Black Women & Fibroids

Black Women and Fibroids

Uterine fibroids are benign growths of the muscular tissue of the uterus. The medical term for a uterine fibroid is leiomyoma or myoma. Uterine fibroids can vary in number and size from a single growth to multiple growths and from a small pea sized mass to a mass as big as 5-7 inches. Fibroids are a relatively common condition and as many as 70-80% of all women may develop them at some stage in their life. However, they are far more common in black women.

Signs and Symptoms of Uterine Fibroids:

Depending upon the number and size of uterine fibroids, mild to moderate or moderate to severe symptoms can be experienced by a woman. The most common signs reported include:

·      Frequent urination

·      Abdominal pain

·      Constipation

·      Fatigue 

·      Difficulty while urination

·      Changes in menstrual cycle including:

§  Severe pain

§  Heavy bleeding with clots

§  Longer periods sometimes lasting more than a week

§  Intermenstrual bleeding

Possible Complications of Fibroids:

Although rare, uterine fibroids may cause a number of complications including:

·      Acute severe pain and heavy bleeding that requires surgical intervention

·      Anaemia due to heavy bleeding

·      Painful intercourse

·      Infertility

·      Miscarriages

·      Preterm delivery as the space needed for the baby is occupied by the tumor

·      Heavy bleeding after delivery

If the cervix is blocked by a fibroid, a caesarean section maybe needed. The position of the baby may also be compromised which requires an emergency caesarean section.

Causes of Uterine Fibroids:

Research shows that there are a number of reasons that contribute towards the development of fibroids. These include:

·      Genetic Mutation:Mutation in certain genes can lead to excessive development of uterine tissue causing fibroids. These mutations can be caused by a wide variety of factors such as chemical agents, exposure to radiations, impaired cell cycle etc.

·      Hormones:Estrogen and progesterone are female sex hormones that control uterine development throughout the menstrual cycle. Hormonal imbalance can promote development of fibroids. Fibroids are also more responsive to the growth stimulatory effects of these hormones.

·      Growth Factors:Hyper-stimulation by growth factors can lead to development of fibroids.

Risk Factors for Uterine Fibroids:

·      Genetic Predisposition:Uterine fibroids usually run in families. Women with a family history are more likely to develop them at some stage in life.

·      Race:Black women are at a greater risk to develop fibroids than women from any other race. They are also likely to develop them at a younger age.

·      Other Factors:Use of birth control, alcohol consumption, vitamin D deficiency and increased use of dairy products have been linked to an increased risk of development of uterine fibroids.

Why are Black Women More Likely to Develop Uterine Fibroids?

Black women are 3 times more likely to develop uterine fibroids. They may also develop earlier in black women and can have greater number and larger sizes. Several studies have been conducted to find out why black women are more susceptible to the development of fibroids.

·      Family history increases the risk of development of uterine fibroids and since they run in black families, black women are automatically at a greater risk to develop them. If a mother has fibroids, her daughter is three times more likely to develop them as compared to someone with no family history.

·      A link has been found between the use of hair relaxing products and uterine fibroids. Since black women use these products extensively, they are at a higher risk to develop fibroids.

·      A possible explanation is that genetic makeup of black women predisposes them to the development of uterine fibroids.

·      Lack of vitamin D in the environment of black women increases the risk of uterine fibroids development. Vitamin D is protective against fibroids.

·      Stress associated with poor living standards has been linked to the development of uterine fibroids.

The susceptibility of black women to the development of uterine fibroids has been a matter of debate. A number of sources such as azuravascularcare.com,healthline.com,ncbi.nlm.nih.govetc. has brought the matter to light to raise public awareness.

Treatment for Uterine Fibroids:

The treatment of choice for uterine fibroids may vary depending upon a number of factors such as age, general health, symptoms, size, number and type of fibroids etc. The commonly employed treatment options for uterine fibroids are:

Symptomatic Treatment:

·      Painkillers such as ibuprofen or mefenamic acid to reduce pain

·      Iron supplements to prevent anaemia

·      Tranexamic acid to reduce blood loss

Hormonal Therapies:

·      Contraceptive pills to manage heavy periods

·      Hormonal Intrauterine Devices (IUDs) to reduce pain and blood flow

·      Hormonal shots that help shrink fibroids by preventing ovulation. 

Surgical Intervention:

·      Hysteroscopy: In this procedure, the inside of uterus is visualized using a camera and fibroids are removed.

·      Endometrial Ablation: It can be used if fibroids are small in size. It may not only stop the bleeding associated with fibroids but also stop menstruation all together.

·      Uterine Artery Embolization: This process involves haltering the blood flow to the fibroid which causes it to shrink and eventually disappear. It is a non-invasive procedure suitable for women who do not wish to become pregnant in future.

·      Myomectomy: This procedure involves the removal of fibroids from the uterus. It is a suitable option for women who want to become pregnant in future. However, it cannot keep new fibroids from growing.

·      Hysterectomy: Surgical removal of uterus all together. It is an option for women who do not want to have kids in future and for whom no other procedure works successfully. 

Black women tend to have higher hysterectomy rates compared to white women. On average 49.5 per 10,000black women undergo a hysterectomy. It is important to pay attention if you are experiencing any of the above mentioned signs and symptoms as a late diagnosis can lead to more complications and longer treatment.

Apart from the traditional medical treatment, which can sometimes be overwhelming, more natural options such as vaginal steaming can be used that cleanses uterus and vagina and relieves the symptoms of fibroids such as painful cramping, bloating and menstrual irregularities.