Uterine fibroids: A problem for all, more common in African-American women

The numbers are in and they don't look good: 80% of black women and 70% of white women in North America will develop benign (non-cancerous) uterine fibroid tumors by their late 40s - so says the U.S. National Institute of Environmental Health Sciences based on new studies to investigate this chronic ailment that plagues millions of women every year.

Fibroids are tumorous growths made up of muscle and fibrous tissue that develop in a woman's reproductive tract, typically along the uterine lining and the uterine wall; they may expand into the uterine cavity and the abdominal cavity causing discomfort, pain and vaginal bleeding. Fibroids can vary in size from as small as a quarter to as large as a grapefruit, and women may have several fibroids at a time. Fibroids appear to increase in frequency with age, peaking at peri- and pre-menopause, but diminishing with the onset of menopause.

The good news is that less than 1% of fibroids are cancerous. The bad news is that they can still cause serious health problems, from mild to severe pelvic and abdominal pain, and excessive and abnormal menstrual bleeding. Other symptoms of fibroid growth include anemia (iron-depletion from excessive blood loss), and constipation and hemorrhoids caused by pressure from growing fibroid tissues. However, many women have fibroids with little or no problematic symptoms. Fibroids may be detected by a transvaginal ultrasound, magnetic resolution imaging (MRI) or endometrial biopsy.

Current treatment options for fibroids are limited and include anti-inflammatory drugs (e.g. Ibuprofen), hormone therapy (typically, through birth control pills), or surgical procedures, such as a D+C (dilation and curettage of the endometrial lining), myomectomy (the surgical removal of the fibroid) or hysterectomy (the surgical removal of the uterus and the fibroid). Researchers, health educators and activists have recently highlighted that fibroids have been one of the main causes for the performance of unnecessary hysterectomy, and that new and less invasive treatment options need to be made available to women with problematic fibroids.

A more recent non-surgical procedure for the treatment of fibroids is uterine artery embolization which prevents blood flow directly to the fibroids. Unfortunately, despite the numbers of women with fibroids, there still exists no definitive lifestyle or treatment options for the prevention of fibroid growth.

Medical scientists currently do not know what causes fibroids or how to prevent them or even how to control them. Environmental chemicals that are mediated through estrogen, such as pesticides, plastics, some detergents, industrial chemicals and heavy metals, may be the most likely culprit, say researchers. Other risk factors for developing fibroids include obesity, early menstruation, and no or fewer and later pregnancies, and possibly, diets high in red meat.

Copyright Initiatives for Women's Health, Inc. May/Jun 2003
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