Uterine fibroids are noncancerous growths that develop in or around the uterus. They can affect females of any age or ethnicity, but in the United States, they are more common among Black females than white females across all age groups.

This information comes from an article in Seminars in Reproductive Medicine.

On average, fibroids also affect Black females more severely than white females, with higher rates of severe symptoms and hysterectomy. Black women are also more likely to develop fibroids at a younger age.

This article will discuss how common fibroids are in Black females and the potential causes for this. We will also look at the symptoms, diagnosis, and treatment of fibroids.

A woman sat in a doctor's office on a bed in a blue hospital gown, waiting to discuss fibroids with a doctor..Share on Pinterest
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In the U.S., the incidence of uterine fibroids in Black females is up to 3 times greater than among white females.

Compared with white females of similar socioeconomic status, Black females also tend to develop fibroids:

  • at a younger age – 5.3 years younger, on average
  • in greater numbers
  • of larger size
  • that cause more severe disease
  • that grow more quickly, in females aged 45 or older
  • that do not decline in growth rate with age

There are also differences in treatment and health outcomes. For example, compared with white females, Black females:

  • undergo surgical treatment at a younger age
  • receive more invasive treatment from doctors
  • have higher rates of recurrence after treatment

Black females also experience more significant outcomes for their reproductive health, including being 2.4 times more likely to have a hysterectomy, which means a person can no longer get pregnant.

Learn more about recovery after a hysterectomy here.

There is no firm evidence that explains why fibroids affect Black females more often and more severely than white females. This is partly because researchers are not sure what exactly causes fibroids in anyone.

There is also a lack of research on how and why fibroids develop in people of color and why invasive surgery is more common.

Researchers have suggested that the following factors may play a role in the prevalence and severity of fibroids among Black females:

Family history

Fibroids appear to be more likely if a person has close relatives who also develop them. This is true regardless of race, ethnicity, or nationality.

However, there are currently no studies that have identified a genetic component in the development of fibroids in any group.

Diet and nutrition

Researchers believe there may be a link between nutrition, body weight, and fibroids. People with a higher body weight may be more likely to develop them.

According to the American Psychological Association, obesity is more common among Black people in the U.S. than other groups, which could explain the higher prevalence of fibroids in Black females.

The higher rates of obesity in Black communities result from health inequity and socioeconomic inequality, which systemic racism perpetuates.

On average, predominantly Black neighborhoods have less access to fresh and healthy food or affordable, safe spaces for exercise.

Vitamin D deficiency

Some studies have found a correlation between vitamin D deficiency and higher rates of fibroids. This may affect people with darker skin more than people with lighter skin because they have more melanin in their skin. Higher levels of melanin prevent the skin from synthesizing as much vitamin D from sunlight.

Taking vitamin D supplements may have a protective effect against fibroids.

Learn about vitamin D deficiency here.

Difficulty accessing healthcare

Systemic racism also makes it more difficult for marginalized groups to access quality healthcare and health insurance.

This can make seeking treatment for fibroids expensive, stressful, or in some cases, less effective, as people in rural areas may not have access to the same treatments.

People in this position may avoid seeking help or wait until symptoms have become severe before reporting them.

Black females can also have difficulty getting appropriate healthcare once they do speak to a doctor. For example, a 2016 study revealed that many medical students believed in false biological differences between races, including a false perception that Black people feel less pain than white people.

This, along with other explicit or implicit biases, could explain why doctors seem more likely to recommend invasive procedures in Black females with fibroids.

Learn more about racism in healthcare.

Perceptions about periods

Heavy periods and pelvic pain are common fibroid symptoms. Individuals and healthcare professionals sometimes overlook these symptoms or believe they are a normal part of menstruation. As a result, many females do not seek treatment for fibroids for over 3 years.

A 2015 survey on the impact that fibroids have on mental health found that half of the 60 participants felt helpless because they thought they had no control over it. Nearly 62% of the participants were African American.

Learn more about period pain and its broader impact.

Can hair relaxers cause fibroids?

There is evidence to suggest that the use of hair relaxers increases the risk of uterine fibroids.

The 1997–2009 Black Women’s Health Study assessed hair relaxer use in more than 23,000 females. Throughout the study, the researchers found a positive trend between hair relaxer use and fibroids.

Fibroids were more likely in participants who:

  • used hair relaxers more frequently
  • used hair relaxers long-term
  • experienced more burns on the scalp

Learn about Black hair care here.

Not everyone with fibroids experiences symptoms. When symptoms do occur, they may include:

Around 25–50% of people with fibroids will experience symptoms, and they can have a significant impact on quality of life. A national survey revealed that 28% of participants reported missing work due to their symptoms and that almost a quarter believed that their symptoms stopped them from reaching their full potential.

Learn more about fibroid symptoms here.

In addition to the factors that may particularly affect Black females, other risk factors can increase the chances of developing fibroids. These include:

  • being aged 30–40
  • beginning periods at a younger age
  • drinking alcohol

In the Black Women’s Health Study, researchers noted that alcohol, particularly beer, had associations with fibroids. However, smoking cigarettes and consuming caffeine did not appear to affect the risk.

Learn about moderate drinking and how it affects the body here.

The main method of diagnosis for fibroids is an ultrasound of the uterus, either through the stomach (transabdominal) or the vagina (transvaginal). Sometimes, a doctor may recommend other imaging tests and techniques, such as:

  • a sonohysterography, which uses a saline solution to enlarge the uterine cavity before an ultrasound
  • a hysterosalpingography, which uses dye to emphasize the uterus and fallopian tubes on an x-ray
  • a hysteroscopy, which involves the insertion of a small telescope and light through the cervix into the uterus
  • a laparoscopy, which is similar to a hysteroscopy but involves an incision below the navel to enable the surgeon to view any fibroids that are on the outside of the uterus

There are many different treatment options for uterine fibroids. Options include:

The “watchful waiting” approach

If fibroids are not causing symptoms or only cause mild symptoms, a person may not need any treatment. A doctor may recommend waiting to see how the fibroids progress. Sometimes, they shrink with age.

Medication

Medications that may help reduce the symptoms of fibroids include:

GnRH agonists can stop the menstrual cycle and shrink fibroids, but they have side effects. Doctors typically only prescribe them short-term.

Learn more about period symptoms that you should not ignore here.

Noninvasive or minimally invasive procedures

Several noninvasive or minimally-invasive treatment options exist for uterine fibroids. All carry the risk of the fibroids returning. Some may also affect fertility.

Therefore, individuals should talk with their doctor to determine which option is best for them. Options include:

  • endometrial ablation
  • hysteroscopic myomectomy
  • laparoscopic or robotic myomectomy
  • laparoscopic radiofrequency ablation (Lap-RFA)
  • MRI-guided focused ultrasound surgery (FUS)
  • uterine artery embolization

Learn more about fibroid surgery here.

Surgical procedures

Traditional surgical procedures include:

  • abdominal myomectomy, where the surgeon removes the fibroids during open surgery
  • hysterectomy, which removes the uterus

An abdominal myomectomy can cause scarring, which can potentially affect fertility. If a person does become pregnant following this procedure, they may have to deliver via a Caesarean section.

A hysterectomy would result in someone no longer being able to get pregnant.

Learn more about fibroids and pregnancy here.

People experiencing pelvic pain or pressure, long or heavy periods, or difficulty urinating should speak with a doctor if they can. People do not have to live with these symptoms, as treatments are available to improve their quality of life.

However, Black females may find it more challenging to find a doctor who understands how fibroids affect people of color and who will treat the condition appropriately.

Some Black people may feel more comfortable speaking with a female doctor, a Black doctor, or both.

The Association of Black Women Physicians offers a search function on their website to help people find a doctor from the National Medical Association. People can also ask friends and family for recommendations.

People can also consider seeking support if fibroids are having an impact on their mental health. Organizations that specialize in mental health services and information for Black people include:

Learn how racism affects mental and physical health here.

Fibroids are more common among Black females than among other groups. Scientists are not sure why, as the cause of fibroids is unknown, and many factors appear to affect their development. However, it seems likely that health inequity is a key factor.

Scientists need to carry out more research to understand the causes of fibroids. There are several medications and procedures that can help reduce the symptoms.