Not as simple as Black and White

In the last post we talked about some factors that increase certain women's risk of developing fibroids. One of the most significant is race. The cumulative incidence, or the total percentage of new cases, is over 80% in black women by the age of 50. Some studies have looked at why these racial differences exist. This can partially be explained by the racial differences in the other risk factors. For example, Black women on average experience their first periods at a younger age than white women. Because we know that an early period is already a risk factor for fibroids, this can explain some of the differences between the races. However, accounting for each of the individual risk factors does not explain the wide gap between black and white women's fibroid risks.

Lots of research is currently being done to try to explain these differences. One area that has received much attention is dairy consumption. One study asked black women about their diet and then followed them to see if they developed fibroids. Women consumed more servings of dairy per day had a lower risk of developing fibroids than those who ate less dairy. This was the first study to find this kind of relationship so there is still a lot of research that needs to be done particularly to see if adding calcium to the diet could decrease the development of fibroids.

Another possible explanation for racial differences is stress or racism. Several studies have looked at this relationship and found that women who reported experiences of racism in their lifetime or discrimination in their daily life had an increased risk of developing fibroids. The risk increased even more for a higher number of life events reported. There have been other diseases associated with a stressful life so this could be an explanation for the development of fibroids.

Let's Talk About Risks

So now that we've covered the basics let's move on to some more specific topics. In this post we're going to discuss risk factors for fibroids - in other words what are characteristics make you more likely to develop them. Some of these risk factors are modifiable and others are not. While many different characteristics have been researched to see if they have a connection to fibroids, today we'll only discuss a few of the most important ones to consider when determining your own risk for fibroids.

Race - The rates of fibroids are very different between black and white women with black women 2 to 3 times the rate of developing fibroids. In fact, 50% of black women in menopause are found to have fibroids compared to only 35% of white women in the same age range. The way that fibroids progress also differs by race. Black women tend to have symptoms from their fibroids at an earlier age, as a result they also have more hysterectomies for their fibroids. The reasons why these racial differences exist is not really understood but we'll look at some possible explanations in the next post.

Menstrual history - Women who had their first period at a young age (usually considered less than 10) also have a higher risk of developing fibroids. Having multiple children decreases risks.

Myth alert!!! - Some people think that using birth control pills makes fibroids grow, but this has NOT been found to be true in several studies on the topic.

Diet - Eating lots of red meat or ham can increase risks, while green vegetables can decrease risks of developing fibroids. Drinking alcohol, particularly beer can also increase risk.

Smoking - Women who smoke usually have a lower risk of developing fibroids. The reason for this is unknown but considering all of the other increased risks of smoking you still shouldn't smoke!!

Family history - Women who have family members with fibroids are also more likely to develop them.

So to wrap up, these are some of the most common risk factors for developing fibroids. As with most medical conditions everyone's body is different so ask your doctor if you have questions about your specific risk.

What are Fibroids?

You may have heard your doctor mention them after your yearly exam. Maybe a sister, aunt or friend has asked you about them. Uterine fibroids are the most common pelvic tumor in women. Now don't be alarmed by the word tumor. Fibroids are benign which means they aren't cancerous. However, fibroids can still be a serious medical problem for many women. Fibroids can also be called leiomyomas or myomas so don't be confused if you hear those words tossed around too.

So what are they exactly?

Fibroids are basically an overgrowth of the muscle that makes up the uterus. They can be located within the wall of the uterus, inside the uterine cavity, and some even grow on stalks.

It is estimated that up to 25% of women of reproductive age have at least one fibroid but as many of 80% of surgically removed uteri are found to have fibroids.

So how do I know if I have fibroids?

Often women who have fibroids don't even know it because they don't have any symptoms. The most common symptom is heavy menstrual bleeding. Some women can experience pelvic pain. Even more rare are difficulties urinating or frequent urination. Fibroids can also cause difficulties getting pregnant (stay tuned for a future post on this topic). Fibroids can be diagnosed by a doctor in a few different ways. First is by pelvic examination. Whether the doctor can feel a fibroid on this exam depends on the location and the size. Ultrasounds are a very reliable way to diagnose them and are the most common method. Often a doctor will order an ultrasound to confirm the suspicion of fibroids. There are other modes of imaging such as MRI and hysteroscopy (camera for the uterus) that may also be used. The final and most invasive way fibroids are diagnosed is during surgery. These are often incidental findings during a procedure for another purpose.