Updated: Oct 7, 2020
Fibroid specialist Dr. Michael Lalezarian discusses how to shrink fibroids, covering non-surgical treatments, dietary supplements, and medications that can help you find relief from fibroids without having major surgery.
If you’ve recently been diagnosed with fibroids, you now face a number of choices around how to best manage them. You may have been offered contraceptive medications to help with bleeding symptoms, or it might be that your fibroids are troublesome enough that your physician has suggested a major surgery to remove your fibroids (myomectomy) or your entire uterus (hysterectomy).
The reality of a major surgery, especially a hysterectomy, leaves many women asking if there are less drastic treatments that shrink fibroid and relieve symptoms.¹ We’re happy to inform you that non-surgical procedures, dietary supplements, and medications are available that may help you find relief from fibroids. To help you navigate your options, we review each of these treatments and assess how effective they are in shrinking fibroids.
Non-Surgical Procedure That Shrinks Fibroids
Uterine Fibroid Embolization (UFE)
What is UFE? – Uterine fibroid embolization (UFE, pronounced ‘you-fee’) is a non-surgical procedure that shrinks fibroids by cutting off their blood supply. We chose to cover UFE first in this review because it provides lasting relief from fibroid symptoms and the procedure is clinically proven to shrink fibroids.²
How Does UFE Shrink Fibroids? – The UFE procedure involves the injection of micro sized beads into the arteries that feed the fibroids. Fibroids rely on their own blood supply from the uterine arteries to maintain their size, so cutting off their blood supply causes them to ‘starve’ and shrink over time.
The UFE Procedure – The UFE procedure is performed by an interventional radiologist. The interventional radiologist uses imaging techniques to navigate a small tube (called a catheter) from an artery in the leg or the arm into the uterine arteries where the micro beads are injected. Because UFE is a non-surgical procedure, there are no major incisions and no cutting, which drastically reduces recovery time compared to surgical approaches. The procedure usually takes no longer than an hour, and usually requires an overnight hospital stay. See UFE in action.
How Long Does It Take Fibroids to Shrink after UFE? – Fibroids begin to shrink immediately after the UFE procedure, and continue to shrink throughout the next year. Many women note improvement in their bleeding symptoms immediately following the procedure, but it can take up to 3 months for fibroids to shrink enough for women to notice major symptom improvements.
On average, fibroids have been observed to shrink by 40% to 75% in the first 6 months following UFE.³ One study followed 200 women that underwent UFE and looked at their symptoms 3 months after the procedure. 87% of women noticed an improvement in their menstrual bleeding, and 93% of women noticed and improvement in pelvic pain and pelvic pressure symptoms.²
Dietary Supplements That May Shrink Fibroids
A few dietary supplements have been studied for the treatment of uterine fibroids, including green tea extract and a specific type of Vitamin D supplement called 25-OH-D3. Laboratory testing and early human studies have shown encouraging results that suggest these dietary supplements may prevent and even shrink fibroids, but we feel that it’s important to emphasize that the clinical data backing these supplements is in its early stages, and these findings are preliminary at best.
Green Tea Extract (EGCG) May Shrink Fibroids
What is Green Tea Extract? – Green tea extract, also called epigallocatechin gallate or EGCG, is available in several dietary supplements. EGCG belongs to a class of compounds called catechins that are found in high amounts in tea leaves, berries, and cocoa. In the biology lab, EGCG has exhibited anti-inflammatory, antioxidant, and antiproliferative effects, all of which may be relevant to shrinking fibroids.⁴
Do Green Tea Extract Supplements Shrink Fibroids? – There has only been one clinical study on the effects of green tea extract supplements on fibroids. The study group consisted of 39 women with symptomatic uterine fibroids, 33 of which completed the study. Two thirds of the women (22) received 800 mg/day of green tea extract, and the other third (11) received a placebo. Green tea extract intake helped shrink fibroids by over 30% over the course of 4 months. On the other hand, fibroids grew by nearly 25% in the placebo group.⁴
Study Limitations – Despite the small sample size, this was a rather good-quality study in that participants were randomized to their respective groups and blinded to which treatment they received. With that said, it is important to keep in mind that this was only a pilot study and may have produced an exceptional result.
Vitamin D (25-OH-D3) May Shrink Fibroids
What is Vitamin D? – Vitamin D is a fat-soluble vitamin that helps your body use calcium, magnesium, and phosphate. Vitamin D is also responsible for a number of other biological functions that keep you healthy, and appears to play an important role in preventing fibroid growth.
Vitamin D Deficiency in Women with Fibroids – The relationship between Vitamin D deficiency and fibroids is a relatively new area of study in medical science. A recent study has shown that women that are vitamin D deficient are more likely to have fibroids than women that have sufficient vitamin D levels.⁵ In the biology lab, vitamin D halts the growth of fibroid cells, promotes fibroid cell apoptosis, and has been shown to shrink fibroid size by nearly 75% in animal tests involving rats.⁶
Do Vitamin D Supplements Shrink Fibroids? – Vitamin D supplements 25-OH-D3 have been clinically tested in one study of 108 women with “small burden” uterine fibroids, meaning that the women in this study had less than 5 fibroids, each less than 50 mm in diameter, and did not have severe fibroid symptoms that required immediate medical attention. The study found that women who did not take vitamin D supplements experienced an average fibroid volume growth of 40% in one year of follow-up, whereas women that regularly took vitamin D supplements experienced no fibroid growth during the same timeframe.⁷
Study Limitations – Vitamin D supplements did not shrink fibroids in this study, but their halting effect on fibroid growth and progression are encouraging. Larger fibroids, more study participants, or longer follow-up might reveal that vitamin D supplements also shrink fibroids.
Curcumin May Shrink Fibroids
What is Curcumin? – Curcumin is another substance that may help to prevent or shrink fibroids. Curcumin is a yellow substance produced by some plants such as ginger. Curcumin is known to have antioxidative, anti-inflammatory, and anti-cancer activities, and multiple scientific groups have studied the effects of curcumin on uterine fibroid cells. In the biology lab, curcumin appears to prevent the multiplication of fibroid cells and hinders the production of extracellular matrix that assists in the formation of fibroids.⁸⁻⁹
Do Curcumin Supplements Shrink Fibroids? – Although curcumin supplements are available, readers should be aware that curcumin intake has not yet been studied as a treatment for fibroids in humans.¹⁰ In other words, curcumin supplements have not been tested and may actually have no beneficial effect on fibroids.
Medications That May Shrink Fibroids
Women with fibroids should be aware that some medical prescriptions for uterine fibroids are not necessarily intended to shrink fibroids. Currently, GnRH agonists are the only medications approved in the United States that are prescribed with the goal of shrinking fibroids. Other medications - DMPA, progestin-releasing IUDs, and birth control pills - are prescribed mainly to help provide relief from bleeding and pain-related symptoms, but have shown mixed results when it comes to shrinking fibroids. It’s also important to understand that DMPA, progestin-releasing IUDs, and certain types of birth control pills have only been tested in women with small fibroids; their effects may be greater or smaller in cases of larger fibroids.
Medications that are used to manage fibroid symptoms work by altering the balance of hormones in your body. By consequence, they tend to have a number of side effects that some women may find intolerable. We encourage our readers to consult with a physician prior to taking any new medication.
Gonadotropin-Releasing Hormone (GnRH) Agonists
What are GnRH Agonists? – GnRH agonists are FDA approved drugs that are prescribed to prepare women for myomectomy surgery. They are administered by injection or in a nasal spray form.
Do GnRH Agonists Shrink Fibroids– GnRH agonists shrink fibroids, shrink the uterus, alleviate heavy menstrual bleeding, and help with anemia. However, the benefits of GnRH Agonists reverse when women stop taking them.¹¹
Side Effects – GnRH agonists are very effective, but also carry a number of significant side effects. GnRH agonists mimic the natural GnRH decapeptide hormone that is released by the hypothalamus to stimulate the secretion of the gonadotropin hormones. When taken, GnRH agonists cause a massive release of gonadotropin hormones that then drastically reduces as the body becomes desensitized. These alterations in hormone levels cause uncomfortable hot flashes and result in significant bone mineral density loss, which is why GnRH treatment is limited to just 6 months and is typically only prescribed to prepare the uterus for myomectomy surgery.¹¹
Depot-Medroxyprogesterone Acetate (DMPA)
What is DMPA? – DMPA (trade name Depo Provera) is a hormonal contraceptive that works by reducing the body’s estradiol (a type of estrogen) and progesterone levels, and is sometimes prescribed to relieve bleeding and painful periods. It is administered by intramuscular injection every 90 days.¹¹ Some early evidence suggests that DMPA may also help to shrink fibroids, and large observational studies suggest that DMPA use can help prevent fibroids altogether.
Does DMPA Shrink Fibroids? – Only one study has looked at the effects of DMPA on fibroid size. This was a very small pilot study of 20 women that observed a 33% reduction in fibroid volume and a 48% reduction in uterine volume over the course of 6 months.¹² These results suggest that DMPA may shrink fibroids, however this is a very early, low-quality evidence by pharmaceutical standards.
DMP and Fibroid Prevention – A handful of observational studies have looked at the relationship between long-term DMPA use and fibroids specifically in African American women. These studies have found that women with a history of taking DMPA were much less likely to be diagnosed with fibroids than women that had never taken DMPA.¹¹ Readers should be aware that the nature of these studies does not definitively establish cause and effect between DMPA use and fibroid prevention, but they do suggest that DMPA may help to prevent fibroids.
Progestin-Releasing Intrauterine Device (IUD)
What is a Progestin-Releasing IUD? – An IUD is a T-shaped device that is inserted into the uterus to provide birth control. A progestin-releasing IUD differs from a copper IUD in that it has a reservoir of the synthetic hormone levonorgestrel (LNG) that is slowly released inside the uterus. In addition to birth control, a progestin-releasing IUD may be prescribed to help manage heavy bleeding and painful periods in women with fibroids, endometriosis, adenomyosis, or endometrial hyperplasia.¹¹
Do Progestin-Releasing IUDs Shrink Fibroids? – Some studies have reported that a progestin-releasing IUD reduces fibroid size while others have shown that the device has no effect on fibroid size. Because of these inconsistent findings, more recent literature has concluded that these devices do not significantly shrink fibroids.¹³⁻¹⁴
Progestin-Based Oral Contraceptives (Birth Control Pills)
Do Oral Contraceptives Shrink Fibroids? – Progestin-based oral contraceptives (birth control pills) are sometimes prescribed to women with symptomatic uterine fibroids to help with heavy bleeding and period pain. Although many studies have looked at the effects of birth control pills on fibroid size, data that shows a benefit is inconsistent. The general scientific consensus is that oral contraceptives do not significantly shrink fibroids,¹⁵ but they may help to prevent the initial development of fibroids.¹¹
There are treatments available that shrink fibroids and do not require you to have a major surgery.
Uterine Fibroid Embolization (UFE) - UFE is a minimally invasive procedure that has been in practice for over 20 years, and has accumulated a wealth of clinical evidence that supports how effective it is in shrinking fibroids and relieving fibroid symptoms.³
Dietary Supplements - Researchers have only recently started looking at the effects of green tea extract and Vitamin D dietary supplements in women with fibroids. Results so far are encouraging in women with especially small fibroids, but early data is rarely definitive and more studies are needed.
Medications - Hormone-modifying medications such as GnRH agonists, DMPA, and progestin-based contraceptives may be prescribed to provide relief from bleeding and painful periods. GnRH agonists are very effective in shrinking fibroids, but are typically only used in women to prepare for fibroid removal surgery because of their harmful side effects. Whether or not DMPA shrinks fibroids is uncertain, and the current evidence for progestin-based contraceptives suggests that they do not have a significant impact on fibroid size.
About the Author
Dr. Michael Lalezarian is a practicing interventional radiologist with the Fibroid Specialists of University Vascular in Los Angeles, CA. In addition to patient care, Dr. Lalezarian teaches and supervises medical students, residents, and fellows as a full time teaching Professor in the Department of Radiology at UCLA. He is regarded as an expert in uterine fibroid embolization. You can view Dr. Lalezarian's full bio here.
This blog post was written with research and editorial assistance from OnChart™.
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