According to the National Institutes of Health (NIH), most American women will develop fibroids at some point in their lives. One study found that, by age 50, 80 percent of blacks and 70 percent of whites had fibroids.
In many cases, fibroids are believed to not cause symptoms, and in such cases, women may be unaware they even have them. However, according to HealthDay, black women are three times more likely than other groups to suffer from fibroid complications.
“Up to 80 percent of African American women will develop fibroids during their lifetime,” says Elizabeth A. Stewart, MD, Department of Obstetrics and Gynecology, Mayo Clinic. “The risk of fibroid surgeries is up to seven times increased for black women. When you look at the cost and impact on their health this has true public health implications.
One of the most frustrating aspects of a fibroid diagnosis is the lack of conclusive answers regarding the how’s and why’s of the problem.
“Unfortunately, there is no sure-fire way to prevent complications from fibroids,” says Stewart.
What are fibroids?
According to Mayo Clinic, uterine fibroids are noncancerous growths of the uterus that often appear during childbearing years. Also called leiomyomas (lie-o-my-O-muhs) or myomas, uterine fibroids aren’t 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). Essentially, a single cell divides repeatedly, eventually creating a firm, rubbery mass distinct from nearby tissue. Fibroids 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.
As far as size, fibroids range in size from seedlings, which are undetectable by the human eye, to bulky masses that can distort and enlarge the uterus. A woman can have a single fibroid or multiple.
Fibroids may be discovered incidentally during a pelvic exam or prenatal ultrasound, particularly since they cause no symptoms in some cases.
But if there are symptoms?
According to Mayo Clinic, when women do have uterine fibroid symptoms, the most common ones include:
- Heavy menstrual bleeding
- Prolonged menstrual periods — seven days or more of menstrual bleeding
- Pelvic pressure or pain
- Frequent urination
- Difficulty emptying your bladder
- Backache or leg pains
Rarely, a fibroid can cause acute pain when it outgrows its blood supply. Deprived of nutrients, a degenerating fibroid can cause pain and fever. Also, a fibroid that hangs by a stalk inside or outside of the uterus (called a pedunculated fibroid) can trigger pain by twisting on its stalk and cutting off its blood supply.
What are the types of fibroids?
According to Mayo Clinic, there are three main types of fibroids:
Submucosal fibroids. Fibroids that grow into the inner cavity of the uterus (submucosal fibroids) are more likely to cause prolonged, heavy menstrual bleeding and are sometimes a problem for women attempting pregnancy.
Subserosal fibroids. Fibroids that project to the outside of the uterus (subserosal fibroids) can sometimes press on your bladder, causing you to experience urinary symptoms. If fibroids bulge from the back of your uterus, they occasionally can press either on your rectum, causing a pressure sensation, or on your spinal nerves, causing backache.
Intramural fibroids. Some fibroids grow within the muscular uterine wall (intramural fibroids). If large enough, they can distort the shape of the uterus and cause prolonged, heavy periods, as well as pain and pressure.
What causes fibroids?
Again, one of the most frustrating aspects of uterine fibroids is the lack of scientific understanding of what causes them in the first place. This said, research and clinical experience, including Mayo Clinic findings, do point to certain factors:
Genetic changes. Many fibroids contain changes in genes that differ from those in normal uterine muscle cells. There’s also some evidence that fibroids run in families.
- Estrogen and progesterone, two hormones that stimulate development of the uterine lining during each menstrual cycle in preparation for pregnancy, appear to promote the growth of fibroids. Fibroids contain more estrogen and progesterone receptors than normal uterine muscle cells do. Fibroids tend to shrink after menopause due to a decrease in hormone production.
- If your mother or sister had fibroids, you’re at increased risk of developing them.
- Black women are more likely to have fibroids than women of other racial groups. In addition, black women have fibroids at younger ages, and they’re also likely to have more or larger fibroids.
- Diets that are higher in red meat and lower in green vegetables and fruit, as well as alcohol consumption, appear to increase the risk of developing fibroids.
Recently, there have also been connections made between the chemicals found in hair relaxers and a higher rate of uterine fibroids in black women.
What if I have symptoms?
According to HealthDay, women with uterine fibroid symptoms wait more than three years on average before seeking treatment, even though symptoms often interfere with their everyday lives. Even worse, even though nearly 80 percent of black women suffer from fibroids, nearly 42 percent of African-American women surveyed waited four or more years before seeking treatments, according to Dr. Elizabeth Stewart.
“It’s very important to seek help when you first start to have symptoms,” Dr. Stewart says. “Being persistent in asking for all available treatments are keys to good outcomes from fibroid treatment.”
For more information about fibroids, visit the mayoclinic.org