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What are Uterine Fibroids?

January 7, 2019
uterine fibroids, toronto naturopath, naturopathic doctor toronto, fertility naturopath

When you think of fibroids, your brain may automatically jump to the scary C word. But fibroids are not the same as cancer.

Uterine fibroids are tumours that that come from the same tissue as the uterus. They grow at a modest rate, and are affected by hormones like estrogen and progesterone.

Uterine Fibroid Risk Factors

Some of the risk factors for uterine fibroids include:

  • Increasing age, around 40-50 years old
  • Family history of uterine fibroids
  • Getting your period before 12 year old
  • African American
  • Obesity

Types of Uterine Fibroids

Subserosal Uterine Fibroids

These fibroids project outside of the uterus. Surgical removal isn’t typically recommended and they don’t appear to impact fertility.

Submucosal Uterine Fibroids

These fibroids project within the uterus and can impact fertility in a negative way by affecting implantation rates, clinical pregnancy rates, ongoing pregnancy, miscarriage and live birth rates. Pregnancy rates may improve following surgical removal of the fibroids.

Intramural Uterine Fibroids

These fibroids are found within the myometrium (middle layer of uterine wall). They may affect fertility by negatively impacting implantation and clinical pregnancy rates.

Signs and Symptoms of Uterine Fibroids

The most common symptom is heavy, prolonged or abnormal bleeding. Unsurprisingly this can be followed by iron deficiency anemia.

You may also notice pelvic pain or pressure, although this is rare. And obstructive symptoms may present with larger fibroids.

Fertility may also be impacted depending on the type of fibroid you have.

Confirming the Presence of Uterine Fibroids

Palpation can give you an idea if you have fibroids, but you’ll need a more definitive diagnosis – preferably with imaging.

Two of the most common (and least invasive) tests are:

  • Transvaginal and transabdominal ultrasonography
  • MRI

Uterine Fibroids in Fertility

Depending on the location of your fibroid, it may decrease your fertility. Fibroids may decrease implantation and clinical pregnancy rates, based on where they present. Intramural and submucosal will affect fertility more than subserosal.

Uterine Fibroids in Pregnancy

Fibroids might remain the same size or become smaller in pregnancy. In the postpartum period, fibroids may shrink or completely disappear.

Sometimes they may have an impact on pregnancy outcomes, including an increased risk of malpresentation of your baby, increased chance of c-section, and increased risk of preterm delivery.

Treating Uterine Fibroids Naturally

Uterine fibroid treatment is dependent on the symptoms you’re experiencing.

If you’re not experiencing any symptoms, then doctors usually take a watch and wait approach. If you are experiencing symptoms, then treatment depends on your desire for fertility.

There are many drugs out there for the treatment of fibroids, and if you’re familiar with my website, I often focus on natural alternatives instead. Moreover, if you’re here because your fibroids are affecting your fertility, many of the recommended treatments wouldn’t be compatible (ex. birth control).

It’s important to note that natural therapies may not make your fibroid completely disappear. And this is one of the conditions where we’re focusing on the symptoms you’re experiencing.

Nutrition and Uterine Fibroids

One of the goals when you have fibroids is to adopt an anti-inflammatory diet. This means whole foods, fresh and organic fruits and vegetables, cold-pressed oils, oily fish, and nuts and seeds.

Sadly this leads to an avoidance of red meat, processed foods, refined carbohydrates, sugar, saturated fats, fried foods, dairy, caffeine, and alcohol.

Fibre is very important in assisting the elimination of estrogen and promoting bowel movements. Before you chug back some psyllium husk, berries and leafy greens are a great source of soluble fibre (the type of fibre that bulks up your stool). An easy way to ensure you’re getting enough fibre during the day is to start your morning off with a berry and spinach smoothie (ps. don’t forget the fat and protein!).

Lifestyle and Uterine Fibroids

Because obesity plays a role in fibroid development, it may be helpful to achieve a healthy body weight. Obviously many factors (ex. hormones) affect weight, so one of the simplest ways to start to process is to focus on nutrition.

Stored fat is often transformed into estrogen which may become stored in the body and ultimately affect hormones.

Liver Support and Uterine Fibroids

Yes, I brought up the liver because it detoxes! While we know that your liver knows how to detox. It’s important to consider that it may be burdened with outside estrogens. This may be affecting how your fibroids grow, and ultimately, this might slow down its detoxing job.

Detoxification happens in 2 steps, and if you don’t have the necessary nutrients for both, your liver may not do its best work. So what’s a person to do? Instead of tossing a pre-packaged detox into your cart, make sure you’re eating a variety of protein, getting your daily dose of B vitamins, and making broccoli (and other brassica vegetables) are you friend.

Once your liver gets these toxins out, they still need to be excreted via urine or stool. A healthy gut microbiome and frequent bowel movements will ensure that estrogen is not recirculated back into your system. But if you experience constipation (ex. less than 1 bowel movement per day) or uncomfortable digestive symptoms, then you may need some digestive support.

Nutrients and Uterine Fibroids

These vary and are based on the symptoms you may be experiencing. However, one important nutrient will be iron, especially if you’re noticing excessive menstrual bleeding (losing over 90mL of blood each cycle). Having your ferritin tested, will give your ND an idea if you should be supplementing.

Other nutrient actions that may be beneficial are anti-inflammatories, immune support, and specific antioxidants.

Herbs and Uterine Fibroids

This is another category that varies based on your symptoms and goals. We may want to consider:

  • Hormonal modulators (to improve hormonal regulation)
  • Liver tonics (to support liver detox)
  • Uterine tonics (to improve uterine tone)
  • Uterine astringents (to reduce uterine bleeding)
  • Uterine stimulants (to relieve pelvic stagnation)
  • Uterine antispasmodics (to reduce pain)

Obviously this is a huge list, and I haven’t listed off any herbs – mostly because you should be taking them under the supervision of a ND or herbalist.

Acupuncture and Uterine Fibroids

It’s no secret that I love acupuncture the most out of all my tools. This can’t be done at home, and should be done in your Naturopath’s or Acupuncturist’s office.

In the case fibroids, your ND will likely focus on ensuring the smooth flow of energy and movement of blood throughout the body. A few treatments are typically needed to see results (it’s not a one and done type of treatment).

Final Thoughts

If you’re experiencing heavy bleeding, it’s important to know that fibroids may be the reason why. Moreover, they may also interfere with your fertility.

If you’re hoping to retain your fertility and address your symptoms through a natural lens, feel free to try some of the above ways or work with a Naturopathic Doctor.

If you found this information helpful, please sign up for my monthly newsletter called The Flow for great and informative content like this!

What should men eat for fertility?

December 24, 2018
male fertility diet, toronto naturopath, naturopathic doctor toronto, fertility naturopath

Spoiler alert: Men can contribute to infertility. 

It’s not just a woman’s issue. And what you’re eating (or not eating), can affect your fertility success. Let’s dive into a couple of things that can help improve sperm parameters in men. 

Fatty Acids and Fertility

The sperm cell membrane high in fatty acids, and these acids are necessary for sperm function. The membrane is pretty important when it comes to fertilization – it helps with cell maturation, penetrating and fusing with the egg. 

The fatty acids that you need to do these jobs can’t be made by your body, so you need to either eat fish, supplement with fish oil, or eat nuts and seeds. Studies have shown that male fertility patients who have a higher intake of omega-3, have more normal sperm. A study looking at walnuts (which are a great source of omega 3s) have been related to higher sperm parameters – vitality, motility (how sperm move), and morphology (how sperm look). Another study showed that men’s fish intake was related to shorter time to pregnancy and a lower risk of infertility. 

It is important to pay attention to mercury levels in fish, and consider avoiding fish with high mercury levels as it may impact fertility. 

Soy and Fertility

Women aren’t the only ones cautious about soy. From my experience, men are pretty fearful too. When we look at the research on dietary soy and men’s health it’s pretty conflicting. While one study mentions that dietary isoflavone intake is associated with higher sperm count and motility, another says that soy intake is associated with lower sperm concentration. 

Here’s the thing, if you’re vegan or vegetarian and soy makes up a large part of your diet, aim for non-GMO and organic sources. 

Dairy & Meat and Fertility

Research on diary and sperm parameters is pretty mixed. One study looking at young men and dairy consumption showed that intake of dairy products (like milk) have been related to lower testosterone, FSH and LH levels. 

When it comes to meat, the same results exist. Some studies show that meat is unrelated to sperm parameters, some show that processed meat affects sperm counts. 

Something to consider though is your cardiovascular health. While that Double Big Mac might not do anything to your sperm, it might affect your heart health! Keep in mind that your body 

Fruits & Vegetables and Fertility

Unsurprisingly, fruits and vegetables are cornerstone of good health. But, many of them are sprayed with pesticides. One study showed that consumption of high-pesticide-residue fruits and vegetable was associated with poor sperm quality in men attending a fertility clinic. 

So what does this mean? Choose organic when eating foods off the Dirty Dozen list. 

Next Steps

Overall, the review that I read didn’t go into as much detail as the female version. However, it did mention that if you’re going to abide by a diet, then the Mediterranean Diet is a good bet. It’s high in seafood, vegetables and fruits, whole grains, etc. Basically you’re not eating processed and packaged foods.  

Changing a diet can be pretty difficult. I’m of the mind of taking it a week at a time, so if you’re introducing a new food or avoiding an old (but problematic) favourite, do it in weekly increments. 

When I was giving up gluten, cow dairy and eggs, I picked one and committed to that for a week, then gave up another, etc. When introducing new foods like salmon, commit to eating it once a week, find different ways to prepare it, etc. Changing your habits around food don’t need to be difficult. But like all things, it does take some work. 

For more information on how you can boost your fertility and improve your sperm parameters, consider working with a naturopathic doctor. If you have any questions, feel free to get in touch!

Reference

Nassan, F., Chavarro, J. and Tanrikut, C. (2018). Diet and men’s fertility: does diet affect sperm quality?. Fertility and Sterility, 110(4), pp.570-577.

What should women eat for fertility?

December 17, 2018
female fertility diet, toronto naturopath, naturopathic doctor toronto, fertility naturopath

It might come as a surprise that few people think about preconception health. And to be honest, when they do, it’s usually because of fertility struggles. Diet plays a huge role in how we feel and function, and provides the necessary building blocks to support conception.

Carbs and Fertility

Carbs might make up a significant part of your diet. When it comes to nutritional science, there’s a lot of learn about carbs, but I want to focus on 2 things: the glycemic index and glycemic load. 

The glycemic index is a value assigned to a particular food on how fast or slow it causes an increase in your blood glucose level.

The glycemic load combined quality and quantity of carbohydrates. It’s calculated by the amount of food you eat and the glycemic index of the particular food.The glycemic load is also associated with higher risks of ovulatory infertility.

In PCOS, it’s been found that women will often consume foods with a higher glycemic index. When women reduce their carb intake (or perhaps choose carbs with a lower index and load), their insulin sensitivity will improve, testosterone will decrease, and ovulation will occur (this is important, because anovulation is a key symptom in PCOS).

Fats and Fertility

Let’s clear something up. Fat isn’t bad. Yes, some are better than others and there are some you should avoid completely. But you need fat to make hormones, help your eggs mature and to get that tiny blastocyst to implant! 

Unsurprisingly, you should be avoiding trans fats. They increase insulin resistance, may prevent ovulation from happening, and decrease your chance of getting pregnant.

To get into specifics, omega 3 fatty acids are associated with progesterone production in the luteal phase (this is important!) and a reduced risk of anovulation. In women undergoing IVF, omega 3 fatty acid intake was associated with better embryo morphology. 

Protein and Fertility

You should be eating at least 1g of protein per kg of body weight (more if you’re active). Protein comes in different forms: animal and vegetable. One study showed that ovulation was negatively affected by increased animal protein. While another study showed that although fish, eggs, and processed meats didn’t have an effect on ovulation, vegetable protein intake decreased anovulation. Blastocyst formation in assisted reproductive technology decreased in patients consuming more red meat. But it was positively affected by fish consumption.

Now before you head on off to the local fish monger, you want to pay attention to fish and mercury content (as it may interfere with hormones and fertility). Fish to avoid would be bigeye tuna, king mackerel and swordfish.

Soy protein often gets a bad rap, but can actually be beneficial in women seeking fertility treatments. Soy isoflavone supplements were associated with improvement in reproductive outcomes, increased live birth after clomiphene administration, and higher endometrial thickness and ongoing pregnancy rates after IVF and ICSI. 

A couple things to consider before ordering your soy latte – choose organic, non-GMO soy. And if you have a thyroid condition, it’s best to avoid dietary soy altogether.

Next Steps

It might be obvious that a diet that leans towards fast food/processed foods and few fruits and vegetables is probably not the best. And when it comes to a diet in particular, adopting a Mediterranean diet (which basically has a foundation of vegetable and fruit, whole grains and fish) has shown to be effective in a few studies. 

Pesticides and other chemicals in our foods may also affect reproductive success, so if possible, choose organic when you can. Basically, if any of the fruits and vegetables that you eat appear on the Dirty Dozen, eat the organic version instead. 

When choosing meats, aim to get your meats from local farms if possible. And grass-fed and antibiotic-free are great options too. 

 If you found this information helpful, please sign up for my monthly newsletter called The Flow for great and informative content like this!

References

Chiu, Y., Chavarro, J. and Souter, I. (2018). Diet and female fertility: doctor, what should I eat?. Fertility and Sterility, 110(4), pp.560-569.