a range of health benefits. These benefits include reducing our risk of heart disease, cancer and other chronic diseases and this is achieved because of their antioxidant and anti-inflammatory effects as well as a range of other effects.
What Does This Research Paper Tell Us?
The researchers who wrote this paper began their exploration by describing four possible factors that contribute to the development of fibroids. These are:
A chronically active inflammatory immune response
Fibrosis (a process that leads to the formation of scar tissue) which is a result of inflammation
Increased rate of cell growth in fibroid cells
The development of new blood vessels which feed fibroid cells
Researchers explained that if phytochemicals are able to address these four factors, they may be useful in preventing and treating fibroids.
Like many fruits, guava and soursop are rich in phytochemicals. Guava is known to contain the phytochemicals lycopene, quercetin, anthocyanin, and many others. Whilst soursop contains reticuline, coreximine, quercetin, gallic acid and others.
In their paper, researchers discuss a range of phytochemicals including ones that are relevant to guava and soursop – lycopene and quercetin. They explain that at the time of the publication of their paper, lycopene and quercetin have not been tested in fibroids, but based on what scientists know about these two chemicals they may be beneficial in the prevention and treatment of fibroids. This is because when we look back at the four possible ways that fibroids develop, these two phytochemicals can potentially target these processes. They have both been found to have the following effects:
An anti-inflammatory effect
Anti-fibrotic effect
Prevent the growth of different types of tumour cells (fibroids are benign tumours)
Prevent the development of blood vessels that feed tumour cells
Researchers couldn’t make any conclusions on these phytochemicals with regards to fibroids, but their discussion has identified these and other phytochemicals which could be beneficial in the prevention and treatment of fibroids. These include:
Allicin (found in garlic)
Ellagic acid (found in strawberries, raspberries, cranberries, blackberries, pecans, pomegranates, walnuts, wolfberry and grapes)
Indole-3-carbinol (found in cruciferous vegetables e.g. broccoli, cabbage, cauliflower, Brussel sprouts, bok choy, collard greens, kale etc.
Lycopene (found in tomato, watermelon, papaya, pink guava, pink grapefruit and apricots)
Quercetin (found in lemon, tomato, onion leaves, strawberries, soursop and tea)
They stated that based on the information they presented, there is a need to understand whether these phytochemicals are indeed beneficial for fibroids and this should be explored through future studies that carefully and accurately determine their mechanism of action and effectiveness in the treatment and prevention of fibroids.
What Does this Mean for Women With Fibroids?
This research study has raised the idea that the phytochemicals in soursop and guava may be beneficial in the treatment and prevention of fibroids. It doesn’t mean that eating soursop and guava will cure your fibroids, the reason for this, and this is discussed in the research paper, is that when you eat these fruits we don’t know if your body is absorbing enough of these phytochemicals to have a significant impact on the growth and development of fibroids.
What we can say is that if you have fibroids, if you haven’t already, we recommend that you adopt a healthy diet that is rich in fruits and vegetables, this can include soursop and guava, but should include cruciferous vegetables. Studies have shown that making dietary changes can be helpful in improving some of the symptoms of fibroids as can introducing more exercise into your routine.
It is also recommended that women with fibroids avoid certain foods such as alcohol, caffeine, red meat and foods that may contain high levels of hormones like oestrogen.
If you have fibroids and would like to explore dietary changes and exercise as a way of managing your symptoms, please speak to your doctor first. She/he will be able to advise you on the best approach based on your specific situation as the success of these approaches will depend on the size of your fibroids and other factors. You may also want to speak to a registered dietitian who along with your doctor will be able to provide some advice on the dietary changes that you can make.
Was this Helpful?
Were you one of the people looking for information on fibroids and guava and/or soursop? Was this article helpful? Let us know your thoughts by leaving a comment below. We would love to hear from you.
References
Agu KC, Okolie PN. Proximate composition, phytochemical analysis, and in vitro antioxidant potentials of extracts of Annona muricata(Soursop). Food Sci Nutr. 2017;5(5):1029-1036. Published 2017 Jun 29. doi:10.1002/fsn3.498
Chiari-Andréo, Bruna & Trovatti, Eliane & Marto, Joana & Almeida-Cincotto, Maria & Melero, Ana & Corrêa, Marcos & Chiavacci, Leila & Ribeiro, Helena & Garrigues, Teresa & Isaac, Vera. (2017). Guava: Phytochemical composition of a potential source of antioxidants for cosmetic and/or dermatological applications. Brazilian Journal of Pharmaceutical Sciences. 53. 10.1590/s2175-97902017000216141.
Deepa PC., Kumaria IR., and Lavanya B. (2015) Phytochemical Analysis, Antioxidant and Anti Microbial Activity of White and Pink Psidium Guajava Linnaeus. International Journal of Current Pharmaceutical Research, 7(2), pp 29-31.
Islam MS, Akhtar MM, Ciavattini A, et al. Use of dietary phytochemicals to target inflammation, fibrosis, proliferation, and angiogenesis in uterine tissues: promising options for prevention and treatment of uterine fibroids? Mol Nutr Food Res. 2014;58(8):1667-1684. doi:10.1002/mnfr.201400134
Jacoby VL, Jacoby A, Learman LA, et al. Use of medical, surgical and complementary treatments among women with fibroids. Eur J Obstet Gynecol Reprod Biol. 2014;182:220-225. doi:10.1016/j.ejogrb.2014.09.004
Leitzmann C. Characteristics and Health Benefits of Phytochemicals. Forsch Komplementmed. 2016;23(2):69-74. doi:10.1159/000444063
Shen Y, Wu Y, Lu Q, Ren M. Vegetarian diet and reduced uterine fibroids risk: A case-control study in Nanjing, China. J Obstet Gynaecol Res. 2016;42(1):87-94. doi:10.1111/jog.12834
July is recognised as Fibroid Awareness Month in some countries and it’s a great opportunity to put the spotlight on a health condition that receives little attention.
This year, we are delighted to be a part of the newly formed Global Fibroids Alliance whose aim is to raise awareness of fibroids and advocate for the change that is required to improve the health and wellbeing of women with fibroids as well as the quality of care women receive.
The Global Fibroids Alliance is a diverse group of health and wellbeing practitioners, researchers and consultants who have come together to strengthen the global approach to improving the information, treatment, care and support for all those affected by fibroids. We hail from the Caribbean, US, UK and France and are calling for:
More awareness campaigns on fibroids
Fibroids education to be part of menstrual health education and delivered to all girls from the age of 10.
Every country to provide women with all the treatment options for fibroids.
Each woman suspected to have fibroids to be carefully assessed, and a treatment and wellness plan be developed in collaboration with the patient that suits the patient’s specific situation and is based on the concept of informed and shared decision-making.
Collaborative alliances to be formed between traditional and non-traditional/complementary therapists, gynaecologists and counsellors to ensure that women are receiving a holistic and comprehensive approach when deciding on their wellness plans.
More research to establish the cause of fibroids so that more effective treatments can be developed.
More attention on the psycho-social impact of fibroids so that we can determine the full impact of fibroids and the support that women throughout the world require.
As part of Fibroid Awareness Month, we are delighted to invite women with fibroids to our first event which is a webinar on Fibroids and COVID-19. This webinar aims to explore how the COVID-19 pandemic may be affecting women with fibroids and will discuss what women can do to improve their physical and mental health during this challenging period.
Today’s blog post comes from Mariana Ndrio. Mariana is a second-year medical student at the University of Medicine & Health Sciences (UMHS) in St. Kitts and is currently serving as the President of the American Medical Student Association (AMSA) on campus.
Today, Mariana discusses the challenges that fibroids patients may be experiencing during this COVID-19 pandemic and shares some evidence-based self-care and stress management tips to help women with fibroids manage during this difficult period.
As the COVID-19 pandemic continues to prompt stressful changes to our daily routine and lifestyle, health-related worries regarding ourselves and loved ones have undoubtedly intensified. While the growing uncertainties stemming from financial difficulties and social isolation impact the health and personal decision-making of everyone across the globe, women suffering from uterine fibroids are facing unprecedented challenges in their attempts to preserve their mental and physical wellbeing.
Uterine fibroids are the most common benign tumours among women. While some cases of fibroids are accompanied by no side effects, other cases contain patterns of heavy menstrual bleeding, long and irregular periods, pelvic pressure and pain, constipation, frequent urination, and in rare occasions, infertility.
Treatment for fibroids can range from no treatment at all to surgery, depending on the severity of symptoms. Aside from apparent physical symptoms, the psychological impact of fibroids should not be disregarded. In a 2013 national survey of 968 women suffering from fibroids, 79% of the surveyed women expressed fear that their fibroids will grow or experience further health complications. According to a 2014 study assessing the emotional impact of fibroids half of the participating women reported feeling helpless and that they had no control over their fibroids, because of the difficulty managing and predicting the heavy menstrual flow.
Black women are 3 times more likely to become diagnosed with fibroids than white women, just as they are more likely to develop fibroids at a younger age; moreover, their fibroid size, frequency, and symptom severity are much greater.
As a medical student that remains generally impressed by the increasing amount of existing medical and scientific knowledge, researching gynaecological diseases such as fibroids have led me to a stark realization: that despite the high prevalence of uterine fibroids among women, not enough high-quality data is available to formulate evidence-based guidelines that address patients’ needs adequately. This points to a larger, unforgiving gap in medical knowledge pertaining to common diseases affecting women, and when combined with the gap in medical knowledge regarding COVID-19, a mixture of increased emotional stress and confusion is to follow. Such stress can hinder overall physical health and may exacerbate fibroid symptoms by influencing cycle length, vaginal bleeding patterns, and painful periods. If you are feeling uncertain or anxious, know that you are not alone; your worries and feelings are valid.
For that matter, we compiled some scientifically-backed tips that could be helpful in restoring a sense of control and ease in these difficult and unprecedented times.
First, don’t hesitate to reach out.
While staying home and self-isolating is the best way to stay protected from COVID-19 and prevent the spread of the virus, this should not halt or compromise access to necessary medical care for women suffering from fibroids.
If you needto see a healthcare provider for a gynaecological reason, reach out to your medical provider and try to see if they are able to set up a virtual appointment or address non-urgent concerns over the phone (such as prescription refills).
While it is true that a lot of non-urgent appointments and elective surgeries are cancelled, many medical professionals and medical facilities are encouraged to use and have already embraced telehealth services which allow long-distance patient and clinician care via remote and virtual appointments, intervention, education, and monitoring. Telehealth services vary based on your location and medical provider. But even if you are having difficulties accessing gynaecological telehealth services locally, you might be able to reach out to service providers in other countries such as the U.K, U.S, or Canada. For example, USA Fibroid Centers provide virtual appointments you can schedule online. Women to Women OB GYN Care, located in Florida, states in their website that they welcome appointments from women internationally and the Caribbean. The Pan American Health Organization (PAHO) has also attempted to establish or expand telehealth services in a lot of Caribbean countries.
Keep up to date with your prescribed medications.
Keeping up to date with your prescribed medications can be confusing during a pandemic. You might feel like your regular access to your medical provider or pharmacy is compromised, you might worry that your current medications might be making you vulnerable to the COVID-19 or you might be feeling uncertain regarding the continuation of your current prescribed medications or supplements.
Nonetheless, it is important that you continue taking your prescribed medications and/or supplements unless otherwise advised by your physician. If you are receiving preoperative therapy (Zoladex, Lupron, etc.) but your surgery is cancelled, ask your physician regarding the course of your current prescribed therapy. If you have been prescribed a drug called Esmya (Ulipristal Acetate), you must consult with your physician regarding its discontinuation; as of 2020, Esmya’s license has been suspended due to the risk of serious liver injury. As mentioned previously, do not hesitate to discuss any concerns you might have regarding your current medications and supplements with your medical provider.
Plan ahead.
Studies show that women with fibroids might present heavier, prolonged bleeding and frequent, irregular periods. While everyone during a pandemic is worrying and trying to secure produce and disinfecting supplies, women suffering from fibroids have to also think about stocking up on female hygiene products. Especially, since frequent trips to the stores must be limited due to social distancing/quarantine rules.
Ensure that you have enough gynaecological hygiene products at home, to eliminate frequent trips to the store and avoid exposure to the virus. This by no means should be considered as the green light to go into a buying frenzy. Try to remain conscientious of the needs of others.
If buying hygiene products in bulk is not an option due to financial difficulty or store availability, reach out to local non-governmental organizations (NGOs) or philanthropic entities, that might be willing to donate hygiene products such as the Days for Girls International Organization or even by reaching out directly to product manufacturers. Local grassroots organizations or associations in your region might also be able to donate hygiene items. Moreover, the governmental departments of public health or genders affairs might be willing to assist women in need of hygiene products.
This pandemic could also be a good time to consider reusable, more economical and environmentally friendly menstruation products such as washable pads, menstruation caps, or absorbent underwear. Check Days for Girls .org and learn how to make sanitary washable period pads during the COVD-19 pandemic, diligently following sanitary safety precautions.
Maintain healthy eating habits.
Research has shown that following a healthy balanced diet, filled with fruits and vegetables, could lower the risk of developing fibroids and may help to alleviate symptoms.
While access to your usual healthy foods might be compromised at the moment, try to make healthy dietary choices while in quarantine. More specifically, dieticians recommend an increase in the consumption of cruciferous vegetables such as cabbage, broccoli, and kale. This category of food contains a phytochemical called indole-3-carbinol which recent research has suggested may prevent the cellular proliferation of fibroids and consequently prevent exacerbation of fibroid symptoms.
For many years, there has been a significant amount of scientific evidence that vitamin D may inhibit fibroid growth. Get your serum vitamin D levels tested and supplement (with medical supervision) as needed to correct a deficiency. A few recently published studies assessing the role of vitamin D against COVID-19, suggested that there is a possible link between the two and that vitamin D can have a protective effect against COVID-19.
Stay hydrated by consuming adequate amounts of water during the day and eliminate alcohol and caffeine. Researchers are advising women to avoid alcohol and caffeine because these substances are metabolized by the liver adding more stress on it and making it work less effectively at metabolizing oestrogen in the body. Additionally, amidst the COVD-19 pandemic, the World Health Organization (WHO) urged the public to reduce alcohol consumption because alcohol compromises the body’s immune system and increases the risk of adverse health outcomes, making people more vulnerable to COVID-19. In other words, by cutting out alcoholic beverages, you are protecting yourself from adverse outcomes from both the COVID-19 and fibroids.
In addition, researchers believe that endocrine-disrupting chemicals (EDCs) which mimic oestrogen activity, may fuel fibroid growth. Examples include processed foods which contain various oestrogen-like preservatives; bisphenol A in water bottles, canned foods and plastic containers; various pesticides, herbicides, insecticides; and additive hormones and steroids used in meats and dairy products.
Try to choose organic, locally grown and in-season foods that are hormone and pesticide-free.Attentively wash any produce and peel fruits and vegetables.Reduce the use of plastics whenever possible and avoid reusing plastic water bottles or microwave food in plastic containers.
Stay active.
Research shows that a higher BMI – body mass index – is linked to the development of fibroids. By exercising you can reduce your BMI and prevent the fibroids’ growth. It may also help alleviate symptoms caused by fibroids. At the same time, exercise improves mental health by reducing anxiety, depression, and negative mood and by improving self-esteem.
Continue performing simple or recreational household chores and find an indoor workout routine such as yoga or aerobic exercises that you can perform at home while keeping up with the rules of quarantine. Choose what works best for you, based on your physical fitness and medical advice.
Be gentle to yourself—your body & your mind
On days that you are feeling pain and other fibroid symptoms, rest up and give your body time to heal. Try to soothe cramps by applying heat and wear comfortable clothes.
It’s okay to spend a whole day in bed recovering. Be gentle with yourself and do not undermine what your body is trying to tell you.
We live in a society where time and productivity are precious and synonyms for money and self-worth. Yet, nothing is more precious than your physical and emotional well-being. Do not feel guilty for taking some time to rest and recover.
Although self-care looks different for everyone and should be based on your personal needs and situation, there are a few suggestions that could work for you and help you boost your mental well-being:
Try to meditate and practice mindfulness. You can find a lot of free guided meditations online or on YouTube.
Monitor your thoughts and feelings in a journal.
Practice good sleep hygiene. Maintain a sufficient sleep schedule, stay away from electronic devices while in bed, and start a regular bedtime routine—such as drinking a soothing tea, taking a warm bath or shower, reading, etc.
Limit the amount of media you ingest daily.
If you live alone reach out to family and friends via phone or video. If you live with family, roommates, or a partner use this time to connect and nurture your relationships.
And remember, during these confusing and unprecedented times and while you are feeling that this pandemic is affecting you, in particular, a bit harder than the rest, there is always a community of women who are feeling exactly like you—you are not alone.
The BMJ, British Medical Journal Publishing Group: “Uterine Fibroid Drug Is Recalled after Case of Liver Failure Requiring Transplant Prompts EU Review.” www.bmj.com/content/368/bmj.m1112.
Journal of Obstetrics and Gynaecology: “Vegetarian diet and reduced uterine fibroids risk: A case-control study in Nanjing, China.” https://www.ncbi.nlm.nih.gov/pubmed/26458740
We are absolutely delighted to inform you that our fibroids research study has now begun after receiving ethics approval from the Ministry of Health last month. Our research project will explore the experiences of women residing in St Kitts and Nevis, who have been affected by fibroids.
The reason for trying to understand these experiences is because it has become clear that fibroids are a common health issue affecting women in St Kitts and Nevis. It is therefore important to explore if fibroids are affecting the quality of life of women in the Federation and understand what challenges women may be facing so we can provide effective and appropriate support, advocate on behalf of women, and ensure that women receive the best medical care possible.
We’re Looking For Volunteers
If you live in St Kitts and Nevis, are between the ages of 18 and 55 and have been diagnosed with fibroids within the last 5 years (any time between January 2015 and January 2020), you can take part in this research.
As a participant, you will be asked to take part in a 90-minute interview and in exchange for your time, you will receive $50EC.
More Information
If you’re interested in taking part in this study or have any questions, please contact Abi Begho by emailing research@lakehealthandwellbeing.com or calling 1 869 765 8702.
Ethics Approval Details
This research study was granted ethics approval by St Kitts Ministry of Health’s Interim Ethics Review Committee on 12th December 2019 (our ethics approval number is IERC-2019-12-035)
