Uterine fibroids (leiomyoma) is a significant health problem women all over the world, especially those of African origin face. Therefore, it is very important that every African woman knows as much as she can about fibroids (as much she knows the back of her hands).
Who Is at Risk for Fibroids?
Women are at greater risk for developing fibroids if they have one or more of the following risk factors:
- a family history of fibroids- you are more likely to have fibroids if your mother or sister has fibroids.
- being over the age of 30.
- being of African American descent.
- having a high body weight.
- Nulliparity- women that have never been pregnant have a higher risk of developing fibroids. So the older a woman gets without having children, the more likely she is to have fibroids.
- Early menarche- Women who start menstruating early are more likely to develop fibroids.
What you should know about fibroids:
Women of African origin, even those living outside of Africa, have greater chances of suffering from uterine fibroids. The risk is 2-3 times higher than that seen in Caucasian women. If either of your parents or grandparents are of African parentage, you should educate yourself about uterine fibroids.
African American women have thicker endometrium (the innermost layer of the uterus) than that seen in Caucasian women. Women of African origin also have heavier uteri than Caucasian women.
The average number of fibroids per uterus, in African American women, is twice the number of fibroids per uterus seen in Caucasian women
Fibroids that change the shape of the uterine cavity (submucous) or are within the cavity (intracavitary) or within the wall of the uterus (intramural) can cause spontaneous miscarriages decreasing fertility by about 70% and removal of these fibroids increases fertility by 70%.
A study has estimated that only 10% of African-American women have sufficient levels of Vitamin D in their blood. In the same study 25% of Caucasian women had normal levels of Vitamin D in their blood. Lower levels of Vitamin D increase the chances for forming uterine fibroids in African-American women. Exposure to sun to allow for formation of vitamin D is important for women of African origin.
Childhood sexual abuse can increase the risk of development of uterine fibroids in women. Psychosocial factors such as these are prevalent in the African-American community in the USA, where this study was conducted. In a study of 9910 Black women in the USA, childhood sexual abuse showed a strong correlation with development of uterine fibroids later in life.
Chemical hair relaxers can increase the risk for development of uterine fibroids. Women of African origin favour the use of chemical relaxants as part of the hair management culture and are at greater risk. If you like to use chemical hair relaxers often to create a hairdo, you may actually increase your chances of suffering from uterine fibroids.
Women of African origin suffer from more severe symptoms of uterine fibroids (e.g heavy menstrual bleeding, abdominal pain etc.) than women of Caucasian origin. The symptoms of uterine fibroids can cause pain enough for women to miss work. Symptoms severe enough to interfere in normal daily life are reported more by women of African origin than by those of Caucasian origin.
In women of African origin, weight gain after childbirth increases the risk of contracting uterine fibroids. African women who reach a Body Mass Index (BMI) of 30 kg/m, after having children, are at greatest risk for suffering from uterine fibroids compared to African women who remain thin after bearing children. Reducing your weight and maintaining a healthy BMI is very important for women of African origin.
In developing nations such as Nigeria, hysterectomy is the most preferred option for treatment of uterine fibroids. However, the risks of complications associated with hysterectomy, like need for blood transfusion, are also higher. Even surgical procedures to remove only fibroids and not the whole uterus (myomectomy) can cause severe post-operative complications.
Uterine fibroids can be treated with options other than hysterectomy. Having fibroids in your uterus does not automatically mean that you have to undergo surgery and get the whole uterus removed. Modern techniques like Uterine Artery Embolization (UAE) can be used to treat uterine fibroids without losing the whole uterus -which gives you a chance to have children later and live a life free of pain from uterine fibroids.
Normally, uterine fibroids shrink after menopause when the production of oestrogen and progesterone reduce/stop so if your symptoms can be managed by medication till you reach menopause, you may choose not to go for surgery.