As July is fibroid awareness month, it is a good time to reflect on this condition that affects most women at some point in their lives. This blog will serve as a useful guide to uterine fibroids; what they are, who gets them, common symptoms, and possible treatment options. There is currently not enough discussion on fibroids but the importance of educating women on them is undeniable with 70-80% of women between 35 and 54 being affected by them, and the numbers being even higher for black women.[i]
What are Fibroids?
Fibroids are non-cancerous growths in the uterus. They vary in size so they can be very small, or they can be bulky masses that enlarge and change the shape of your uterus. Other common names for fibroids are leiomyoma and myoma.
Fibroids are categorised depending on where they are located in the uterus:
Intramural - grow within the uterine wall
Submucosal - protrude into the uterine cavity
Subserosal - project outward from the uterus[ii]
Here is a useful diagram to illustrate this:
Causes and Risk Factors
No clear cause has yet been determined for the occurrence of fibroids but there are certain risk factors associated with them:
- Black women have a greater likelihood of developing fibroids than other ethnic groups, and at younger ages. They also are more likely to have larger fibroids, and experience symptoms more severely.
- Family history of fibroids – if your mother or sister have/had fibroids, you have a heightened risk of developing them yourself.
- Other factors – early onset of menstruation, obesity, alcohol consumption, and diet high in red meat and low in green veggies.[iii]
Symptoms
It is often the case that women don’t know they have fibroids due to the absence of symptoms and are surprised when they are discovered during a routine gynaecological exam. For the 1 in 3 women that do have symptoms, these may be:
- Heavy or long periods
- Pelvic pain and pressure
- Lower back or leg pain
- Constipation
- Frequent urination and difficulty emptying bladder[iv]
- Painful sex
- Pregnancy complications and fertility problems (rarely)[v]
Treatment
There are a range of treatments available for symptomatic fibroids:
- Medication to reduce symptoms and shrink fibroids – these target hormones that regulate the menstrual cycle and may relieve heavy periods and pelvic pressure.[vi]
- Non-invasive procedures, and minimally invasive procedures – such as uterine fibroid embolization (UFE) which shrinks fibroids and causes them to die by blocking blood flow to them.[vii]
- Surgical procedures such as hysterectomy – eliminates the problem but not ideal if you are looking to become pregnant, and myectomy – better for those who want to get pregnant but usually requires multiple surgeries so is a short-term solution[viii]
Make sure to carefully consider your options and discuss what is best for you with your healthcare provider.
Prevalence of Fibroids
While many women develop fibroids in their reproductive years, women of colour are disproportionally affected by them. This is especially so for black women, who are up to three times as likely to develop fibroids than other women. Current research indicates that higher rates of obesity and vitamin D deficiency, as well as inequities in access to healthcare (e.g. delays in diagnosis) may contribute to the greater prevalence in black women.[ix]
Evidently, more inclusive research is required to better represent and understand the experiences of all women. Beyond the physical pain, many experience a psychological impact[x] as symptoms interfere with their day-to-day activities, work, and relationships.[xi] The disparities can be tackled firstly by listening and providing emotional support. Raising awareness this month and beyond will also help amplify this message.
Where to get help?
It is important for us all to educate ourselves and others on fibroids because awareness of issues regarding women’s menstrual health, such as fibroids, is much needed and has the effect of uplifting us all! If you are someone who has fibroids, know that you are not alone and can get help from support groups such as the British Fibroid Trust, or if you have persistent symptoms contact your GP.
[i] Fibroid Institute Dallas, ‘July Is Fibroid Awareness Month. Why It Matters.’ Available at: https://www.fibroidfree.com/fibroids/fibroid-awareness-month-matters/
[ii] Women’s Healthcare of Princeton, ‘Eight Facts about Fibroid Tumors Every Woman Should Know’. Available at: https://www.princetongyn.com/blog/eight-facts-about-fibroid-tumors-every-woman-should-know
[iii] Mayo Clinic, Uterine Fibroids. Available at: https://www.mayoclinic.org/diseases-conditions/uterine-fibroids/symptoms-causes/syc-20354288
[iv] Ibid
[v] NHS, Overview: Fibroids. Available at: https://www.nhs.uk/conditions/fibroids/
[vi] NHS, Treatment: Fibroids. Available at: https://www.nhs.uk/conditions/fibroids/treatment/
[vii] Fibroid Institute Dallas, ‘July Is Fibroid Awareness Month. Why It Matters.’ Available at: https://www.fibroidfree.com/fibroids/fibroid-awareness-month-matters/
[viii] Fibroid Treatment Collective, ‘What is the Best Fibroid Treatment?’ Available at: https://fibroids.com/blog/what-is-the-best-treatment-for-fibroids/
[ix] Healthline: Black Women, Fibroids, and Heavy Bleeding. Available at: https://www.healthline.com/health/womens-health/black-women-and-heavy-periods
[x] UoM Health Lab, ‘Understanding Racial Disparities for Women with Uterine Fibroids’. Available at: https://labblog.uofmhealth.org/rounds/understanding-racial-disparities-for-women-uterine-fibroids
[xi] Healthline: Black Women, Fibroids, and Heavy Bleeding. Available at: https://www.healthline.com/health/womens-health/black-women-and-heavy-periods
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