The Evolving Role of Natural Compounds in the Medical Treatment of Uterine Fibroids

Abstract

Uterine fibroids (UFs) remain a significant health issue for many women, with a disproportionate impact on women of color, likely due to both genetic and environmental factors. The prevalence of UFs is estimated to be approximately 70% depending on population. UF-derived clinical symptoms include pelvic pain, excessive uterine bleeding, gastrointestinal and voiding problems, as well as impaired fertility. Nowadays numerous methods of UF treatment are available—from conservative treatment to invasive surgeries. Selecting an appropriate treatment option should be individualized and adjusted to the patient's expectations as much as possible. So far, the mainstay of treatment is surgery, but their negative impact of future fertility is clear. On the other hand, emerging new pharmaceutical options have significant adverse effects like liver function impairment, hot flashes, bone density loss, endometrial changes, and inability to attempt conception during treatment. Several natural compounds are found to help treat UFs and relieve their symptoms. In this review we summarize all the current available data about natural compounds that may be beneficial for patients with UFs, especially those who want to preserve their future fertility or have treatment while actively pursuing conception. Vitamin D, epigallocatechin gallate, berberine, curcumin, and others are being used as alternative UF treatments. Moreover, we propose the concept of using combined therapies of natural compounds on their own or combined with hormonal agents to manage UFs. There is a strong need for more human clinical trials involving these compounds before promoting widespread usage.

Nutrition in Gynecological Diseases: Current Perspectives

“…The annual costs attributed to UFs range between $5.9 and $34.4 billion per year in the United States alone and hundreds of billions worldwide [ 86 ]. Although UFs are benign tumors, they can cause a myriad of symptoms and outcomes, including pelvic pain, abnormal uterine bleeding, bladder dysfunction, and even infertility [ 87 ]. Despite the high morbidity and cost associated with UFs, the exact pathophysiology is not completely delineated [ 88 ], yet there are theories and reports of associated risk factors.…”

“…The authors found that Alba and Romina cultivars presented the best results: they decreased collagen 1A1, fibronectin, versican, and activin A mRNA expression in UF cells [ 112 ]. In vitro studies have shown that curcumin, which is abundantly found in turmeric, prevents fibroid growth as it inhibits UF cell proliferation by regulating the apoptotic pathway [ 87 ]. Isoliquiritigenin, which is abundantly found in liquorice, and soybean have been reported to induce growth inhibition and apoptosis of UF cells [ 114 ].…”

“…Lower concentrations (≤1 μg/mL) stimulated proliferation, whereas higher concentrations (≥10 μg/mL) significantly inhibited proliferation, decreased proliferating cell nuclear antigen (PCNA), and increased apoptosis of both myometrial and leiomyoma cells. Finally, resveratrol, found in mulberries, peanuts, and grapes, is shown to be inversely associated with the proliferation of fibroids also via inducing apoptosis of UF cells in vitro [ 87 ].…”

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“…Usage of plant products such as leaf, bark, fruits, roots, etc. is a very common practice since ancient time in the field of medicine 9,[39][40][41][42][43][44][45][46][47] .…”

Herbal Medicine in Uterine Fibroid

“…Nonetheless, there is still no significant clinic evidence available so far. Therefore, it is highly recommended to obtain more clinical trials utilizing these compounds before endorsing widespread usage [5].…”