Treating Uterine Fibroids with TCM
Uterine Fibroids Uterine fibroids (also known as uterine leiomyoma, myoma, fibromyoma, leiofibromyoma, fibroleiomyoma, and fibroma) are benign tumors that originate from the smooth muscle layer (myometrium) and the accompanying connective tissue of the uterus.
Fibroids are the most common benign tumors in females and typically found during the middle and later reproductive years. Fibroids are dependent on estrogen and progesterone to grow and therefore relevant only during the reproductive years, they are expected to shrink after menopause. They are more common in African Americans than Caucasians. Uterine fibroids are more common in overweight women, perhaps because of increased estrogen from adipose aromatase activity.
Fibroids are often described by their location in the uterus:
• Intramural Fibroids grow in between the muscles of the uterus.
• Submucosal Fibroids grow just underneath the uterine lining.
• Subserosal Fibroids grow on the outside of the uterus.
• Pendunculated Fibroids grow into a long stalk on the outside of the uterus or inside the cavity of the uterus Causes
The cause of uterine fibroid tumors is unknown. However, research and clinical experience point to several factors:
• Genetic alterations Many fibroids contain alterations in genes that code for uterine muscle cells.
• Hormones Estrogen and progesterone, two hormones that stimulate development of the uterine lining in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and estrogen receptors than do normal uterine muscle cells.
• Other chemicals Substances that help the body maintain tissues, such as insulin-like growth factor, may affect fibroid growth.
Signs and Symptoms
While most fibroids are asymptomatic, they can grow and cause symptoms, generally related to the location of the lesion and its size.
The most common signs and symptoms of uterine fibroids include:
• Heavy menstrual bleeding (menorrhagia), sometimes with the passage of blood clots
• Menstrual periods that may last longer than normal
• Pelvic cramping or pain with periods
• Abnormal uterine bleeding between periods
• Abdominal discomfort or bloating
• Constipation or painful defecation
• Increased urinary frequency or retention
• Pain during intercourse
• Back pain
When to see a doctor
See your doctor if you have:
• Overly heavy or painful periods
• Spotting or bleeding between periods
• Pain with intercourse
• Difficulty emptying your bladder
• Difficulty moving your bowels
• Pelvic pain that doesn't go away
Seek prompt medical care if you have severe vaginal bleeding or sharp pelvic pain that comes on suddenly.
Uterine fibroids are frequently found incidentally during a routine pelvic exam. A pelvic examination may show an irregularly shaped, lumpy, or enlarged uterus. A transvaginal ultrasound or pelvic ultrasound may be done to confirm the diagnosis of fibroids. Sometimes, a pelvic MRI is used to confirm the diagnosis. An endometrial biopsy or laparoscopy may be needed to rule out cancer.
Most fibroids do not require treatment unless they are causing symptoms. After menopause fibroids shrink and it is unusual for fibroids to cause problems. Symptomatic uterine fibroids can be treated by medication to control symptoms, medication aimed at shrinking tumors, ultrasound fibroid destruction, various surgically aided methods to reduce blood supply of fibroids, myomectomy or radio frequency ablation, or hysterectomy.
• Hormonal therapy Gonadotropin-releasing hormone may be used to drop estrogen and progesterone levels and to help shrink the fibroids. This therapy is used only for a short period of time, either before surgery to remove a fibroid or when a woman is expected to reach menopause soon. Side effects include hot flashes and vaginal dryness.
• Intrauterine devices (IUDs) Progestin-releasing IUD can relieve heavy bleeding and pain caused by the fibroids. A progestin-releasing IUD provides symptom relief only and doesn't shrink fibroids or make them disappear.
• Androgens Danazol, a synthetic drug similar to testosterone, may effectively stop menstruation, correct anemia and even shrink fibroid tumors and reduce uterine size. However, occasional unpleasant side effects, such as weight gain, dysphoria (feeling depressed, anxious or uneasy), acne, headaches, unwanted hair growth and a deeper voice, make many women reluctant to take this drug.
• Birth control pills Oral contraceptives or progestins can help control menstrual bleeding, but they don't reduce fibroid size. • Nonsteroidal anti-inflammatory drugs (NSAIDs). Ibuprofen or Naprosyn can be used for cramps or pain, but they don't reduce bleeding caused by fibroids.
• Iron supplements Iron supplements can be used to prevent or treat anemia due to heavy periods
Surgery and other procedures
• Hysteroscopic resection of fibroids Women who have fibroids growing inside the uterine cavity may need this outpatient procedure. In this procedure, a small camera and instruments are inserted through the cervix into the uterus to remove the fibroid tumors.
• Uterine artery embolization Uterine artery embolization (also called UAE or uterine fibroid embolization) is a treatment that blocks the blood supply to fibroids, causing it to die and shrink. Uterine artery embolization is not used to treat large fibroids. Women who may want to become pregnant in the future should NOT have this procedure.
• Myomectomy Myomectomy is a surgery done to remove fibroids and reduce heavy menstrual bleeding. It is often the chosen treatment for women who want to have children, because it usually can preserve fertility. Another advantage of a myomectomy is that it controls pain or excessive bleeding that occurs in some women with uterine fibroids. However, there is a risk that fibroids will come back after myomectomy; between 10 and 25 percent of women who have myomectomy will need a second fibroid surgery.
• Hysterectomy Hysterectomy is a surgery that removes the uterus. The ovaries and cervix are sometimes removed, along with the uterus. Hysterectomy is a permanent treatment that cures heavy menstrual bleeding. However, it is major surgery, and you will need up to six weeks to fully recover. This invasive surgery may be an option if medicines do not work and other surgeries and procedures are not an option.
Fibroids may cause pregnancy complications, although the risk is thought to be small:
• Most women are able to carry their babies to term, but some end up delivering prematurely because there is not enough room in the uterus.
• Some pregnant women with fibroids may need a cesarean section because fibroids can occasionally block the birth canal or cause the baby to be positioned wrong.
• Some pregnant women with fibroids have heavy bleeding immediately after giving birth.
Other complications of fibroids include:
• Severe pain or excessively heavy bleeding that may require emergency surgery
• A pedunculated fibroid can become twisted and cause a kink in the blood vessels feeding the tumor (this type of fibroid may need surgery)
• Anemia (which may be severe if the bleeding is very heavy)
• Urinary tract infections, if pressure from the fibroid prevents the bladder from fully emptying
• Cancerous changes called leiomyosarcoma (in rare cases)
• Infertility (rarely)
Uterine Fibroids in Traditional Chinese Medicine
The first discussions of uterine fibroids in the Chinese Medicine can be traced back all the way to the Huang Di Nei Jing (Yellow Emperor's Inner Canon), an ancient Chinese medical text that has been treated as the fundamental doctrinal source for Chinese medicine for more than two millennia and until today. In Ling Shu (Spiritual Pivot, 1st century BCE), one of two parts of Huang Di Hei Jing, defined this disorder as “Shi Jia, stony-like mobile abdominal masses” (Shi = stone; Jia = mass) which are attributed to cold penetrating into the lower abdomen causing stagnation of Qi and Blood in the Penetrating (Ren) and Conception (Chong) vessels.
In Chinese Medicine, the modern disease category of uterine fibroids fall under two general categories of abdominal masses (Zheng Jia) or abdominal lumps (Ji Ju). Zheng describes solid masses (concretions) with defined physical form and fixed location, accompanied by pain in a specific location. In these cases, pathological changes have taken place in the visceral organs and usually involve the blood; therefore, Zheng is often referred to as Ji, blood stasis masses.
Jia, on the other hand, describes masses without a distinct physical form (conglomerations), manifesting and dispersing without apparent pattern. Accompanying pain is not fixed in location. In these cases, pathological changes have taken place in the bowel organs and involve Qi, the vital energy of the body; therefore, Jia is often referred to as Ju, Qi masses.
Etiology and Pathogenesis
• Emotional strain Emotional strain is the most common cause for the formation of the abdominal masses. Anger, especially when repressed, frustration, resentment, and/or hatred can all lead to stagnation of Qi and, in the long run, to stasis of Blood. The Liver channel plays an important role in the movement of Qi in the lower abdomen and, in women, Liver-Blood plays a paramount role in the circulation of blood in this area.
• Diet Diet is another important etiological factor in the formation of abdominal masses. Irregular eating or excessive consumption of cold and raw foods may lead to the formation of cold in the lower abdomen. Cold contracts and naturally interferes with the circulation of Qi and Blood. Excessive consumption of greasy foods, on the other hand, impairs the Spleen and may lead to the formation of Dampness and Phlegm, which can settle in the lower abdomen and bring about abdominal masses. There is also a close interaction between Phlegm and stasis of Blood so that one may lead to or aggravate the other.
• External pathogenic factors When pathogenic cold, dampness, heat, or toxins attack, they may remain in the body for a long time and impair the functions of internal organs, causing Qi, Blood, and/or Phlegm stagnation. Over a long time, abdominal masses are produced. The most important pathogenic factor is external Cold which can invade the lower abdomen and impair the circulation of Blood, eventually leading to stasis of Blood. External dampness may invade the channels of the legs and then creep up them to settle in the lower abdomen whew it transforms into Phlegm and may give rise to abdominal masses.
As for pathology, abdominal masses are always characterized by either stagnation of Qi (non-substantial) or stasis of Blood (substantial). In addition to stagnation, there may also be Phlegm. However, in all cases of abdominal masses, there is always an underlying deficiency of anti-pathogenic Qi (normal Qi). Abdominal masses gradually develop when the body's anti-pathogenic Qi fails in its struggle against the attacking pathogenic factors and fails to transport and transform the Qi and Blood. This disease is principally related to the Liver and Spleen.
In Traditional Chinese Medicine, the disease category of abdominal masses (Zheng Jia) is divided into two sections, the Qi masses and the Blood masses. The Qi masses have two patterns; Liver Qi Stagnation pattern and Retention of Food and Phlegm pattern. The Blood masses have three patterns; Stagnation of Qi and Blood pattern, Stasis of Blood knotted in the Interior pattern, and Deficiency of body’s Anti-pathogenic Qi and Stasis of Blood pattern.
However, a famous contemporary Chinese physician, Professor Shen Zhong-Li, has found that uterine fibroids represent as stagnation of Qi and Blood caused by a combination of Spleen/Stomach depletion and Liver constraint or fire leading to a gradual loss of function in the extraordinary vessels. Based on his deep understanding in the ancient theories and many years of observation utilizing both Chinese and Western medical diagnostic methods, Professor Shen has sorted women suffering from fibroids into three major patterns; Qi and Blood Stagnation, Yin Deficiency with Fire, and Liver Qi Stagnation with Spleen Qi Deficiency.
Qi and Blood Stagnation
Qi stagnation is often brought on by emotional stress. Both Qi Stagnation and Blood Stasis may be a result of physical trauma as in major surgery, a significant injury or even a difficult childbirth. Blood stasis can be caused by abnormally heavy bleeding with menses or an improper sex life (excessive sexual activity, or having sex while menstruating). This type manifests predominantly as subserosal or intramural fibroids.
The menstrual cycle is usually regular, though in severe cases the Penetrating and Conception vessels will be damaged leading to heavy periods. Patients with this pattern may present with scanty but long-lasting menstrual bleeding. There may be lower abdominal distension or latent pain and a dragging sensation in the rectum. The tongue tends to be dark red and the sides may show purple stagnation spots. The pulse will be deep and wiry, or thin and choppy.
Yin Deficiency with Fire
It is an advanced stage of Yin Deficiency. Deficiency of Kidney Qi or chronic illness is the origin of this pattern. This type frequently manifests as submucosal or intramural fibroids or as multiple fibroids.
Menstruations tend to be early and heavy or scanty but long-lasting bleeding and are often accompanied by a burning sensation in the chest or a feeling of heat in the lower abdomen. Patients may complain of pain in the nipples, sensation of itching in the breast, or even a stabbing pain and distension and pain in the entire breast before the period. After the period blood-streaked white discharge or yellow-white vaginal discharge may be observed. The tongue will be red with little moisture and the tongue coat will be reduced or thin yellow. The pulse will be wiry and thin or thin and rapid.
Spleen Qi Deficiency with Liver Qi Stagnation
This type also manifests mainly as submucosal or intramural fibroids or as multiple fibroids. The fibroid tumor is often a soft mass. Patients present with mixed repletion and depletion patterns that change from predominant repletion at the onset of the disorder to increasing depletion over time.
The menstrual cycle tends to be normal or latend with increased bleeding often accompanied by clotting. There may be a dragging down sensation in the lower abdomen, diarrhea and/or other digestive problems, and thin vaginal discharge following menstruation. The tongue body tends to be pale with a white fur that may be thick or thin. The pulse typically is soggy and thin or thin and wiry.
Treating Uterine Fibroids with TCM
In Traditional Chinese Medicine, the treatment of uterine fibroids depends on the pattern differentiation according to the signs and symptoms of individual patient. Acupuncture, Chinese herbs, abdominal massage, topical herbal applications, dietary regulation, and exercise including Qi Gong are all useful in the treatment of fibroids.
A pilot study published in 2002 researchers assigned a group of 37 women with uterine fibroids to six months of treatment with TCM, including weekly acupuncture treatment, herbal medicine, nutritional therapy, body therapy, and guided imagery training. The study results showed that sizes of 22 leiomyoma cases zoomed out or ceased growing, and all of the cases’ syndrome were relieved and received a fairly high degree of satisfaction. Comparing with other medicine and surgery operation, the author believed that TCM treatment for uterine fibroids was value for money and worth a try (Mehl-Madrona, 2002).
In recent years, the multi-approach treatment with TCM had made new achievements and their clinical effect was obvious which were better than treatment with Western medicine. According to a study designed to review the recent research progress of TCM in treating uterine fibroids and to evaluate its clinical effect, the effective rate of treating uterine fibroids by TCM was more than 85% and the cure rate was as high as 30% (Mu et al., 2009).
Acupuncture is a healing tradition that has been used for centuries to successfully treat fibroid tumors as it addresses the cause rather than the symptom. Acupuncture treatments primarily used to facilitate the circulation of Qi and Blood and reduce the pain associated with fibroids.
The stimulation provided by the acupuncture has been found to induce the regression of pathologic proliferating cells locally. Humoral factors at a distally stimulated acupuncture points which control and prevent local overgrowth of regenerating and proliferating cells (those that invigorate the blood) also systemically affect the growth of distant tumors. A study conducted in China has shown that acupuncture has a regulative effect on the pituitary and thyroid as well as the central nervous system, without presenting pharmacological interference or having a long-term effect (Lan and Li, 1997).
In most cases of Gynecological treatment in TCM, Chinese herbal medicines are recommended to increase effect of acupuncture treatments and to correct imbalance of the internal organs. The basic principle of formulating Chinese herbal medicine for uterine fibroids are; invigorating Qi and Blood, resolving Phlegm, and softening the masses. The Chinese herbs for this purpose are generally called ‘attacking herbs’. The most commonly used attacking herbs are; E Zhu, San Leng, Shi Jian Chuan, Ban Zhi Lian, Qian Niu Zi, Shan Ci Gu, Hai Zao, and Xia Ku Cao.Gui Zhi Fu Ling Wan, an ancient Chinese formula, has been studied as the main formula in treating uterine fibroids in both China and Japan. According to a clinical observation study conducted in China,
Gui Zhi Fu Ling Wan has the function of lowering progestogen level and altering the content of smooth muscle cell progestogen receptors. (Song et al., 2006). A similar study on the use of modified Gui Zhi Fu Ling Wan on 100 patients showed that 46 cases had the mass eliminated, and 34 had it shrunk by at least half. Treatment time was 1-7 months (Yang, 1984). In another study , Gui Zhi Fu Ling Wan plus turtle shell, oyster shell, artemisia, blue citrus, dipsacus, phellodendron, astragalus, and selaginella (often used as an anticancer herb) was used. Of 60 patients treated, 43 were said to be cured and 11 markedly improved using from 1-9 months of treatment (Huang, 1982). In a Japanese study of the mechanism of action of Gui Zhi Fu Ling Wan, it was mentioned that shrinkage of uterine myoma occurred in 62% of the 110 cases treated, and that the treatments treatments alleviated excessive menstrual bleeding and resulting anemia as well as dysmenorrhea (Sakamoto et al., 1992).
As with all Chinese Medical treatments, however, the most efficacious results will result from treating the pattern. Different herbs will be added for the different patterns of the imbalance. Formulas for the treatment of underlying patterns can be divided according to the three types outlined above.
• Qi and Blood Stagnation This pattern is treated with formulas that moderate the harsh action of the attacking herbs by using herbs that tonify or supplement body’s Qi and herbs that regulate Qi and Blood simultaneous. The most commonly used formulas for this pattern are; Dang Gui Shao Yao and Ge Xia Zhu Yu Tang. A typical formula might contain individual herbs such as Sheng Di Huang , Chi Shao, Gan Cao, Huang Jing, Dang Gui, Chuan Xiong, Yan Hu Suo and Fu Ling.
• Yin Deficiency with Fire Treatment for this pattern combines attacking herbs with formulas that clear heat, supplement yin and stop bleeding. Xi Jiao Di Huang Tang, Sheng Mai San or Zhi Bai Di Huang Wan are widelyused herbal formula for this pattern. A typical formula would contain herbs such as Sheng Di Huang, Mai Men Dong, Tian Men Dong, Shui Niu Jiao, Huang Jing, Zhi Mu and Huang Bai.
• Spleen Qi Deficiency with Liver Qi Stagnation Treatment for this pattern focuses on the Spleen and nutritive Qi. Xiao Yao San is a leading formula to address this pattern. Supplementing formulas such as Gui Pi Tang or Ju Yuan Jian can also be used in addition to the attacking hers. A typical formula thus would contain herbs like Dang Shen, Huang Qi, Bai Zhu, Bai Shao, Gan Cao, Shu Di Huang and Chai Hu.
In addition to the formulas mentioned above, a wide range of formulas can be used to accomplish reduction of fibroids according to the constitution and presenting signs and symptoms of each patient. Complete resolution of fibroids has been reported several times, and substantial reduction of myoma size is apparently common in all but the largest or most aggressively growing fibroids. Treatment times are typically in the range of 1-8 months, with some lasting up to 10 months (Dharmananda, 2003).
Other Herbs for Fibroid Tumors
• Chasteberry Reduces excess estrogen, balances hormones, reduces inflammation and symptoms of PMS Other Herbs for Fibroid Tumors The following herbs are often used in naturopathic medicine in order to help shrink fibroid tumors by balancing hormone level, regulating menstruation, and reducing inflammation (Kadison, 2009).
• Red raspberry Controls excess bleeding, helps replenish lost vitamins and minerals
• Motherwort Relaxes the uterine muscles, prevents cramps, balances hormones
• Siberian ginseng Prevents heavy bleeding
• Red clover Helps the liver in metabolizing excess estrogen
• Goldenseal Reduces inflammation, promotes uterine tissue health
• Echancia Controls benign tumors and reduces inflammation
• Licorice root (Gan Cao) Reduces bloating and helps with liver detoxification
• Black cohosh (Sheng Ma) Relieves menstrual pain and menopausal symptoms, protects the liver, reduces inflammation
• Dandelion, Milk Thistle, Yellow Dock Root Help metabolize and eliminate excess estrogen
Nutritional therapy can be used to avoid developing uterine fibroids as well as to prevent fibroid tumors from getting bigger. The patient should begin a hormone-balancing diet, involving foods with low inflammation effects, low acidity, and a low glycemic load.
• Seaweeds In Chinese herbal medicine, seaweeds such as Kun Bu and Hai Zao are used to promote blood circulation and eliminate phlegm stasis. In Korea, seaweeds are known as ‘female’s food’ and often consumed before and after menstruation or childbirth. In recent researches have shown that some forms of seaweed have excellent nutritional qualities and brown seaweed in particular, has been shown to prevent the formation of blood clots, lower cholesterol and halt the growth of tumors. Studies in animals showed that a significant lowering of fats in the liver occurred when seaweed was eaten which has strengthened the belief that seaweed can be a valuable part of a good liver detoxification. In addition, when consumed daily, seaweed has advantages beyond ridding the body of heavy metal stores. It is regarded by some as a powerful ally in regard to healing and lessening the severity of fibroids (Hopkin, 2009). What to Eat
• Cold-water fish Clod-water oily fish such as salmon, herring, mackerel, anchovies and sardines are good source of omega 3 and omega 6 fatty acids. Unlike many ‘Omega 3 products’ on the market which contain only α-linolenic acid (ALA), these fishes have eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) as well as α-linolenic acid (ALA). Omega 3 fatty acids play an important role in nutritional treatment for uterine fibroids. Along with omega 6 fatty acids, EPA and DHA stimulate blood circulation, increase the breakdown of fibrin (a compound involved in clot and scar formation), reduce blood triglyceride levels, and have anti-inflammatory effect on the human body.
• Soy products Soy has been found to help shrink uterine fibroids, as they contain isoflavones and phytoestrogens which help to regulate estrogen levels in the body. High estrogen levels feed growing fibroids, while soy evens out estrogen production, eliminating fibroid feeding levels. Soy products such as tofu, miso, soymilk, or tempeh will be all beneficial.
• Legumes Beans, peas, lentils, and edamame have hormone-modulating flavonoids and can safely be eaten. Legumes are naturally low in fat and high in dietary fiber. They also are high in folate, phosphorus, potassium, iron, zinc, calcium, and selenium. Legumes have many of the B vitamins and are rich in antioxidants which can prevent cell damage. Many kinds of beans, including soybeans, are rich in saponins, an anti-inflammatory compound which helps strengthening the immune system. • Fruits, vegetables, seeds, and nuts containing omega 3 fatty acids. Fruits, vegetables, seeds and nuts are another source of omega 3 fatty acids. Flaxseed oil consists of approximately 55% ALA, and Purslane (portulaca) contains more omega-3 fatty acids, particularly ALA than any other leafy vegetable plant. Other examples of fruits, vegatables, seeds, and nuts that contain omega 3 fatty acids are: Chia (Chia sage), Kiwi, Black raspberry, Lingonberry (cowberry), Perilla (shiso), Camelina (Gold of pleasure), Hemp seeds, Pumpkin seeds, Buttternuts, Walnuts, Pecans, and Hazel nuts.
• Cruciferous vegetables Cruciferous vegetables such as broccoli, Brussels sprouts, cabbage, cauliflower, Chinese cabbage, collards, kale, mustard, radish, rutabaga, and turnip are high in vitamin C and soluble fiber and contain multiple nutrients with potent anti-tumor properties. One characteristic that sets cruciferous vegetables apart from other vegetables is their high glucosinolate content. Some glucosinolate hydrolysis products may alter the metabolism or activity of hormones like estrogen in ways that inhibit the development of hormonesensitive cancers.
• Green tea In an animal study published in 2010, scientists discovered that eight weeks of treatment with green tea extract led to a significant decrease in the volume and weight of uterine fibroids among a group of mice (Wong, 2010).
What To Avoid
• Red meats, poultry, and dairy products These acidic, inflammatory foods are sources of arachidonic acid, which can increase the inflammatory prostaglandins and other inflammatory mediators, supporting fibroid growth. Available evidence suggests that women who eat more than one serving of red meat per day have a 70% greater risk for uterine myoma, compared with women who eat the least. Women who eat more than one serving per day of green vegetables have a 50% lower risk. Avoiding the commercial meat products also reduces exposure to the added hormones in these products. Small amounts of range-fed meats can be added back as inflammation subsides. What to Avoid
• Sweets and other foods with high glycemic index These foods will raise insulin levels, increase estrogen dominance, and also support fibroid growth. It is also imperative to eat a breakfast containing good quality protein, fats, and carbohydrates in combination to avoid hypoglycemic stress–induced cortisol and epinephrine elevations, which via gluconeogenesis will deplete lean muscle and increase the tendency for insulin resistance.
• Gluten grains Especially wheat, rye, and barley contain genetically engineered gluten that is much stronger than that in the more ancient gluten grains such as spelt. These grains can increase estrogens via the cytochrome P450 3A4 enzyme system and can also affect thyroid hormone.
• Alcohol Alcohol is all right if consumed in moderation. Studies show that women consuming more than five alcoholic drinks per week have a higher risk of breast cancer. This increase is probably due to the effect of alcohol on detoxification of estrogens. • Caffeine Studies have shown that caffeine increases production of the estrogen, especially estradiol. Caffeine also interferes with the liver’s ability to metabolize excessive estrogen in the body, causing increase in serum level estrogen. Organic coffee in moderation (1 to 2 cups per day) is safe.
• Artificial ingredients, colorings, flavorings, and preservatives should be eliminated.
• Margarines and other sources of trans fatty acids are likewise unhealthy and must be avoided.
Mind Body Awareness
Body awareness exercises such as Tai Chi and Qi Gong help with meditation and visualization exercises geared to reduce blood flow in fibroids and lessen their impact. These forms of moving meditation exercises also help to move stagnated Qi, as does deep tissue massage and psychotherapeutic techniques such as bioenergetics and acupuncture.
Meditation is often recommended to the patients in order to create emotional flexibility by ‘staying in the moment’. Exercise of all kinds has been shown to reduce the harmful effects of stress. Living in the present moment, we reduce stress that comes from worrying about a possible future that may never come and from fretting about a past that cannot be changed. This stress, which raises cortisol levels and lowers dehydroepiandrosterone (DHEA) levels, contributes to estrogen dominance by ‘stealing’ progesterone to produce more cortisol. Exercises like stretching and yoga not only help maintain physical flexibility, but also promote emotional flexibility.
Another powerful technique that supports meditation and stress reduction, thereby alleviating symptoms of fibroids and reducing their growth, is visualization (Rakel, 2007).
Visualization for Blood Stasis in the Uterus
• Exercise 1, for the follicular phase. Perform this exercise daily, between the first day of menstruation until ovulation only.
o Step 1 Lay down, on your back, with your eyes closed. Relax and breathe deeply. Notice any areas of tension you feel in your body from your head to your neck, down your arms and hands, through your torso, down your abdomen, buttocks, thighs, calves and feet. Tense the tight areas in your body even more, one by one. Breathe in, inhaling deeply down into your lower abdomen. Push your stomach out as you breathe in. Focus your attention on the tension in your body, then tighten the muscles in the area even more, and relax them fully as your exhale. Exhale all the way, deflating your abdomen when you breathe out. Breathe the tension in your body out through the breath. Focus your attention on the tension, the breath, and the relaxation. When the tension in that particular part of your body is gone, move on to the next part. When you feel relaxed throughout your body, and your mind is clear, begin the visualization. Continue the deep breathing exercise, breathing deep into your abdomen and relaxing with each exhalation.
o Step 2 Now focus the breathe down into the pelvis. Breathe into your uterus. Let the uterus draw the breath in itself. Let these breaths be cleansing. The uterus has one energetic function. It is downward. It takes the blood and the breath in through the top, and lets them out downward through the bottom. Think of the uterus as a receptive, sponge-like organ. It draws in blood and energy through the breath to prepare a garden-like home for implantation. Picture a lush, green, mossy garden. With every breath in, you bring purifying energy in through the top of the uterus. With every exhalation, breathe out any impurities downward through the bottom of the uterus. Any pain, any toxins, any impurities are released downward, with each breath. You are helping to prepare these luxurious surroundings for implantation. This is a pure, flourishing, abundant home. It is open, receptive, and fertile. It cannot afford to foster toxins. Release them. When your uterus feels pure, open and receptive, you are finished.
• Exercise 2, for the luteal phase. Practice this visualization from ovulation until menstruation begins.
o Step1 Perform Step 1 as above .Practice this meditation and visualization from ovulation until menstruation begins.
o Step 2 Breathe in very deeply, and concentrate on bringing your breath from your nose and down the midline of your body, between the breasts, down the abdomen, and eventually focusing your breath down to the region two inches below your navel. This is called the Dan Tien. Let the breath energy pool here.
• Aerobic exercise Aerobic exercise consumes oxygen and helps to burn carbohydrates. This exercise is exemplified by running, fast walking, and swimming. Because carbohydrates are consumed during aerobic exercise, it is associated with improvement in insulin resistance and sugar utilization as well as hormone balance.
• Anaerobic exercise Anaerobic exercise classically uses fats as an energy source. That is why weight trainers consume medium-chain triglycerides during their workouts. Weight training also helps balance hormones such as growth hormone and testosterone. Because fat cells (adipocytes) are known to produce inflammatory mediators and estrogens, limiting them will also reduce estrogen dominance. Regular exercise of either kind has also been shown to lower the incidence of breast cancer and colon cancer (Rakel, 2007).
• Castor oil packs Applying warm castor oil on the lower abdomen 2-3 times per day to invigorate the blood, assist the lymphatic symptom and balance hormone levels.
• Rest and wear loose, comfortable clothing.
• Take warm baths (with aromatherapy if you wish).