Uterine fibroids affect up to 70–80% of women by age 50, and are a leading cause of heavy bleeding, pelvic pain, and hysterectomy. They are far more common in industrialised societies than in hunter-gatherer populations. The difference, evolutionary medicine suggests, is in how many menstrual cycles women now experience.
The oestrogen accumulation problem
Women in ancestral environments had roughly 100–160 menstrual cycles in their lifetimes — pregnancy, extended breastfeeding, and earlier menopause dramatically reduced exposure to cyclic oestrogen. Modern women have approximately 400–450 cycles. This three-fold increase means the uterine muscle is exposed to oestrogenic stimulation on a scale our bodies never evolved for.
Fibroids are oestrogen-dependent: they grow in response to oestrogen and regress after menopause. The dramatic increase in lifetime oestrogen exposure — compounded by environmental oestrogens in plastics, pesticides, and personal care products — creates conditions in which uterine smooth muscle cells are chronically overstimulated.
Fibroids and the musculoskeletal system
Large fibroids create mechanical disruption beyond the uterus. They alter the positional relationship of pelvic organs, can impair bladder and bowel function, and change load distribution through the pelvic floor and sacroiliac joints. Pelvic pain from fibroids often has a musculoskeletal component that is amenable to osteopathic assessment.
What this means at OQ
OQ does not treat fibroids medically. But we regularly work with women whose pelvic pain, low back pain, and postural symptoms are influenced by the mechanical consequences of fibroids and uterine dysfunction. Understanding the hormonal and evolutionary context is part of why we approach these presentations as whole-body problems.
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