HOW TO TREAT FIBROIDS AND HEAVY BLEEDING NATURALLY

Interview with Carolyn DeMarco, M.D.

Carolyn DeMarco, M.D. is a Canadian author, speaker, and lecturer who has been in clinical medical practice for over 25 years, and who has a special interest in women's health and alternative medicine. The author of Take Charge of Your Body: A Woman's Health Advisor, she also has two national newspaper columns. She is widely known and respected as a pioneer in the use of alternative medicine to treat women's health problems.

JLML: Uterine fibroids are one of the most common problems of perimenopause and one of the leading causes of hysterectomy. Can you tell us exactly what a fibroid is from a medical point of view?

CDM: Fibroids are benign tumors of the uterus. They're made of smooth muscle and fibrous tissue. They can be located either outside or inside the uterus. They range in size from a pea to a melon, but they're usually between the size of an orange and a grapefruit. They're hard, white gristly tissue with a whorl-like pattern. Their size varies depending on where you are in your menstrual cycle. There's no doubt that estrogen excess is the main cause of fibroids.

JLML: What are the symptoms that a woman with fibroids might have?

CDM: Fibroids don't commonly have symptoms. When they do, they will cause heavy bleeding, pelvic pressure, and urinary frequency (you have to pee more often) when they press on the kidney, bladder or ureter. Pain is unusual. Fibroids can also be on a stalk which can twist. They can break down and degenerate, which can be painful, but that's very unusual. Fibroids can also cause infertility and miscarriage.

JLML: How are they best treated?

CDM: If there are no symptoms a “wait and see” approach is best, because fibroids will usually shrink at menopause. Many doctors will recommend a hysterectomy even if there are no symptoms. Fibroids cause a third of all hysterectomies.

There are other surgical alternatives, such as a myomectomy (removing only the fibroid), or a hysteroscopy which removes the fibroid through the cervix. Both procedures take considerable surgical skill. It's much simpler to take out the uterus than to take out a fibroid.

JLML: Simple for the doctor and complicated for the woman.

CDM: That's right. The surgical complication rate for the ordinary hysterectomy is very high — 40 to 50 percent. It's a complicated major surgery and the recovery time is quite long. I am fundamentally opposed to taking out the uterus unless there's a serious problem.

Often a surgeon will take out the ovaries as well, and that causes instant menopause. Even if your ovaries are left, you tend to go into menopause an average of two years earlier, and some women's ovaries don't recover and they rapidly go into menopause. It's shocking the number of ovaries that are taken out for no good reason. The vast majority of hysterectomies are done between the ages of 20 and 49. Half of the women over 40 who have a hysterectomy are convinced to have both ovaries removed at the same time, although there's rarely a medical reason to do so.

At menopause the ovaries do not suddenly go dead: they’re winding down but they continue to secrete small amounts of hormones, which really cushions the perimenopausal transition period. A hysterectomy can also change your experience of sex negatively because you can no longer have a uterine orgasm. If the ovaries are removed or stop functioning you lose 50 percent of your testosterone, and some women lose their sexual desire as a result.

Also, research is now showing that the uterus has other functions: it secretes hormonal and other active substances such as prostaglandins which may play a role in preventing arthritis.

JLML: That's fascinating. Getting back to fibroids, could a woman with fibroids as small as one to two inches have symptoms?

CDM: They can, depending upon where they're located. I've found that fibroids located in the wall of the uterus can cause quite a bit of bleeding.

JLML: Would you say that's one of the primary causes of heavy bleeding?

CDM: Yes, it is, along with excess estrogen in general. Perimenopause is a time when many women have heavy bleeding, and it is debilitating. It makes you feel panic stricken, so when the doctor says, “Oh, let's just yank it all out, that will solve all your problems,” that is almost an irresistible offer. But as we've discussed, it doesn't solve your problems at all.

One thing I've found about women with heavy bleeding is that there’s almost always an emotional factor where you have too much to do, or you have too much stress, and you're overwhelmed.

One of the biggest problems with heavy bleeding is iron-deficiency anemia. I've known women who suffered for months who had excessive, debilitating fatigue, chest pains and shortness of breath from anemia caused by heavy bleeding. If you're anemic, you'll bleed more so it'll be a vicious circle. Sometimes women will just drag themselves around thinking their fatigue is caused from trying to do too much.

Anemia is very easy to treat. Women generally report that they feel like a whole new person after a month of iron supplements. Any woman with heavy bleeding should have her hemoglobin, iron stores and thyroid checked. If your thyroid is malfunctioning it can cause menstrual irregularities and heavy bleeding, especially if it's under-functioning. I don't recommend that women just start taking iron supplements. If you have these symptoms you need to find out what's going on.

JLML: How do you treat heavy bleeding?

CDM: I have found that acupuncture, Chinese herbs and natural progesterone are very often helpful in bringing the system back into balance. I also recommend high doses of bioflavonoids (over 1,000 mg per day, especially quercetin and rutin) because that improves blood clotting and strengthens the capillaries in the uterus.

JLML: How do you treat fibroids in your patients?

CDM: I break it down into five steps: 1) Decrease the estrogen overload, 2) Support liver function, 3) Increase pelvic and general circulation, 4) Do a cleansing and detox, especially for the liver, and 5) Deal with emotional conflicts that might be playing a role. Other things to check for are low thyroid and adrenal function. [Editor’s note: See the July '98 issue of this newsletter for details on treating tired adrenals.]

To reduce estrogen it's important to maintain a healthy diet and support the liver. If your liver isn't working well, estrogen can stay in your system longer than it's supposed to. To stimulate the liver you can use lemon juice, and put bitter greens such as dandelion greens, endive and raddichio in your salad. You can take liver-supporting herbs including dandelion root, milk thistle, burdock, artichoke and turmeric. I also suggest taking a B-complex vitamin, and lipotrophic factors like methionine, choline and inositol. The other way to reduce the estrogen imbalance of course is with natural progesterone cream. It's a key component to treating a fibroid. I put every fibroid patient on a natural progesterone cream, applying it days 12 to 26 of the cycle, ¼ to ½ tsp per day.

I have several ways to improve local pelvic circulation. One is castor oil packs or clay packs, another is hydrotherapy with hot and cold packs. Sometimes a chiropractic or osteopathic adjustment works.

On the emotional level, there are various theories. Dr. Christiane Northrup says that fibroids represent creativity that was never birthed. She talks about dead-end jobs and relationships, and conflicts about reproduction and motherhood. I also see women with fibroids who have internal conflicts about their sexual orientation.

It's important for women to know, especially with a large fibroid, that there's no quick fix. This is a long-term process of healing, and you don't want to try to let all these toxins out of the body overnight. They've been encapsulated because your body's protecting you from them, so you have to gradually release them.

The approaches I’ve suggested will usually keep a fibroid from growing any more, and will sometimes shrink it.

JLML: Thank you for your insights and expertise.

This interview was originally published in the John R. Lee, M.D. Medical Letter. The Medical Letter is no longer published, but you can find many articles from it on this website.