Black Women and Fibroids: Why Are the Rates So High?

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Written by Bernadette Anderson, MD, MPH | Reviewed by Karla Robinson, MD

If you’ve been told you have fibroids, you’re not alone. It’s a common condition for all women — with 8 out of 10 developing fibroids by the age of 50. But Black women are three times more likely than white women to get uterine fibroids. Let’s take a closer look at why Black women are at risk for fibroids and what you can do about it.

What are fibroids?

Uterine fibroids are noncancerous growths that develop from the muscle of the uterus. They’re more likely to develop during your childbearing years. Fibroids are a common cause of removal of the uterus (hysterectomy) and can be a significant health concern for many women.

There are four different types of fibroids based on their location within or on the uterus:  

• Intramural fibroids grow within the muscular uterine wall. These fibroids are the most common type.

• Submucosal fibroids develop just underneath the inner uterine lining. They can lead to heavy menstrual bleeding and complications.

• Subserosal fibroids appear on the outer surface of the uterus. They can press against nearby organs, causing pain or discomfort.

• Pedunculated fibroids resemble a mushroom. They're connected to the uterus by a stalk or a stem and can be either submucosal or subserosal. 

Why are fibroids more prevalent in Black women?

Experts do not know the exact cause of fibroids. But it’s clear that fibroids are much more common in Black women than white women. Several reasons may explain this difference. One factor is the prolonged stress from experiencing racism and discrimination. It can negatively affect health and increase the risk of fibroids in Black women. 

Genetics and hormones may also increase your risk for fibroids. Hormones like estrogen can cause fibroids to grow. Some risk factors increase your lifetime exposure to estrogen, like if you:

• Get your first period at an early age

• Don't have kids

• Go through menopause at an older than the average age (45 to 55)

Research also shows that certain genetic mutations (changes) are common in women with fibroids. If your mother or sister has fibroids, there's a higher chance that you might get them too.

Differences in outcomes for Black women with fibroids

The impact of fibroids on Black women is a complex issue. Black women are more likely to have fibroids than women from other racial groups. And it’s also harder to get the diagnosis and the right treatment. 

Research has shown the following differences among Black women who have fibroids:

• Earlier onset and increased severity: Black women often get fibroids at a younger age. And their fibroids tend to be bigger with more severe symptoms.

• Delayed diagnosis and treatment: Fibroids are found and treated later in Black women. Low income, limited access to healthcare, and biases from health providers play a role. 

• Personal health history: For some of the reasons listed above, Black women tend to have health problems other than fibroids. Obesity, diabetes, and hypertension might make treating fibroids more complicated.

• Effects on fertility and pregnancy: Fibroids can affect a Black woman's reproductive health — making it harder to get pregnant. And there can be more complications during pregnancy including a surgical delivery and premature birth.

• Financial impact and quality of life: Fibroids can lead to missed workdays, low productivity, and decreased quality of life. And this can worsen existing health and money challenges.

What are the symptoms of fibroids?

Fibroids can greatly affect your quality of life and health. Some common symptoms of uterine fibroids are:

• Heavy and prolonged menstrual bleeding

• Iron-deficiency anemia

• Fatigue

• Pelvic pain and pressure 

• Frequent urination 

• Constipation 

• Backache

• Pain during sex 

• Infertility or recurrent miscarriages 

The symptoms of fibroids can range from mild to severe. If you’re having symptoms of fibroids, let your healthcare provider know. They can confirm the diagnosis and come up with a proper treatment plan for you. 

What should you do if you think you have fibroids?

If you think you're having symptoms of fibroids, make an appointment with your provider. They can do a pelvic exam to help make the diagnosis. They may also order other tests to evaluate you for fibroids like an ultrasound. 

Your fibroid treatment options will depend on factors like:

• The size

• The location

• Your symptoms

• Your desire for childbirth

Your healthcare provider may offer options to just monitor the fibroids. If you’re having severe symptoms, they may recommend medication, minimally invasive procedures, or surgery. There’s a wide range of treatment options, and they greatly depend on your personal circumstances. So talk to your provider to find an approach that works best for you.

References

Agyemang, P., et al. (2014). Obesity and Black women: Special considerations related to genesis and therapeutic approaches. Current Cardiovascular Risk Reports. 

Borah, B. J., et al. (2014). The impact of uterine leiomyomas: A national survey of affected women. American Journal of Obstetrics and Gynecology.

Source: GoodRx Health: Published on December 18, 2023

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