Uterine fibroids are non cancerous growths that develop in or around the uterus and affect millions of women worldwide. Although fibroids afflict women of any age or ethnic background, research studies reveal an alarming disparity in fibroid rates in Black women when compared to other racial and ethnic groups.
According to a study published in the American Journal of Obstetrics and Gynecology, by age 50, about 80% of Black women have fibroids compared to 70% of white women. Furthermore, fibroids tend to occur at an earlier age, grow larger, and cause more severe symptoms in Black women. In fact, nearly 25% of Black women between 18 and 30 will experience symptoms from their fibroids compared to about 6% of white women, and by age 35, that number increases to 60%. (https://www.verywellhealth.com/).
In addition to fibroid rates, there are differences in treatments once fibroids are found because, on average, Black women receive more invasive treatments than white women. Black women are 7 times more likely to undergo a hysterectomy (surgical removal of part or all of the uterus) to treat uterine fibroids compared to non-Hispanic white women. In addition, the National Institute of Health indicates that Black women are 2 times more likely to have “open” or more invasive surgery to remove their uterus and less likely to have laparoscopic (made with a few small incisions) hysterectomies than white women.
Hormonal imbalances and chronic stress are some of the reasons given for these differences. Hormonal imbalances – like higher levels of estrogen and progesterone – can increase fibroid growth. Furthermore, in the United States, Black women experience higher levels of chronic stress due to systematic social inequalities. Higher stress levels are linked to increased levels of cortisol (a major stress hormone), and higher levels of cortisol then influence the growth of uterine fibroids.
Other issues like inequities in the healthcare system, medical mistrust due to consistent mistreatment and misdiagnoses, limited access to quality healthcare and lack of health education worsen the problem. Diet and lifestyle also contribute to the disparity. Women with healthier diets and lower weight have better results. However, one in five Black households are located in a food desert, with little access to grocery stores, restaurants, and farmers markets. Instead food deserts tend to have processed foods, caffeine, and fried foods — which may increase fibroid production or inflammation. All of these factors make it difficult for Black women to manage fibroids.
Quality of Life
Fibroids cause physical discomfort and a host of other problems. They can cause heavy and prolonged menstrual bleeding, pelvic pain, urinary frequency, infertility, miscarriage, preterm labor, placental abruption, fetal growth restriction, and require childbirth by cesarean delivery. The mental health effects of dealing with chronic pain, reproductive challenges, and the stigma about fibroids can cause anxiety, depression, and reduced quality of life. These complications can take a toll on Black women’s professional and personal lives. The symptoms may result in missed workdays, reduced productivity, and financial strain due to higher healthcare costs. The stigma surrounding fibroids also can affect relationships, self-esteem, and body image.
Understanding the broader life impacts of uterine fibroids is important to advocating for comprehensive support and treatment options for Black women.
What can be done?
Reducing these disparities means addressing the many reasons why they exist. These efforts must include improving access to quality healthcare – through community health clinics, telemedicine services, and culturally competent medical providers. Education also plays an important role in empowering patients to make informed health decisions. We must raise awareness about fibroids, including risk factors, symptoms, and treatment options, in order to advocate for our own well-being. Public health campaigns, community workshops, and online resources can disseminate accurate information, dispel myths surrounding fibroids and empower patients to advocate for better health.
If you have fibroids, researching various treatment options is critically important. While surgical interventions like hysterectomy are common, other less invasive therapies, like uterine fibroid embolization, show promise in preserving fertility. Increased funding for fibroid research also is necessary to develop more targeted and effective treatment options.
For more information on uterine fibroids visit the Living Well Black Health Library here: