Anti-estrogen therapies

High levels of estrogen are considered an element of uterine fibroids

Various tactics can be used to improve estrogen balance in the body:

How to reduce estrogen in the body

• Aromatase inhibitors used to reduce fibroids Malartic et al (2008) – The effect is believed to be partially due to (i) Lowering ovarian production and systemic estrogen levels and (ii) Inhibiting locally overexpressed aromatase in fibroids.  Aromatase inhibitors have also been used experimentally in treatment of endometriosis, which indicated that aromatase inhibitors might be particularly useful in combination with a progestogenic ovulation inhibitor.
• Phytoestrogens – compete for receptors with endogenous estrogens; isoflavones daidzein and genistein are found in soy, but have been found to worsen fibroids when consumed in too high amounts. Lignans found in flaxseed.
• I3C in cruciferous vegetables – promotes formation of less potent estrogen metabolites Minich & Bland (2007)
• Reduce caffeine intake – to <500 mg / day (e.g.  2 cups coffee / day)
• Reduce alcohol consumption to 1 drink / day
• Increase fiber – helps remove excess estrogen from GI tract aiding excretion; reduces enterohepatic estrogen recirculation and/or shields estrogen absorption;
• Consume anti-inflammatory omega-3 fats and reduce inflammatory omega-6 fats to reduce estrogen production
• Iodine has a critical role in maintaining the body’s estrogen balance and can reduce uterine fibroids.  Based on a controlled clinical trial with 1,365 women, 4mg daily of molecular iodine quickly resolves fibrocystic breast disease(FBD) – Iodine makes breast lumps and cysts disappear usually within only two months for most women. Iodine can similarly reduce uterine fibroids – one of the first conventional medical treatments for severe fibroids was to “paint”the uterus with iodine.

The primary aromatase promoter in leiomyomata tissues in non-Asian U.S. women is the inflammatory prostaglandin PGE2 Imir et al (2007)

Omega-3 fat reduces release of growth hormone – which promotes formation / growth of fibroids

Myoma is associated with beef and ham consumption, whereas high intake of green vegetables seems to have a protective effect Chiaffarino et al (1999)

Iodine -“The Universal Medicine”

Vitamin D3 decreases fibroid cell size and disrupts the formation of fibroid muscle cells

Vitamin D3is typically deficient in many populations today – E.g. Elderly, office workers, African Americans

• D3 treatment has been shown to inhibit leiomyocyte proliferation at physiological doses – Leiomyomas widely express the vitamin D receptor.
• Vitamin D decreases mitogenic activity of insulin and IGF-1
• Active metabolites of calcitriol (Active form of Vitamin D) down-regulate epidermal growth factor receptors (EGFRs) known to be active in mitogenic pathways in uterine leiomyomas. Down-regulation of these receptors shown to decrease growth / differentiation of tumor cells
• Risk of developing uterine fibroids in American black women REDUCED with just increased daily servings of “vitamin D-added” milk.
• Research shows that physiological doses of vitamin D have significant growth-inhibiting effect on leiomyomata cells Blauer et al (2009)

Vitamin D – “The Sunshine Vitamin”

Bioflavonoids reduce risk of malignant tumors

There is an inverse association between bioflavonoid intake and risk of malignant tumors – reported biological activities include:

• Induce apoptosis
• Cell cycle arrest
• Antiproliferative
• Anti-inflammatory
• Antioxidant protection against oxidative stress
• Anti-estrogenic

Asian women consume a lot of bioflavonoids and have lower incidence of hormonally dependent solid tumors – E.g. breast cancer in Asian women is 4-6 times lower than in American women, and several generations after migration to America they line up with the American statistics, suggesting an environmental rather than a genetic influence. Asian women consume a lot of soy-based foods, containing bioflavonoids that show up in blood and urine samples at significantly elevated levels.

“Bioflavonoids are . . . found in legumes, nuts, onions, apple, broccoli, red wine, grreen tea, cocoa powder, and dark chocolate. The best known anti-tumor flavonoids are epigallocatechin gallate (EGCG)from green tea, genistein (from soy and red clover), curcumin (from turmeric), silibin (from milk thistle), quercetin (from many yellow vegetables such as onions), and resveratrol (from grapes and red wine).”

–    James H. Segars, author of the book Fibroids

Quercetin, EGCG, Curcumin, Silibrinin – (In berries, tea, grapes, olive oil, dark chocolate, walnuts, citrus):

• Inhibits IGF-1 signaling
• Anti-estrogenic – Estrogen receptor antagonist
• Alters cell cycle

Resveratrol (In red wine, grape, berries, dark chocolate, also peanuts (not recommended because of common fungal content); produced in plants in response to injury or fungal/ bacterial presence)

• Induces apoptosis
• Anti-estrogenic -Weak estrogen receptor agonist / antagonist
• Decreases collagen production

Resveratrol study-reported properties include:

• Anti-proliferative – mainly as a preventative; Decreases growth and increases death of fibroid cells in vitro;
• Cardio-protective
• Anti-diabetic
• Neuroprotective -possibly by chelating copper
• Reduces opioid tolerance -by increasing NMDA receptors
• Anti-inflammatory
• Antiviral activity

Curcumin (spice) – decreases growth and increases death of fibroid cells in vitro. Curcumin inhibited uterine leiomyoma cell proliferation by inducing apoptosis, and inhibited production of the ECM component fibronectin. (Malik et al, 2009; Kenji et al, 2011; )

Licorice (contains flavonoid isoliquiritigenin) – decreases growth and increases apoptosis of fibroid cells in vitro.

Green Tea (epigallocatechin gallate) – decreases growth of fibroid cells in vitro.

Retinoic acid

GI tract health strongly linked to uterine fibroid growth

Gastrointestinal problems (e.g. leaky gut syndrome, candida (yeast), intestinal bacterial overgrowth and gut inflammation) can indirectly lead to:

• Abnormal growth factor expression
• Excess estrogen
• Immune dysfunction.
• Toxic heavy metals can lead to abnormal bacterial growth in the gut and breakdown of the mucosal lining in the intestines. Hedburg, N (2011)

Female support herbs

There is supportive evidence thatvitex, yarrow and capsella buras-pastoris can reduce menstrual bleeding and PMS symptoms.

Vitex agnus-castus (Vitex, Chaste Tree, Chasteberry)

• Typical extract doses significantly inhibit prolactin secretion – (basal and TRH-stimulated) – presumed to be via dopaminergic effects. At low doses, such as might have been used in previous centuries for suppression of sexual desire, it inhibits activation of DOPAMINE 2 receptor by competitive binding, causing a slight increase ▲  in release of prolactin. In higher concentrations, as in modern extracts, the binding activity is sufficient to reduce ▼  the release of prolactin. A study found that treatment of 20 healthy men with higher doses of Vitex agnus-castus was associated with a slight reduction of prolactin levels, whereas lower doses caused a slight increase as compared to doses of placebo. (Merz et al, 1996)

  • A decrease of prolactin influences levels of follicle-stimulatin hormone (FSH) and estrogen in women, and testosterone in men.

  • Chemical analysis of vitex agnus-castus has isolated the following compounds – flavonoids, alkaloids, diterpenoids, Vitexin, Casticin and steroidal hormone precursors, some of which are believed to affect the pituitary gland explaining its effects on hormone levels.