Q: Can fibroids shrink through diet and exercise?

A: Fibroids are common noncancerous (benign) tumors that grow in the muscular layer of the uterus. Fibroids vary in size from smaller than a pea to as large as a melon. They can weigh up to several pounds. Many women with fibroids have no symptoms. In others, fibroids cause pelvic pain, abnormal bleeding, heavy menstrual periods, and pelvic pressure.

Often, the location rather than the size of a fibroid determines if it is causing symptoms. A large fibroid growing toward the outer wall of the uterus may cause no problems. On the other hand, a small fibroid growing within the cavity of the uterus may cause troublesome symptoms.

The goal in treating someone with fibroids is not simply to shrink the tumor but to relieve the symptoms of pain and bleeding. Many options are available. Choosing the most appropriate treatment is done on an individual basis in consultation with a doctor familiar with your condition and medical history.

A healthy diet and regular exercise are important parts of a good health plan, but there is no evidence that they will directly affect the growth or symptoms of fibroids.

The cause of fibroids is unknown, although they tend to grow in association with high estrogen levels. Fibroids often grow in the estrogen-rich environment during pregnancy and they often shrink after menopause when estrogen drops.

Drugs called GnRH-agonists decrease estrogen levels. They are used to shrink fibroids and control symptoms. Unfortunately, the tumors grow back and symptoms return as soon as the drug is stopped. And this medication cannot be used long term because of side effects.

Another treatment for fibroids is uterine artery embolization. A small tube is passed into the blood vessel that supplies the fibroid with nutrients. Material is injected to block the blood flow. This causes the tumor to shrink.

A new treatment is focus ultrasound ablation. Fibroid cells are destroyed with high-energy ultrasound waves.

Fibroids can also be removed surgically. Often this is done with minimally invasive techniques. These techniques have lower risk and shorter recovery times compared with traditional surgery.