Deep-rooted systemic inequalities in the American healthcare system have contributed to skepticism within the African American community.
With a history marked by disparities in pain management and healthcare access, the issue of fibroids and hysterectomies has emerged as a prominent concern, particularly impacting Black women.
In the United States, 26 million women aged 15 to 50 have uterine fibroids, or benign growths of the uterus, and more than half of those women will experience associated symptoms and health risks.
For African American women, the lifetime incidence of fibroids is even higher. They tend to have fibroids diagnosed at earlier ages, and they are more likely to present symptoms.
African American women also have higher rates of hospitalizations due to their fibroids, as well as higher rates of myomectomies and hysterectomies, compared to their White counterparts.
Widespread Prevalence
Fibroids, noncancerous growths in the uterus, affect a staggering 80% of women and individuals with uteruses by the age of 50, according to the Office on Women’s Health. This highlights the urgent need for understanding and addressing this common health issue.
Disproportionate Impact
Shockingly, Black women are three times more likely than their white counterparts to develop uterine fibroids, as reported by the Mayo Clinic. This racial disparity underscores the urgent need for targeted awareness, support, and accessible healthcare for affected communities.
Varied Symptoms, Severity
Fibroids can manifest in several ways, leading to a range of symptoms such as heavy menstrual bleeding, pelvic pain, frequent urination, and even fertility challenges. The severity of symptoms can vary, highlighting the importance of personalized medical care and tailored treatment plans.
Reproductive Health
Fibroids can significantly impact reproductive health, including fertility and pregnancy outcomes. They can increase the risk of complications during pregnancy, including preterm birth and miscarriage. It is crucial for individuals considering starting a family to be aware of the potential implications and seek appropriate medical guidance.
Diverse Treatment Options
While a hysterectomy, the surgical removal of the uterus, has traditionally been the standard treatment for fibroids, there are now a multitude of alternative options available. These include minimally invasive procedures, hormonal therapies, and uterine fibroid embolization, which offer less invasive alternatives and preserve fertility for those who desire it.
Researchers analyzed U.S. cancer data for women 40 and older and found overall uterine cancer death rates increased by 1.8% per year from 2010 to 2017, according to the study.
“The worrying issue is that more and more women are being diagnosed with aggressive types of cancer, who are more at risk of dying of disease,” Dr. Dineo Khabele, Washington University School of Medicine professor and chair of Obstetrics & Gynecology told the St. Louis American in August 2022.
“They’re more at risk of getting a late diagnosis when the cancer has already spread and is harder to treat.”
An estimated 65,950 new cases of uterine cancer will be diagnosed in the U.S. this year and 12,550 women are expected to die from it, according to the AMA.
Khabele said some obstetrics and gynecology departments lack adequate uterine screenings and sometimes fail to see the signs the indicate an individual may have uterine cancer.
“We do know that bleeding after menopause is abnormal but because Black women are often diagnosed with fibroids, which are benign and can cause bleeding, this can cause a delay in diagnosis,” Khabele said.
According to Dr. Brianna Walton, urogynecologist and medical director for female pelvic medicine and reconstructive surgery at UM Capital Region Health, many African American women don’t even know they have them.
She said race is one of the main risk factors for uterine fibroids, as Black women have fibroids at higher rates than their counterparts. They are more likely to have larger fibroids, as well as more severe symptoms.
Aside from being a woman of reproductive age, other risk factors for fibroids include obesity, family history of uterine fibroids, vitamin D deficiency and high blood pressure.
JoAnn Weaver of the St. Louis American contributed to this report.
