Uterine fibroids are a common health issue affecting many women, but research shows that Black women develop fibroids at significantly higher rates than their white counterparts. Fibroids, which are non-cancerous growths in the uterus, typically start to develop after puberty.
While most diagnoses occur between the ages of 18 and 50, cases can appear earlier. Older research has indicated that by age 50, 80% of Black women have fibroids compared to 70% of white women. The reasons behind this disparity remain unclear, and the lack of comprehensive studies on Black women exacerbates the issue.
One major hurdle in understanding why Black women are more prone to fibroids is their underrepresentation in scientific research. Dr. Yolanda Lawson, President of the National Medical Association, highlights the problem: “Family history, environment, and age are known factors affecting fibroid growth, but information on genetics is limited. Because so few Black women are included in clinical trials, and those trials are sometimes performed in locations with very few women of African descent, the research is insufficient.”
Dr. Michelle Louie, a minimally invasive gynecologic surgeon, echoes this sentiment: “Many studies have tried to determine why Black people are more prone to developing fibroids, but there are no definitive answers yet. Certain genes have been correlated with fibroid growth, but studies of these genes have not included a representative sample of Black people.” This gap in research prevents the medical community from fully understanding the genetic factors at play.
Several factors have been linked to the development of fibroids, but none have been proven to cause them definitively. An older study published in the National Library of Medicine connected the use of hair relaxers to an increased risk of fibroids among African-American women.
The study suggested that chemicals in relaxers, known as phthalates, might disrupt hormone balance, raising the risk by 17% for each year of use. However, this study has not been replicated in other Black populations.
Furthermore, stress is another significant factor. Women who experienced sexual, physical, or emotional abuse in childhood were more likely to develop fibroids. Conversely, supportive and loving relationships might offer some protection against fibroid development.
Additional risk factors include:
– Age: Fibroids are more common as women age.
– Family history: Having a mother with fibroids increases risk.
– Obesity: Higher body weight is linked to a higher risk.
– Never being pregnant: Pregnancy appears to reduce the risk of fibroids.
– High blood pressure: Hypertension is associated with fibroid growth.
– Vitamin D deficiency: Low levels of vitamin D may increase risk.
– Hormone replacement therapy: Use after menopause can raise risk.
– Certain food preservatives: Chemicals like butylated hydroxytoluene found in processed foods.
The evidence regarding smoking, drinking soybean milk, and using oral contraceptives is unclear. However, alcohol consumption, particularly beer, has been shown to increase the risk due to the presence of estrogen-like compounds known as phytoestrogens. Similarly, caffeine consumption, particularly in younger women who drink large amounts, is also linked to higher fibroid risk.
On the flip side, certain lifestyle choices can help reduce the risk of developing fibroids.
Protective Factors
– Diet: Consuming fruits and vegetables has been shown to lower the risk. Women who ate four or more servings of fruit per day were 10% less likely to have fibroids.
– Exercise: Regular physical activity reduces risk, with those exercising more than two hours a week having lower rates of fibroids. The lowest risk was observed in women who exercised over seven hours a week.
– Pregnancy: Women who have had three pregnancies are five times less likely to develop fibroids than those who have never been pregnant.
Dr. Lawson stresses the importance of further research into fibroids. “We need more research into fibroids and their occurrence in Black women,” she says. In the meantime, she encourages women to manage their risk factors through weight management, adequate vitamin D intake, and regular exercise.
For women already diagnosed with fibroids, early medical intervention is crucial. “Not all fibroids are equal. Management plans can vary based on the fibroid location, size and symptoms, age, and desire for future pregnancy. If you are diagnosed with uterine fibroids, it is very important to work with your gynecologist to determine a specific treatment plan,” Lawson advises.
By increasing the representation of Black women in clinical trials and conducting more comprehensive studies, the medical community can work towards understanding the root causes of uterine fibroids and ultimately improve treatment and prevention for Black women.
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