Uterine fibroids (aka leiomyomas or myomas) are tumors that grow in or around the uterus.
The good news: They’re noncancerous. The bad news: They can cause a slew of painful and potentially dangerous symptoms. And despite having the same equipment as other uterus owners, Black women are up to three times more likely to have uterine fibroids.
So why are Black women more likely to have fibroids?
Research shows uterine fibroids are more common in Black women, and Black women also tend to show symptoms at a younger age.
TBH, we still don’t exactly know why. But studies suggest certain genetic and environmental factors increase a Black woman’s risk of developing fibroids.
Here are the facts on fibroids, how Black women are more affected, and what treatment options are available.
Obesity rates and diet
About 4 in 5 Black women in the United States are overweight or have obesity, according to the U.S. Department of Health and Human Services Office of Minority Health.
Women with a higher body mass index (BMI) tend to have higher estrogen levels than folks who have a lower BMI. This extra estrogen may lead to fibroid growth.
Having less access to nutritious foods could also be a major factor in higher body weight and fibroids. Studies have found that Black women often eat fewer fruits and veggies and take fewer vitamin and mineral supplements that might help protect against fibroids.
Higher rates of vitamin D deficiency
Folks with darker skin tones are more likely to have a vitamin D deficiency thanks to melanin. This natural skin pigment protects you from ultraviolet (UV) radiation. But it also makes it harder for your body to create vitamin D from the sun, especially in a cloud-covered climate.
Vitamin D may prevent uterine fibroid growth, so having low levels of this vital nutrient could increase your risk.
Research suggests there’s a link between fibroids and certain hair care products. Hair relaxers, which are used by millions in the Black community, can expose you to hormonally active compounds that could contribute to fibroid growth.
Fibroids can affect everyone differently, but Black women are often more likely to experience severe pain and invasive surgery.
Black women tend to have more severe fibroid symptoms than non-Black women.
Symptoms can include:
- leg pain
- pain during sex
- lower back pain
- difficulty peeing
- frequent urge to pee
- pelvic pain or pressure
- heavy menstrual bleeding
- prolonged or irregular periods
Black women are also more likely to develop anemia due to the heavy bleeding.
Even though Black women need fibroid treatment more often than other women, they often face more difficulty getting the right medical care.
A 2016 study shows that Black women are less satisfied with their fibroid treatments and face more financial obstacles compared with Asian, Hispanic, and white women.
Some research also suggests Black women in the United States often aren’t aware of fibroids, as a result of a lack of resources like internet access and education. This may make these women less able to advocate for treatment.
More invasive surgery
Research shows about 49 percent of hysterectomies are performed to relieve abnormal bleeding and fibroids.
This surgery that removes the uterus is typically done only in severe fibroid cases. But Black women with fibroids are 2.4 times more likely to have a hysterectomy than white women.
What gives? We don’t know for sure, but it might be because more Black women don’t get a correct diagnosis until their fibroids are severe. It could also be because Black women are disproportionately affected by fibroids.
Studies suggest that up to 35 percent of women have heavy menstrual bleeding, and Black women experience heavy periods more often than non-Black women. A 2014 study suggests higher rates of uterine fibroids in Black women might be to blame.
Reminder: Periods should last about 7 days max. Talk with your doc ASAP if you’re experiencing prolonged or heavy bleeding for more than a week.
Increased cancer risk
According to the Centers for Disease Control and Prevention (CDC), uterine cancer rates are higher in Black women.
There might be a link between these rates and fibroids. Research shows that Black women with fibroids are 40 percent more likely to get endometrial cancer.
A physical exam (in which your gyno presses their hand into your abdomen) may not confirm your fibroids. If that’s the case, ask for testing that will really show what’s going on in your uterus.
Medical professionals use these common tests to diagnosis uterine fibroids:
- Ultrasound. A medical pro will scan over your abdomen or insert an ultrasound probe into your vagina.
- Hysteroscopy. Your doc will insert a small telescope through your cervix and into your uterus. This will allow them to examine your uterine walls and the openings of your fallopian tubes. They may also take a tissue sample to be sent off for testing.
- Hysterosonography. Sterile saline helps expand your uterine cavity. This helps your doc get better images of fibroids.
- Hysterosalpingography. A dye is used to highlight your reproductive system to help determine if your fallopian tubes are blocked.
- Magnetic resonance imaging (MRI). This imaging test will show the size and location of your fibroids.
Speak up at the doc: It’s OK to ask for help
In a perfect world, every doctor would run every possible test to determine a diagnosis. But we often have to be our own health advocates.
Your pain and experiences are absolutely valid, so don’t dismiss your symptoms.
If you feel your doctor isn’t listening to your concerns or won’t look into your symptoms, it’s time to find a new doc.
There’s no one-size-fits-all fibroid cure. Treatment depends on your symptoms and other health factors.
Medications to regulate your hormone levels may help shrink fibroids. Your doc may suggest a birth control pill or injection or a hormonal intrauterine device (IUD).
Over-the-counter pain relievers and anti-inflammatory meds can help you manage the discomfort, but they won’t stop new fibroids or shrink existing ones.
In May 2020, the Food and Drug Administration (FDA) approved a medication called Oriahnn to treat heavy menstrual bleeding caused by fibroids.
Two clinical trials including 591 premenopausal women found that Oriahnn reduced period blood loss by half in 77 percent of participants.
In severe fibroid cases, your doc may suggest a hysterectomy. This is a major surgery in which your uterus is completely removed, which means you’ll no longer be able to get pregnant.
A hysterectomy is really a last-resort treatment for fibroids, and you should discuss other options with your doc first. Other surgeries can remove fibroids without completely ruining your chances of conception.
During a myomectomy, fibroids are surgically removed and the uterus is reconstructed. This surgery gives you a better chance of getting pregnant because you’ll still have your uterus.
But a myomectomy may still affect your fertility if your fibroids are really severe. A 2018 study found that women who had more than six fibroids removed were less likely to get pregnant and needed more fertility treatments.
Less invasive procedures
There are lots of noninvasive or minimally invasive procedures that can help too:
- Cryomyolysis. Your fibroids are frozen using extreme cold.
- Uterine artery embolization. Small particles are injected into your uterus to cut off the blood supply to the fibroids.
- Forced ultrasound surgery (FUS). High frequency, high energy sound waves target the fibroids inside a special MRI machine.
- Endometrial ablation. A doctor uses a special instrument to destroy the lining of your uterus with heat or electrical waves. The procedure doesn’t get rid of fibroids, but can help heavy bleeding from fibroids. (This isn’t recommended if you want to get preggo.)
Some folks find fibroid symptom relief with natural remedies. But keep in mind: There’s little to no research to show that these treatments can cure fibroids. They might just ease your symptoms in the short term.
Alternative treatments include:
- heating pads to ease cramps
- a traditional Chinese medicine called Gui Zhi Fu Ling Tang
Def let your doctor know before you opt for any of these remedies.
Uterine fibroids occur in up to 70 percent of women but are most common in Black women. Black women are also more likely to experience severe symptoms and have symptoms at an earlier age.
Early intervention is super important when it comes to treatment. Let your doc know pronto if you have long, heavy, or painful periods. Also push for additional testing if a physical exam can’t determine the cause of your pain.
And remember, you’re not alone ❤️. There are lots of amazing organizations that offer support and information to Black women with fibroids, including: