Overcoming Fibroids For A Vibrant Future
Uterine fibroids are a common reproductive condition of many assigned females at birth. It's estimated that about 20% to 80% of women will develop fibroids by the time they turn fifty years old. Most uterine fibroid cases are found in women in their forties and early fifties. While fibroids affect many women, there's little research about this women's reproductive health issue causing many women to suffer in silence with the condition, especially Black/African American women impacted at a higher rate by this medical condition than any other demographic.
What Are Uterine Fibroids?
Uterine fibroids are noncancerous growths that develop in the female reproductive tract and mainly affect women of reproductive age. These noncancerous growths can grow as a single nodule or within clusters. The uterine fibroid clusters can range from as small as a seed or one millimeter to more than eight inches in diameter, as big as a watermelon, and sometimes even bigger. These noncancerous growths typically develop in the walls, central cavity, and/or the inner and outer surfaces of the uterus.
The Different Classifications Of Uterine Fibroids
Uterine fibroids come in various forms based on their positioning within the uterus. The four distinctive classifications based on the fibroids' locations shed light on their whereabouts and potential impact on the body. The four uterine fibroid classifications are listed below:
Pedunculated Fibroids-This type of fibroid attaches to the uterine wall by a stalk-like growth called a peduncle. The pedunculated fibroid differs from the three other classifications because it has the potential to grow both inside and outside of the uterus. Pedunculated fibroids are typically linked to pain and pressure in the abdomen.
Submucosal Fibroids- The submucosal fibroid bulges into the uterine cavity and projects outside the uterus. The submucosal fibroids can cause heavy menstrual bleeding and, atypically, lengthy or irregular periods. This fibroid classification is most likely causation of fertility and pregnancy issues, like miscarriages.
Subserosal Fibroids- This type of fibroid is the most common and occurs under the outside covering of the uterus. The subserosal fibroid puts press on surrounding organs and can potentially cause severe pelvic pain. This fibroid classification has been linked to frequent urination, constipation, abdominal cramping, lower back and leg pain, and dyspareunia or painful sexual intercourse.
Intramural Myometrial Fibroids- Intramural Myometrial fibroids grow in the uterus's muscle wall. Like subserosal fibroids, they can cause irregular periods but also behave like the other three classifications and cause pelvic pain and fertility issues.
The Signs & Symptoms Of Uterine Fibroids
The size and location play an integral role in whether or not the person with fibroids will experience any symptoms. For many women with small fibroids, they don't experience any symptoms. In comparison, those with larger fibroids can experience several symptoms with various degrees of severity. You should consult your doctor if you're experiencing any of the following symptoms:
Chronic persistent pelvic pain
Overly heavy, prolonged, or painful periods
Spotting or bleeding between periods
Difficulty emptying your bladder.
Unexplained low red blood cell count (anemia)
There is a possibility that after you've gone through menopause, uterine fibroid symptoms will stabilize or disappear because of the decline of hormone levels within the body.
What Puts Women At Risk For Uterine Fibroids
When it comes to the development of uterine fibroids, knowledge is power. Women must be aware of the factors that can increase their risk. Numerous studies have shed light on these risk factors, revealing a multifaceted interplay between our lifestyle choices and the environment. Obesity, for instance, has emerged as a significant risk factor, with excess weight putting additional strain on hormonal balance and increasing the likelihood of fibroid growth.
Diet, too, plays a role, as certain food choices can disrupt hormonal equilibrium and contribute to fibroid development. Environmental factors, such as exposure to toxins and chemicals, have also been linked to an increased risk. Surprisingly, using hair relaxers has been identified as a potential risk factor, as the harsh chemicals they contain can disrupt hormonal balance in the body. Lastly, hormonal imbalance itself stands as a critical risk factor, with fluctuations in estrogen and progesterone levels creating an environment conducive to fibroid growth. Understanding these risk factors allows women to make informed choices, adopt healthier lifestyles, and proactively manage their reproductive health.
How Lifestyle Influences Uterine Fibroids
Lifestyle and nutrition are critical in balancing hormones, an underlying factor in managing fibroids or treatment. Women should take the following measures:
Understand Your Menstrual Cycle: Hormones can be balanced by tracking your menstrual cycle and proper diet. Research has shown that the prevalence of fibroids in many Black/African American women is due to high consumption of dairy products and junk food, which is also a risk factor for obesity.
Balance Your Estrogen: Estrogen dominance supports the growth of uterine fibroids. It is, therefore, necessary to eliminate dairy products that are raised with synthetic hormones that perform the roles of estrogen or act as estrogen in the body and consume foods that balance estrogen, like flax seeds, apples, beans, pears, and whole grains.
Balancing Microbine: Microbine contains estrobolome, a bacteria that helps metabolize estrogen. A healthy microbine means a healthy estrobolome. Estrogen builds up when the bugs in the microbine are not balanced. The best way to heal the microbine is to ditch sugar, dairy products, and gluten because these foods destroy estrobolome. You can also supplement with a great probiotic.
Support The Liver Function: The estrobolome metabolizes estrogen, which is then eliminated by the liver. An unbalanced microbine leads to a sluggish liver which then causes estrogen to build up in the body. Eating foods that nourish the liver or using liver supplements supports the elimination of estrogen. Caffeine, processed foods, and foods high in fructose clog the liver and leads to sluggishness in estrogen elimination.
The Potential Causes Of Fibroids
Like many female reproductive health concerns, the causes of uterine fibroid is unknown. Yet, the limited research that has been conducted suggests the following may potentially link to what causes fibroids in women:
Genetic changes: Uterine fibroids contain genes different from those in the uterine muscle cells. Failing to treat fibroids or shrink them puts the entire generation at risk of developing fibroids.
Hormonal Imbalance: Progesterone and estrogen are the two hormones that support the development of the uterine lining in each menstrual cycle. These hormones can naturally maintain balance through routine exercise, a healthy diet, and stress reduction. If these reproductive hormones are out of balance, it can lead to the development of fibroids. Fibroids contain large estrogen receptors compared to progesterone receptors; estrogen dominance causes the growth of fibroids because of the large reception of estrogen into the uterine cells.
Extracellular Matrix (ECM): ECM makes cells stick together. ECM is increased in fibroids, making them more fibrous, thus enhancing their growth because it contains biological changes in the cells.
Heredity: There are higher chances of developing fibroids if there is a family history.
Other factors that put women at a higher risk for fibroids are obesity, vitamin D deficiency, early onset menstruation, heavy alcohol usage, red meat, and other dairy products.
Risk Factors That Increase Fibroid Prevalence In Black Women
Research shows that fibroids can affect women of different ethnicities; however, its prevalence in the past few decades among Black/African American women has significantly increased, with Black/African American women suffering two to three times more than White women. According to research, at approximately age 35, 50% of Black/African American women have fibroids. This increases to 80% by age 50. Uterine fibroids are rarely discussed, and minimal research has been conducted on their causes, especially in Black/African American women. Listed below are some risk factors that are linked to the increase in fibroids in Black/African American women:
Stress: High overall lifetime stress trigger uterine fibroids and might also cause hormonal imbalance.
Environmental Factors: History of abuse and trauma increase the risk of fibroids. The Black woman has, since time in history, struggled to secure a place and battle with so many factors. This trauma is stored in the body and manifests as fibroids passed from generation to generation.
Birth Control/Contraceptives: Certain types of birth control tend to cause hormonal imbalance and release toxic metals to the body; this takes too long to detoxify out of the body. Black/African American women should avoid hormonal contraceptives and use nonhormonal birth control methods. Other family planning methods that can be utilized are condom usage and the fertility awareness method.
Vitamin D Deficiency: Due to increased melanin in the skin, Black/African American women have vitamin D deficiency, which puts them at a higher risk of developing fibroids.
Hair Relaxers And Hair Dyes: Hair relaxers and dyes have harsh chemical components that burn the skin. These chemicals access the body through the scalp and tend to affect the liver, thus altering estrogen elimination. The chemicals in these haircare products increase the risk of developing fibroids and other health conditions.
Inadequate Access To Healthcare: Black/African American women face many challenges regarding healthcare service provision. Thus early symptoms of fibroids are often assumed and left untreated.
Proper Menstrual Education: There is little to no effort in educating the Black/African American girl child on their menses, what is expected, what should be considered normal, and what should not. Early symptoms of fibroids, such as heavy, prolonged, and painful menses, are often considered normal while not normal. There should not be any normalcy in any form of pain.
Lack of Fibroid Education: Little research has been conducted on the reasoning as to why Black/African American women are at a higher risk of fibroids. The lack of research, education, and awareness leaves Black/African American women in the dark about this prevalent reproductive health issue.
Black Women vs. White Women's Fibroid Health Disparities:
Regarding uterine fibroid development, there are notable differences between Black/African American and White women, even among those with the same socio-economic status. Black women, on average, tend to develop fibroids at a younger age, approximately five years earlier than their White counterparts. Additionally, fibroids affect Black/African American women in larger numbers and sizes. Uterine fibroids rapidly grow and do not naturally reduce in size as women age. These disparities highlight the importance of understanding the unique experiences and challenges Black/African American women face concerning fibroids. Increased awareness and targeted interventions are necessary to address these disparities and ensure equitable healthcare outcomes for all women.
Disparities in treatment and health outcomes exist between Black and White women; this trend is seen in those dealing with uterine fibroids. Compared to their White counterparts, Black females often undergo surgical treatment at a younger age. They are more likely to receive more invasive treatment from doctors, which can affect their overall health and well-being. Additionally, Black women experience higher recurrence rates after treatment, indicating the need for improved post-treatment management and follow-up care. These disparities underscore the importance of addressing racial inequities in healthcare and striving for equal access to appropriate and effective fibroid treatments. Ensuring equitable care and improving outcomes for all women, regardless of race or ethnicity, should be a priority in fibroid management and treatment. Black females also experience more significant outcomes for their reproductive health, including being more likely to have a hysterectomy, which means a person can no longer get pregnant.
How Are Uterine Fibroids Diagnosed
Uterine fibroids are frequently found incidentally during a routine pelvic exam. Your doctor may feel irregularities in the shape of your uterus, suggesting the presence of fibroids.
If you have symptoms of uterine fibroids, your doctor may order these tests:
•Ultrasound: If confirmation is needed, your doctor may order an ultrasound. It uses sound waves to get a picture of your uterus to confirm the diagnosis and to map and measure fibroids. A doctor or technician moves the ultrasound device (transducer) over your abdomen (transabdominal) or places it inside your vagina (transvaginal) to get images of your uterus.
•Lab Tests: If you have abnormal menstrual bleeding, your doctor may order other tests to investigate potential causes. These might include a complete blood count (CBC) to determine if you have anemia because of chronic blood loss and other blood tests to rule out bleeding disorders or thyroid problems.
Other Imaging Test Options:
•Magnetic resonance imaging (MRI): This imaging test can show the size and location of fibroids in more detail, identify different types of tumors, and help determine appropriate treatment options. An MRI is often used in women with a larger uterus or in women approaching menopause (perimenopause).
•Hysterosonography: Hysterosonography (his-tur-o-suh-NOG-ruh-fee), also called a saline infusion sonogram, uses sterile salt water (saline) to expand the uterine cavity, making it easier to get images of submucosal fibroids and the lining of the uterus in women attempting pregnancy or who have heavy menstrual bleeding.
•Hysterosalpingography: Hysterosalpingography (his-tur-o-sal-ping-GOG-ruh-fee) uses a dye to highlight the uterine cavity and fallopian tubes on X-ray images. Your doctor may recommend it if infertility is a concern. This test can help your doctor determine if your fallopian tubes are open or blocked and can show some submucosal fibroids.
•Hysteroscopy: Your doctor inserts a small, lighted telescope called a hysteroscope through your cervix into your uterus for this exam. Your doctor then injects saline into your uterus, expanding the uterine cavity and allowing your doctor to examine the walls of your uterus and the openings of your fallopian tubes.
Uterine Fibroid Treatment Options
Multiple factors go into the treatment of uterine fibroids, and it's best to work with a gynecologist to create the best action plan for your treatment. If you aren't experiencing any symptoms disrupting your quality of life, you may not need treatment for your fibroids. If you have asymptomatic fibroids, your healthcare provider may recommend monitoring your fibroids with pelvic exams and ultrasounds but seek no further action.
However, if you are experiencing terrible symptoms, then here are some common ways in which uterine fibroids are treated:
Hormone Therapy: Female sex hormones play an essential role in fibroid growth. Therefore, this makes it possible to shrink fibroids with hormone therapy. The hormones can be used to relieve symptoms or to help prepare for surgery. Some hormone therapies can temporarily relieve heavy menstrual bleeding and period pain. These treatments can also shrink fibroids, but they can't make them disappear completely. Hormones are usually only used for a limited time because of the risk of side effects. But the therapy only works for as long as it is used so that the fibroids may grow again once stopped. Hormone therapy is most commonly used to shrink fibroids before surgery. It may also be an option for women just before menopause – or for women who, for whatever reason, can't have surgery. The different hormone therapies include GnRH analogues (injections or nasal sprays), Progestins (hormonal intrauterine device and progestin-only pills), Progestin and estrogen combinations (combination birth control pills), and Ulipristal acetate (the drug used in the "morning-after pill").
Myomectomy Surgery: Depending on the size, location, and number of uterine fibroids, your healthcare provider may suggest surgical removal as the best treatment option for this medical ailment. Be sure to discuss and consider your future family planning options because some surgical options preserve the uterus while others can damage or move the entirety of the uterus. If you want to become pregnant in the future, then a myomectomy procedure will leave the uterus intact. There are three types of myomectomy procedures to consider: hysteroscopy (a thin, flexible, tube-like scope is inserted through your vagina and cervix and into the uterus cut away and remove the fibroids), laparoscopy (a few small incisions are made and a scope is used to remove the fibroids through the abdomen), and laparotomy (one large incision is made in the stomach and fibroids are removed through this one cut).
Evasive Fibroid Surgeries: If you aren't planning on future pregnancies and due to the severity and occurrence of your uterine fibroid diagnosis, then your healthcare provider may suggest a hysterectomy (complete or partial removal of the uterus), uterine fibroid embolization (a procedure utilizing a catheter in the uterine artery or radial artery to block the flow of blood to the fibroid causing it to result in shrinkage), radiofrequency ablation or RFA (used to treat smaller fibroids in premenopausal women with the use of RF energy).
Because Black/African American women are more likely to develop their fibroids at a younger age, fibroids are more likely to impact their childbearing plans. Unfortunately, many women and their healthcare providers lack basic knowledge of the options that are now available. Educating black women about appropriate alternatives to hysterectomy is critical. The development of aids for decision-making specifically for black women will facilitate meaningful discussions about alternative treatments for fibroids. These aids should be developed with participation by black women and their healthcare providers.
The Black Women's Health Imperative has begun such an effort. The choice of therapy for fibroids should be appropriate for a woman's clinical situation and respect and consider her preferences and life circumstances, including her desire to have children in the future. Black women, and all women, need to know that suffering from fibroids is not normal and learn their options for treatment.
Proactively Fight Against Fibroids With Healthy Habits
Although researchers continue to study the causes of fibroid tumors, little scientific evidence is available on how to prevent them. Preventing uterine fibroids may not be possible, but only a tiny percentage of these tumors require treatment. But, by making healthy lifestyle choices, such as maintaining a healthy weight and eating fruits and vegetables, you may be able to decrease your fibroid risk along with incorporating exercise into your weekly routine, finding beneficial stress management tactics, and going for routine pelvic and physical exams with your healthcare providers.
July is National Fibroid Awareness Month and we want to spread awareness and education about this common reproductive condition. You do not have to suffer in silence and should know your treatment options. Therefore, part of Lala's Bedtime Tales mission is to provide a safe space and judgment-free zone to educate yourself on sexual health & wellness. The Sexual Health & Wellness Corner will have monthly articles dedicated to continuous education on living a positive and sexually healthy lifestyle. Subscribe to Lala's Bedtime Tales Newsletter and follow @LalasBedtimeTales on social media to never miss any sexual education to help you live the healthiest life possible. Also, check out Lala's Bedtime Tales Podcast and Lala's Oh So Exclusive Patreon account for even more content! If you’re browsing for sexy pleasure products or cute giftable items, then check out Lala’s Pleasure Shop.
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