Expert: Dr. Kristina Conner - 6/29/2010

Question
Hi,

I am 49 years old.  I was diagnosed with a fibroid about 3 years ago (in 2007).  I had not had any symptoms until the beginning of this year, when I began experiencing heavy bleeding one day during my menstrual cycle.  I had transabdominal and endovaginal ultrasounds done following a physical exam this year and the fibroid, which was originally about 7.something cm is now about 8.8 cm., with a normal, 6 mm endometrial stripe. I requested a biopsy be done and was told there was no malignancy or pre-cancerous condition.  

In addition to the heavy bleeding for a few hours on about the second day of my monthly periods, I am experiencing bloating and just the intermittant dull menstrual-type of discomfort pain in the area where the fibroid is.  I have done some research and discovered that estrogen dominance is a likely cause of uterine fibroids. I am in good health otherwise, I run 20 plus miles per week and eat healthy.  I have excellent cholesterol levels.  I am 5'3" and about 120 pounds (was about 110 pounds last year, but believe the fibroid issue has caused some water weight/bloating).

I recently purchased some DIM plus, which is supposed to help balance hormones and some Evening Primrose Oil.  I have been reading some conflicting information on EPO and would like to know your thoughts.  The information I have found that bothers me is that this supplement has estrogenic activity.  If I have an estrogen dominant condition, could taking this supplement possibly make matters worse for me (increasing estrogen)? Some material suggests that the EPO produces a weak estrogen which takes the place of the bad estrogen.  I am confused.  I don't want to continue taking this supplement if it is going to make matters worse.

Please help!

Thanks

Answer
Hello Cece,
It's good that you are doing some research before taking supplements.  I would recommend reliable websites like Natural Standard, NIH, and Medline for further research.  Fibroids are considered an estrogen-excess condition, and anything that can be done to reduce the excess and balance with progesterone is useful.  The idea with EPO and many other supplements (soy, flax, red clover, etc) is that they are phytoestrogens; they don't work as replacement but instead provide a decoy that will bind excess estrogens.  Since they are herbs and not isolated estrogen, there are additional ways in which they are helpful, depnding on the herb/food.  Phytoestrogens work well when used with others that help bind, eliminate, and balance hormones (DIM, indole-3-carbinol, and certain types of fiber) along with a foundation of anti-estrogen diet and lifestyle changes; taken alone they are often not as effective.  Fibroids do respond to this treatment but they are challenging to treat, as the endocrine/ gynecological systems are complex.  If you are really looking to treat your condition using natural methods, I'd strongly suggest you seek out a ND (www.naturopathic.org) or holistic MD (www.holistic.org), in your area for more specific guidance.  
In health,
Dr Conner