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While medical researchers have not been able to pinpoint exactly what causes uterine fibroids in women, studies have suggested that family history, a diet heavy with red meat and obesity may all be contributing factors.

One study released this year by researchers at Boston University, however, suggested there may be a link between the kinds of hair relaxers used by millions of black women to increased instances of fibroid tumors.

Dr. Ray L. Howell, an obstetrician, gynecologist, and surgeon based in Atlanta who has specialized in women’s issues for 25 years, has co-authored the book, “Black Women and Fibroids: A Conversation with Black Women,” that cites the study conducted between 1997 and 2009, involving 23,580 pre-menopausal African-American women. The study found 7,146 cases of fibroids—a rate two to three times higher than for women who did not use relaxers.