Uterine fibroids are exceedingly common among women world-wide causing as we all know, bleeding and pain and may cause infertility or pregnancy complications. Unfortunately, most of the current treatments for this condition are highly technical and costly and are thus not available globally to the majority of women. In resource poor communities these treatments are simply too expensive and/or involve highly trained medical personnel and complex equipment. Some of these therapies are not paid for by medical insurance in countries with sophisticated medical care, thus limiting utilization to wealthy individuals. Treatment in the form of oral medication often has undesirable side effects and may not be safe for long term utilization over the necessary years needed during a women’s complete childbearing life. Thus, there is a need for treatments that are available to all women everywhere that are safe, effective and inexpensive. Vitamin D deficiency has been shown in numerous epidemiology studies to be associated with fibroid growth. Green tea, contains epigallocatechin gallate, a substance that has been shown in-vitro to decrease fibroid growth. These are readily available and inexpensive substances. A recent publication in the European Review of Medical Pharmacology by Porcaro and colleagues demonstrates that the combination of Vitamin D and epigallocatechin gallate is a potential cost-effective treatment that would be extremely helpful for women with uterine fibroids and I note especially helpful for those in resource poor communities. They reported that 30 subjects treated with this combination had a 34.7% decrease in fibroid size compared to 6.9% in 15 untreated women. After the Italian government stopped the use of Ulipristal Acetate (UPA) Tinelli and colleagues followed woman who then utilized Vitamin D and epigallocatechin gallate and report this combination of natraceuticals was beneficial suggesting that providers treating women with uterine fibroids should consider this non-invasive treatment. Vergara and colleagues have published a report of the mechanism of action of vitamin D and its effects in uterine fibroids. Their conclusion is that while the clinical studies so far are positive, large randomized clinical trials are necessary to demonstrate efficacy. As a woman physician-scientist with great interest in the need to find cost-effect easy to administer treatments for fibroids, I sincerely hope that such studies will be funded in the future.
By Phyllis C. Leppert
Suggested reading:
Porcaro G., Santamaria A., Giordano D., Angelozzi P. Vitamin D plus epigallocatechin gallate: A novel promising approach for uterine myomas. Eur. Rev. Med. Pharmacol. Sci. 2020;24:3344–3351. doi: 10.26355/eurrev_202003_20702.
Tinelli A, Gustapane S, D'Oria O, Licchelli M, Panese G. Nutraceuticals in fibroid management after ulipristal acetate administration: An observational study on patients' compliance. Int J Gynaecol Obstet. 2021 Apr 2. doi: 10.1002/ijgo.13692. Epub ahead of print. PMID: 33797759
Vergara D, Catherino WH, Trojano G, Tinelli A. Vitamin D: Mechanism of Action and Biological Effects in Uterine Fibroids. Nutrients. 2021 Feb; 13(2): 597.Published online 2021 Feb 11. doi: 10.3390/nu13020597
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