Oral supplementation to treat uterine fibroids

A prospective study has concluded that women of childbearing age with uterine fibroids (UF) who desire to preserve fertility benefit from the combined oral supplementation of vitamin D, epigallocatechin gallate (EGCG) and vitamin B6.

The supplementation was found to reduce the volume of UFs and improve patients' quality of life, without side effects.

“In women of childbearing age, minimally invasive procedures or alternative medical treatments are preferred, avoiding radical abdominal surgery,” wrote the Italian authors in the journal European Review for Medical and Pharmacological Sciences.

The study enrolled 95 women with UFs who were referred to Sandro Pertini Hospital of Rome between April and December 2020. Inclusion criteria were women aged 18 or older within childbearing age and at least one UF with a diameter less than 4 cm detected by vaginal and abdominal ultrasound, along with a fibroid color score between 1 (absence of vascularization) and 2 (peripheral vascularization).

Patients were divided in 2 groups: 41 women were treated daily with 2 tablets of 25 μg vitamin D + 150 mg EGCG + 5 mg vitamin B6 for 4 months; the other 54 women received no treatment (control group).

The total volume and vascularization of UFs were analyzed via ultrasonography.

The treated group at 4 months achieved a significant reduction of 37.9% in total UF volume: from a mean value of 20.55 cm³ at baseline to 12.65 cm³.

The treated group also had a significant reduction in peripheral vascularization: 36.3% pretreatment vs. 28.6% after treatment.

In contrast, the control group had an increase of 5.5% in total UF volume and an increase of 5.5% in peripheral vascularization.

Pelvic pain and bleeding were evaluated as well. In the treated group, the visual analogue scale (VAS) median value improved from 4 at baseline to 2 after treatment (P = .03), whereas the control group showed a value of 4 at both intervals.

Heavy bleeding was reported by patients in both groups, with more of a decrease in the treated group, although the reduction was not statistically significant (P = .09).

The treated group also reported a significant improvement in the questionnaire score for the Short Form Health Survey (SF-36) (mean score pretreatment of 61.86 vs. 80.77 post-treatment) (P < .001).

Likewise, the Patient Global Impression of Improvement (PGI-I) questionnaire revealed a successful result in 85.4% of treated women, with 73.2% stating “very much better” and 12.2% “much better.”

Among smokers treated, there was a 38.49% decrease in total UF volume, which was similar to the entire sample of treated women.

Treated women reported no side effects during the 4 months of evaluation and the supplementation was well tolerated by all.

“Thus, this supplementation may represent a valid alternative to the classic ‘wait and see’ approach and, at the same time, an adjuvant treatment that could be administered along with pharmacological therapies, even before surgery to reduce the occurrence of possible complications,” wrote the authors.

The next step is to acquire a better understanding of how the 3 natural compounds work together synergistically against UFs.

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Reference

  1. Miriello D, Galanti F, Cignini P, et al. Uterine fibroids treatment: do we have new valid alternative? Experiencing the combination of vitamin D plus epigallocatechin gallate in childbearing age affected women. Eur Rev Med Pharmacol Sci. 2021;25(7):2843-2851. doi:10.26355/eurrev_202104_25537