Since getting her first period in her early teens, Nina Lemtir had dreaded the debilitating pain that came with it each month.
At school, she would sometimes bleed so heavily that her clothes – and even the chair she was sitting on – would be soaked.
But for years, doctors told her this was normal – and she believed them.
It wasn’t until Nina suffered two miscarriages in her early 30s that doctors discovered the cause of her pain and infertility: noncancerous growths in the walls of her uterus – including one the size of a soccer ball.
Known as fibroids, these growths affect as many as eight in 10 women during their lifetime, although few cases become as severe – or the growths as large – as Nina’s.
In fact, most women with fibroids never realize they have them and experience no symptoms at all.
But for others, the growths can cause debilitating symptoms, including heavy bleeding, severe abdominal pain and fertility problems.
For decades, the main treatment for troublesome fibroids was surgery.
Since beginning her period in her early teens, Nina Lemtir dreaded the debilitating pain it brought each month
Smaller growths can often be removed through a procedure called a myomectomy, in which the fibroids are cut from the uterine wall and removed while leaving the uterus intact.
But for some women, the growths are so large by the time they are discovered that doctors may recommend a hysterectomy – surgery to remove the uterus.
And in more than half of patients who undergo a myomectomy, fibroids will regrow or increase in size, potentially requiring further treatment or surgery.
Today, more than 30,000 hysterectomies are performed because of fibroids in the UK each year.
Nina, a lifestyle strategist from Coventry, England, had always wanted to become a mother and was desperate to avoid a hysterectomy.
‘I was told to be prepared for my uterus to be removed if the damage was too severe,’ she said.
‘I had never even heard of fibroids before my diagnosis. But I knew I wanted children, so I begged them to remove only the two largest, which were roughly the size of a football and a grapefruit. I told the doctors I could figure out the rest.’
Nina’s surgeons were able to remove the two largest fibroids without taking out her uterus. But she was still left with around six growths, some as large as apples and oranges.
Yet she kept her word. Today, Nina, now 41, says she hasn’t just stopped her remaining fibroids from growing – they have actually shrunk to the size of peas, while some have disappeared altogether.
She’s also now a mom of three, having conceived naturally and given birth without complications.
And she says it wasn’t due to any breakthrough medication.
Instead, Nina credits changes to her diet and lifestyle – including cutting out alcohol and processed foods and eating more fatty fish and vegetables – with transforming her health and ending the debilitating symptoms she once suffered.
Today, Nina, now 41, hasn’t just prevented her fibroids from growing further – she’s actually shrunk them to pea-sized growths, with some disappearing altogether
And experts say Nina is not an anomaly.
‘Lifestyle changes were overlooked for a long time – but now we have evidence that they can make a big difference,’ says Dr Pandelis Athanasias, an OB-GYN at the London Women’s Centre.
‘Nutrition won’t be as effective as surgically removing a fibroid, but it can slow their growth and help with symptoms.
‘And there’s now some evidence that lifestyle changes and supplements may even help reduce the size of fibroids. For women with small growths that will gradually get bigger, making these changes early could help them avoid major surgery in the future.’
Made up of muscle and fibrous tissue, fibroids are driven by hormones including estrogen and progesterone.
They can vary dramatically in size – from as small as a pea to as large as a watermelon.
Some women will have just one fibroid, while others, like Nina, may develop numerous growths.
And while experts don’t know exactly why some women experience severe symptoms and others don’t, age, ethnicity and genetics are all believed to play a role.
Fibroids are most common from a woman’s 20s through her 40s, when the body produces higher levels of estrogen. After menopause, when estrogen levels fall, fibroids often shrink or stop growing, experts say.
Black women have the highest rates of fibroids and tend to develop them at younger ages, with 60 percent affected by age 35.
Weight may also play a role. Being overweight or obese has been linked to a higher risk of developing fibroids because excess body fat – particularly around the abdomen – can alter hormone levels, including increasing estrogen, as well as promote inflammation.
Despite how common they are, research into fibroids has only really accelerated in recent years, says Dr Christine Ekechi, an OB-GYN at Imperial College Healthcare and spokesperson for the Royal College of Obstetricians and Gynaecologists.
Historically, fibroids received relatively little research attention because they are noncancerous and rarely life-threatening – contributing to limited research funding and a heavy reliance on hysterectomies as a treatment, she explained.
But new medications, coupled with a shift away from major surgery, have given women with fibroids more treatment options over the past decade.
Venus Williams has previously opened up on her battle with fibroids and claimed she was misdiagnosed
Actress Lupito Nyong’o shared her condition publicly for the first time last year, and said that speaking out has ‘made me feel less alone’ as it’s enabled her to connect with other women going through the same thing
Medications such as tranexamic acid and hormonal birth control can be used to reduce heavy bleeding, while drugs known as GnRH agonists – which suppress the body’s production of estrogen – can help shrink fibroids.
Yet while hugely beneficial for some women, some treatments can interfere with fertility, says Dr Athanasias.
As a result, he says, some of the most intriguing research now focuses on whether diet and lifestyle changes could also help women manage fibroids.
‘We know that fibroid symptoms and growth are influenced by estrogen and inflammation – and there’s increasing evidence that there are supplements women can take and dietary changes they can make that may help address this,’ he said.
Research has found a link between vitamin D deficiency and an increased risk of uterine fibroids, with studies consistently showing that women with fibroids tend to have lower levels of the nutrient – which the body produces in response to sunlight and which is also found in some foods.
A 2021 clinical trial found that vitamin D supplements could significantly reduce fibroid volume and help prevent further growth.
And a randomized, double-blind study published in 2022 found that a year of vitamin D supplementation reduced the risk of fibroids returning by 50 percent.
Omega-3 fatty acids – found in nuts, seeds and fatty fish such as salmon and sardines – may also help manage fibroids by reducing inflammation, says Dr Athanasias.
Studies have found an association between higher intake of polyunsaturated fatty acids – including those found in fish – and a lower risk of developing fibroids.
Finally, green tea extract, which is available as a supplement, has also shown promise. In one clinical trial, women who took the extract experienced a reduction in fibroid volume of more than 30 percent.
And these supplements are widely available and relatively inexpensive.
Vitamin D and omega-3 supplements can be found for just a few cents per pill at major US pharmacies, while green tea extract is widely sold online and in health food stores.
A 2021 clinical trial found that women taking vitamin D supplements could significantly reduce the volume of their uterine fibroid and prevent their growth, while green tea extract has been shown in clinical trials to reduce the volume of fibroids by more than 30 per cent
‘All of these supplements help in different ways, either with the metabolism of estrogen, by reducing inflammation or by directly working against the fibroids,’ said Dr Athanasias.
‘But it’s also important for fibroid patients to try to avoid blood sugar spikes, which cause the body to produce insulin, affecting how the body metabolizes estrogen and potentially encouraging fibroid growth.’
To do this, he recommends focusing on high-fiber carbohydrates that are digested more slowly and produce a more gradual rise in blood sugar, such as beans and whole grains including oats, quinoa and barley.
‘Include greens – like spinach, kale, Brussels sprouts or cabbage – with every meal, together with a protein [such as meat, fish or tofu] and a carbohydrate, as well as plenty of berries, which have anti-inflammatory properties,’ Dr Athanasias explained.
But there are also foods that women with fibroids should consider cutting back on, says Dr Ekechi.
‘Reducing your intake of sugary foods like chocolate and candy and refined carbohydrates like white bread and pasta is really important for fibroid patients,’ she said.
‘These can promote estrogen spikes, which could potentially cause an increase in fibroid growth.
‘There’s also a lot of attention around red meat, as there’s some suggestion that it can affect estrogen and increase the risk of fibroids. I often advise women to cut back on it, but not eliminate red meat from their diet completely.
‘Women with fibroids often have anemia – or low iron levels – and cutting out red meat can exacerbate this. Instead, it’s more about moderation.’
The same is largely true of alcohol, she says. Regular alcohol consumption has been linked to hormonal changes that may affect fibroid growth and symptoms.
‘Reducing it – not necessarily cutting it out completely – will help women’s overall well-being,’ she said.
It’s important to remember, however, that while these dietary changes may help women with fibroids, they are unlikely to be a cure on their own, adds Dr Ekechi.
‘Dietary changes in and of themselves will not shrink fibroids from four inches to nothing, and they won’t stop a woman who is genetically predisposed to fibroids from getting them,’ she said.
‘The women who are most likely to see a significant benefit are those with very small fibroids to begin with, or those who want to prevent surgically removed fibroids from returning.’
For Nina, however, the dietary changes were life-changing.
In fact, she now works as a nutrition coach for other women struggling with the same issues she did, helping them make the diet and lifestyle changes that she says transformed her life through her Instagram account.
‘I’m not super strict with my diet – just focused,’ she said. ‘I haven’t cut out red meat entirely. I just try to eat more plant-based foods and less animal protein, as well as more fatty fish and generally more fresh, Mediterranean-style foods.’
Nina avoids processed foods such as frozen meals and fast food, choosing instead to cook at home. She has also stopped drinking alcohol and dramatically reduced the amount of refined sugar she eats.
‘It’s been 10 years since my diagnosis, and I now have no issues from the tiny fibroids that are still there – my life is so different from my 20s,’ she said.
Dr Athanasias is similarly optimistic.
‘I’m a surgeon – I operate,’ he said. ‘But surgery is an answer together with nutritional and lifestyle therapies.
‘Fifteen years ago, it was just surgery. But now, we need to take a more holistic approach. And from my patients, I can see that makes a big difference.’
