AFRICAN
AMERICAN WOMEN AND FIBROIDS
What are Fibroids?
Fibroids are growths (tumors) that develop from the
smooth muscle layer of the uterus. They are the most common
growths of the uterus and female pelvic organs. One study
found that approximately 50% of women have them. Most often
they are benign. Very rarely they can become cancerous (less
than 0.5% of the time).
The growth of fibroids is dependent on estrogen
production. This is the reason why fibroids have the
potential to enlarge during pregnancy (when increased levels
of estrogen are present) as well as to regress after
menopause (when there is decreased levels of estrogen). They
can be multiple or exist as a single large growth. They can
be located on the surface of the uterus, in the wall of the
uterus, or in the uterine cavity.
Most fibroids do not cause any symptoms and many women
are unaware that they have them. When they do cause
symptoms, it ranges from abnormal bleeding to pelvic
pressure.
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Fibroids in African American women
Fibroids are more common in African American women than
in women of other racial groups. One study showed that
fibroids are three times more common in African American
women than in Caucasian women. Additionally, fibroids tend
to be larger and occur at an earlier age in African
Americans. It is unclear as to why such differences exists.
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What are the signs and symptoms of fibroids?
1. Abnormal menstrual cycle
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Abnormally heavy menstrual bleeding. |
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Abnormally heavy menstrual periods that come
more frequent than your normal cycle (less than every 28-30
days). |
2.
Pelvic pain/pressure
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Painful menstrual periods. |
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Pain during or after sexual intercourse. |
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Pressure on the bladder which can cause
frequent urination. |
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Acute or severe pelvic pain from twisting of
the fibroid on its stalk, or from degeneration of the
fibroid. |
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Complications of fibroids
The most common complication is heavy bleeding which can
lead to anemia. The anemia can be so severe as to
necessitate blood transfusions, and/or an emergency surgery
such as a hysterectomy.
Very infrequently, fibroids may be a cause of infertility
and/or pregnancy loss.
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How can you be evaluated for fibroids?
Fibroids can be diagnosed during a physical exam by your
doctor. He or she can often feel an enlarged, irregular
uterus. Your doctor may use other tests (ultrasound,
hysterogram) to help confirm the diagnosis, and/or to
determine the best treatment option for you.
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Treatment options
There are many options for the treatment of fibroids.
Treatment options will vary based on your symptoms, age, and
desire to conceive. Further discussion with your doctor will
help you decide which treatment is best for you.
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Motrin or other anti-inflammatory medications
may be prescribed for pain. |
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Birth Control Pills help to regulate the
menstrual cycle, control heavy bleeding, and alleviate some
of the pain and pressure. |
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Lupron: another type of hormone that may aid
in shrinking the fibroids and stopping bleeding. |
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Ablation: a surgical procedure in which the
lining of the uterus is destroyed to prevent further
bleeding. |
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Uterine artery embolization: a procedure that
destroys the blood supply to the fibroids thus causing them
to shrink (resulting in less bleeding). |
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Myomectomy: a surgical procedure to remove the
fibroids and to leave the uterus otherwise intact. |
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Hysterectomy: a surgical procedure that
removes the uterus, and thus, the fibroids. |
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References:
1. Berek JS. Novak’s Gynecology. 12th ed.
Baltimore: Williams and Wilkins
2. Rock JA, Thompson JD. TeLinde’s Operative
Gynecology. 8th ed. Lippincott- Raven
www.blackwomenshealth.com
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