A 50-year-old woman came to my practice seeking an alternative to surgery. For approximately five years, she had been using continuous hormonal contraception to suppress menstruation due to the presence of five large uterine fibroids located in different layers of the uterus (subserosal and intramural fibroids), associated with very heavy menstrual bleeding whenever she discontinued the medication.
In addition to the bleeding, she suffered from several symptoms that significantly affected her quality of life: lower abdominal pain and pressure, constipation, persistent bloating, marked fluid retention, edema, and abdominal obesity. Her gynecological evaluation indicated a clear surgical recommendation; however, she wished to explore other options before undergoing an operation.
Following a comprehensive assessment, we decided to discontinue hormonal contraception and initiate an integrative treatment plan aimed at reducing systemic inflammation, optimizing hormonal balance, and supporting her transition into menopause.
The treatment included:
An individualized anti-inflammatory nutrition plan.
Regular meal timing, avoiding constant snacking between meals.
Bioidentical hormone therapy, initially with micronized progesterone and later the addition of low-dose transdermal estradiol to address hot flashes, severe fatigue, and other symptoms associated with the menopausal transition.
Personalized supplementation based on laboratory findings, including vitamin D, sulforaphane, DIM (diindolylmethane), berberine, coenzyme Q10, omega-3 fatty acids, and B-complex vitamins.
Approximately three months after starting treatment, her menstrual cycle returned. The first period was relatively heavy, as expected after years of hormonal suppression, but subsequent cycles became regular and of normal intensity.
Over the following months, the patient experienced significant clinical improvement. Abdominal bloating gradually decreased, bowel function improved, fluid retention diminished, and she lost a considerable amount of abdominal volume. She also reported a marked increase in energy levels, resolution of persistent fatigue, and substantially improved sleep quality.
After ten months of follow-up, a transvaginal ultrasound revealed a reduction in the size of the uterine fibroids and a normal-appearing endometrium without pathological thickening. The combination of clinical and ultrasound findings led to a reassessment of the need for surgery, and the previous surgical indication was no longer considered necessary.
This case highlights how an integrative approach—combining nutritional interventions, hormone optimization, correction of nutritional deficiencies, and individualized care—may significantly improve quality of life in some women during perimenopause. While every patient requires a personalized evaluation and results cannot be generalized to all cases of uterine fibroids, integrative medicine may offer valuable tools alongside conventional gynecological care.
The current goal is to continue supporting the patient throughout her menopausal transition, maintaining her well-being, monitoring the evolution of the fibroids, and helping her reach menopause in the healthiest and most comfortable way possible.
Disclaimer: This is an individual clinical case. The outcome described does not guarantee similar results in other women with uterine fibroids. All treatment decisions should be made on an individual basis and under appropriate medical supervision.
Me alegra que te haya gustado. En inglés queda muy profesional y tiene un tono adecuado para un blog médico o de medicina integrativa.