Uterine fibroids are benign growths that develop from the muscle tissue of the uterus. Also referred to as leiomyomas or myomas, they are the most common type of growth found in the pelvis.
While uterine fibroids are quite common among women aged 30 to 40, there exist racial disparities in their prevalence and manifestation. Not only are Black women more likely to have uterine fibroids, but they also experience their occurrence at younger ages. Additionally, uterine fibroids tend to grow more quickly in Black women. In keeping with the aims of National Minority Health Month, we should work to heighten our awareness and encourage action to protect the members of one of our most vulnerable populations.
While uterine fibroids are medically defined as benign, with them may come a slew of symptoms that, when left untreated, diminish people’s quality of life. Some people experience pain, anemia, bleeding, increased urinary frequency, fertility problems, and pregnancy complications. Black women receive diagnoses at three times the rate of white women, tend to experience larger and more numerous fibroids, and experience these complications at higher rates. What this means is that Black women not only experience uterine fibroids more frequently than their white counterparts, but they also experience the most life-altering aspects of the condition. In fact, Black women’s high rates of diagnosis serve as further evidence—most people seek gynecologic consultation after experiencing abnormal uterine bleeding and/or pelvic pain.
It is important to note what currently bars us from understanding the full scope of the issue: the shortcomings of current medical research on maternal health disparities. Many studies on fibroids are about the genetic and biological basis of their development, which tend to leave researchers with very little information about Black women’s unique circumstances. Because race has no biological basis, studies that fixate on genetics and biology do not paint the full—or in some cases, any—picture. Excluded from many of these studies are the role of environmental factors, or structural racism, in shaping Black women’s health outcomes. In other words, researchers are looking for explanations in places that often obscure and/or disregard the social determinants of health.
Because of the limitations of current research, heightening our awareness must first start with underscoring the necessity of investigation. With stark differences in the manifestation of the condition comes a difference in treatment options. Because of the earlier age of onset and the severity of the symptoms, surgical treatment for fibroids is more prevalent among African American women. Black women are more likely to undergo myomectomies and hysterectomies for their symptoms, which comes with potentially dangerous complications, including hemorrhaging, injury to the uterus, and damage to nearby organs. Existing disparities only worsen these conditions—Black women are twice as likely to experience postoperative complications. Unfortunately, there is also a chance that these fibroids may regrow, which potentially renders this solution temporary.
In addition to the difference in treatment options, the impact of fibroids on pregnancy and obstetric outcomes make the case for a closer look at Black women’s unique experiences. People with intramural fibroids, or fibroids that grow within the muscular uterine wall, tend to experience decreased fertility and increased pregnancy loss. Additionally, uterine fibroids have been associated with obstetric complications that impact both the birthing person and the fetus, such as preterm labor, fetal malposition, placenta previa, postpartum hemorrhage, and neonatal morbidity. Furthermore, studies have shown that birthing people with fibroids more commonly have c-section deliveries than people without fibroids, a procedure that comes with a higher risk of mortality.
Filling racial gaps requires the tackling of an issue larger than uterine fibroids. For Black women, there exist more questions than people working to uncover answers about embodied experiences. We belong to an institution that has done research on Black women to their detriment, rather than conduct research with Black women to improve their lived realities. We must act on the knowledge that Black women are worthy of study and work to uncover the roots to create better conditions of gynecologic and obstetric health.