Uterine fibroids are the most common benign condition among women of reproductive age. Most fibroids develop silently, without symptoms, and are discovered incidentally during general health check-ups, routine gynecological exams, or abdominal ultrasounds.

Many believe soy causes fibroids to grow rapidly because the uterus is influenced by estrogen hormones. Soy contains phytoestrogens, plant compounds structurally similar to estrogen. However, phytoestrogens are not identical to the body's endogenous estrogen. The biological effect of phytoestrogens is much weaker than true estrogen. Currently, there is no clear evidence that eating or drinking soy accelerates uterine fibroid growth.

The exact cause of uterine fibroids and their growth remains undetermined. However, several related factors contribute to fibroid development, most commonly changes in estrogen and progesterone hormone levels. Female hormones are highly active between the ages of 20 and 40, which is why uterine fibroids typically develop most between 20 and 45 years old. During pregnancy, when hormone levels are high, fibroids can grow rapidly. Conversely, after menopause, fibroids often shrink due to declining hormone levels.

Additionally, fibroid development is linked to genetic factors; the risk is higher if a mother or sister has fibroids. Women aged 30-50 are more susceptible, and those who are overweight or obese have a higher risk due to adipose tissue increasing estrogen metabolism. Women who have never given birth or who have children later in life also face an increased risk due to prolonged exposure to hormonal cycles. Pregnant women cease ovulation for 10 to 24 months (depending on the individual case), which means the body has a resting period, halting hormone production.

Dr. CKI Nguyen Gia Hoang Anh advises young women on routine gynecological exams. *Photo: Tam Anh General Hospital*

For Mai Ngan, at 32 years old, with a fibroid that has tripled in size, a specialist doctor needs to monitor and assess its growth rate over time, determine its location (submucosal, intramural, subserosal), and any accompanying symptoms. This increase in size does not immediately imply danger, but close monitoring is crucial to prevent further enlargement, which can lead to complications such as: prolonged or heavy menstrual bleeding, and compression of abdominal organs. Fibroids can also cause infertility and recurrent miscarriages.

Mai Ngan should visit a hospital for an examination, bringing both old and new ultrasound results for the doctor to compare. Regarding diet and lifestyle, women with uterine fibroids should increase their intake of green vegetables and fresh fruits, prioritize plant-based protein, and limit red meat, organ meats, and foods high in preservatives. Soy and soy products can be consumed in moderation (one to two servings per day). High-dose phytoestrogen supplements should not be used without a doctor's recommendation.

Dr. CKI Nguyen Gia Hoang Anh

Department of Obstetrics and Gynecology

Tam Anh General Hospital - District 8