Aids Health Foundation

Black Women’s Health: Fibroids

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More than 3 million cases of Fibroids are diagnosed per year, but there has been no clear link to what exactly causes Fibroids. More importantly by age 50, up to 80% of Black women have Fibroids, and researchers have been unable to pinpoint the exact cause. However, speculation about diet, exercise, and family history are pervasive.

By National Medical Association

According to the Mayo Clinic, uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. They are not associated with an increased risk of uterine cancer and almost never develop into cancer. Uterine fibroids develop from the smooth muscular tissue of the uterus (myometrium). The growth patterns of uterine fibroids vary — they may grow slowly or rapidly, or they may remain the same size. Some fibroids go through growth spurts, and some may shrink on their own. Many fibroids that have been present during pregnancy shrink or disappear after pregnancy, as the uterus goes back to a normal size.

Fibroids range in size from seedlings, undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. They can be single or multiple, and are most often detected by one’s gynecologist in a routine exam. Further imaging (MRI, transvaginal ultrasound, etc.) is required depending on the complications that arise in the patients.

Risk Factors
The National Uterine Fibroid Foundation provides a few risk factors:
•    African-Americans are 2-3 times more likely to present with symptomatic uterine fibroids and typically will do so at a younger age than the rest of the population of women with uterine fibroids.
•    Average age range for fibroids to become symptomatic is 35-50.
•    Obesity is associated with the presence of uterine fibroids. (Of course, which came first — the weight or the fibroids — is still an unanswered question.)
•    Consumption of beef, red meat (other than beef), and ham has been associated with the presence of uterine fibroids.
Additionally, family history, increased exposure to estrogen and even pregnancy may be the cause of fibroids.

Symptoms
Most fibroids cause no symptoms. But women who do have symptoms often find fibroids hard to live with (www.womenshealth.gov) . These symptoms can include:
•    Heavy bleeding (which can be heavy enough to cause anemia) or painful periods
•    Feeling of fullness in the lower stomach area
•    Enlargement of the lower abdomen
•    Passing urine often
•    Pain during sex
•    Lower back pain
•    Constipation
•    Complications during pregnancy and labor
•    Reproductive problems, such as infertility, which is very rare

Prevention
There are no real proven measures, but health professionals concur with the following preventive guidelines to reduce risk:
•    Regular, daily exercise including strength training to maintain hormonal balance
•    Eating more cruciferous vegetables
•    Decrease dairy products
•    Increase fiber consumption through fruits, nuts and vegetables
•    Increase consumption of water
•    Eliminate or drastically reduce red meat from your diet
•    Lose weight if you are overweight/obese
•    Consult with your medical provider annually or as needed

Treatment
In the event that one’s fibroids have grown exponentially or the bleeding is too much to handle, there is an ever burgeoning list of treatments options. It is also important to note that the recurrence rate is especially high. Some of the options include:

•    Medications- oral contraceptives or Gn-RH agonists such as Lupron
•    Noninvasive procedures- MRI focused ultrasound surgery (FUS)
•    Minimally Invasive procedures- Uterine artery embolization which cuts off blood flow to the fibroids
•    Traditional surgical procedures- Myomectomy which removes the fibroids surgically while leaving the uterus intact versus Hysterectomy which provides a permanent solution by removing the uterus

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A 42 year old African American woman describes her life with fibroids:

I know a lot about fibroids and have read more than I’ll ever need to at this point. I am a single, child free, healthy, physically (marathoner) active individual who has NEVER had any healthy issues—but Fibroids continues to be the thorn in my flesh. I was initially diagnosed at the age of 24 on an annual visit to the gynecologist. Because I had no symptoms, my doctor said that we would just watch it. It never caused me any problems, but they were growing so quickly, I decided to have them removed via a myomectomy. At that time, 13 fibroids were removed. At age 29, they came back with a vengeance and left me in extreme pain causing sciatica down my back and legs. I had a 13 hour robotic laparoscopic surgery that was quite complicated, but they removed several more during that surgery. At 35, they reappeared and I decided to watch and wait until at 39, I bled for 40 days straight. This level of discomfort made me both depressed and miserable in both my personal and professional life. My doctor prescribed me with oral contraceptives, and that didn’t stop the bleeding. She soon inserted an IUD and that didn’t work so at the age of 40, I had another myomectomy. So far so good, I have refined my diet yet again, and remain diligent in daily exercise and yoga. While I have been through this a number of times and don’t know why I keep getting fibroids, I do know (according to my doctors) that my optimal health has allowed me to recuperate well and continue to live my best life. I encourage other women to listen and stay in tune with your body and do all you can to live well and be well in all aspects of your life.

B. Walker
Washington, DC

 

Photo credit Cheryl Casey | Dreamstime.com
Illustration Designua | Dreamstime.com

 

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