Why Uterine Fibroids Disproportionately Affect Black Women and What Needs to Change

The disproportionate impact of chronic health conditions on Black women and women of color compared to white women underscores a critical need for change in research and data practices. Currently, there's a significant lack of inclusivity and equity in these areas of research, which impedes our understanding of the unique health challenges faced by minority populations. By implementing these changes, we can work towards a more comprehensive understanding of health disparities and develop targeted interventions to address them effectively (Troy, 2023).

What are Uterine Fibroids?

Uterine fibroids indeed represent a significant health concern, particularly for women of color in the United States. These noncancerous growths in the uterus can lead to a range of symptoms, impacting quality of life and reproductive health (womenshealth; Syl et al., 2017; Stewart et al., 2013; Baird et al., 2003; Dragomir et al., 2010; Eltoukhi et al., 2014). Fibroids are often detected through ultrasound after self-reports of symptoms are discussed. Based on data and statistics, there is a disproportionate burden of this condition on women of color, particularly Black women, highlighting broader disparities in healthcare access and outcomes (VanNoy and colleagues).

Impact on Black women and Women of Color

The higher prevalence of uterine fibroids among women of color is a complex issue influenced by various factors, including access to healthcare, genetic predispositions, and environmental factors (Donnez, 2016; Haesang, 2020; Wise and Laughlin, 2016; Baird et al., 2020; Stewart et al., 2013; Katon et al., 2023; Laily et al., 2024). In fact, Johns Hopkins states approximately 80 percent of black women will be diagnosed with fibroids in their adult years. Addressing these disparities requires a multifaceted approach that includes improved access to healthcare services, increased awareness and education about uterine fibroids, culturally sensitive healthcare practices, and research focused on understanding the underlying causes of these disparities.

Black women often face dismissal when they bring up symptoms to healthcare providers, spanning obstetric care, primary physicians, and mental health specialists, especially if symptoms aren't deemed severe. Despite reporting a lower quality of life due to symptoms like anemia, heavy menstrual flow, and abdominal pain, their concerns are sometimes overlooked. With the growing attention to Black maternal health in the U.S. over the past two decades, discussions should extend to include the impact of fibroids, which can pose risks during pregnancy. Black women diagnosed with fibroids should have their self-reports taken seriously, particularly during pregnancy, when the risk of complications such as miscarriage and preterm birth is significantly higher. Some of these documented self-reports include impacts on relationships, insecurity with their sexuality and physical appearance, and difficulty conceiving, according to Orellana and Stewart and colleagues (Stewart et al, 2013). Many Black women feel neglected and unheard when experiencing fibroid symptoms. Given that fibroids can increase in size by around 25 percent during pregnancy, it's essential for Black women to advocate for themselves and receive equitable care.

Treatments and Interventions in the Washington D.C Metropolitan Area (DMV)

Currently, the most common treatments that are offered for fibroids specifically in Washington, D.C., and Maryland, include hysterectomies, Uterine Fibroid Embolization (UFE), and contraceptives or hormonal treatments. Though women and birthing people with fibroids are classified as high-risk pregnancies, practitioners often will not perform abortions because of the tension the procedure causes on the uterus that will impact the fibroid (Klatsky et al., 2008; Benson et al 2001; Goldenburg et al., 1995, Casini et al., 2006; Bernard et al., 2000; Wallach et al., 1995; Lee et al., 2010).

Resilient Sisterhood Project, an organization in women's health, provides alternative medical treatments such as magnetic resonance-guided focused ultrasounds, which release high energy waves through the ultrasound, which is only offered to women who are not interested in having children or are symptomatic (resilentsisterhoodproject).

Knowledge and Research Gap about Uterine Fibroids

Studies have shown that the lack of knowledge about symptoms and distributing testing impacts the ability to efficiently treat and manage uterine fibroids (Fortin et al., 2018; Ghant et al., 2015; Laily et al., 2024). Proper management permits practitioners to provide equitable treatment options (Donnex, 2012; Evans, 2007, Laily et al., 2024).

Lack of knowledge surrounding fibroids causes women to not advocate for themselves. Oftentimes, hysterectomies are the primary treatment options that are offered according to Dr. AL-Hendy, particularly for black women due to the post-risks that are associated with the procedure.