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The connection between the Black community and the healthcare industry has been strained for generations. Experimental testing and vaccinations, lack of representation in health professions and general mistrust have all contributed to the breakdown.
For Black women, disparities concerning uterine fibroids is an ongoing fight and healthcare professionals are looking to do the work to protect Black health.
Non-cancerous growths on the uterus ranging in size, fibroids are the most common form of pelvic tumors in women. Black women, however, account for more diagnosed cases, resulting in higher rates for hysterectomies and other methods of treatment and removal. Medically, African American women are three times more likely to develop uterine fibroids than any other racial group. While research as to why is still in progress, rates continue to climb.
In fibroids, age is not necessarily one of the factors that contributes to development. At the start of puberty, a woman’s chances of developing a uterine fibroid increases. It is important to note that uterine fibroids will not develop before the start of a menstrual cycle. Black women are being diagnosed at earlier ages.
“It can be diagnosed early in the reproductive years. If a woman starts her period early, this could lead to early predisposition to fibroids,” says Dr. Omar Zwain, a minimally invasive gynecologic surgeon with Ascension Providence Hospital. “Fibroids can be asymptomatic, but there can be menstrual irregularities, pain during sex, bleeding between cycles, abdominal cramping, urge to urinate and can cause issues with fertility.”
Fibroids are sometimes to blame for women who have suffered from infertility or the inability to carry to full term. If a fibroid exists and pregnancy is the goal, watching for symptoms of worsening or improvement can help conception.
“First, not all tumors need to be treated. However, what is important is monitoring your symptoms,” says Dr. Zwain.
African American women over the age of 40 have some different experiences with fibroids. Black women in this age group see fibroids more frequently and the tumors can grow more rapidly. Preserving the uterus is typically the goal, but pain and other health issues can lead to a total uterine removal.
“Many patients have reached a point where fibroids are too large and pass the threshold for minimally invasive procedures. Hysterectomy is the definitive treatment for the fibroids. If we remove the uterus, there will be no growth of fibroids. We try other forms of treatment before hysterectomy is the last result,” says Dr. Zwain.
While little is known as to why fibroids affect Black women at higher rates, research has led to speculation that nutrition and diet, vitamin D deficiencies and family history are all likely to play a role. While it is not thought fibroid tumors are genetic, it is said to have ties to genetics and chromosomes.
“Unfortunately, as of now we don’t know the reason for growth, but it’s not an inherited issue. It can have something to do with genes. We don’t know why, but it could also have something to do with chromosomes,” says Dr. Zwain.
Currently, there are no proven methods of prevention. Hormones and changes in hormonal levels are attributed to the continued growth of fibroids, but gives doctors some methods to help patients.
“There are no certain preventative measures. For some women, birth control pills can decrease the level of hormones and growth of the fibroid. The fibroids grow as a result of the hormones,” says Dr. Zwain.
Women who suspect fibroid tumors are encouraged to reach out to their healthcare provider for treatment and an official diagnosis. Ascension Health has become home to one of the country’s leading centers for fibroid treatment. Opening the first multidisciplinary fibroid center, Ascension Providence Center for Fibroids and Minimally Invasive Gynecologic surgery includes surgeons, radiologists and hematologists.
“Your healthcare professional is here for you and will advocate for you. If you feel like you’re not being offered all the options, there is no harm in seeking a second opinion,” says Dr. Zwain.
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