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WHAT EXACTLY ARE FIBROIDS?

Fibroids are made of the muscular layer of tissue in the uterus. Although they are called “tumors”, they are benign. The size can vary from barely detectable, pea sized, round or heart shaped, egg to eggplant, and up to small pumpkin or grapevine-sized. Fibroids can distort the anatomy within a woman’s pelvis. The location of the fibroids within the uterus can also vary from being entirely inside of the womb, exterior to but attached to the womb, sitting on a stalk connecting to the womb, or occupying a space involving multiple womb layers. The size and location of fibroids can change with time, and as fibroids grow.

LAST YEAR YOU SPOKE ON FIBROIDS AS A RESULT OF BLACK HAIR PRODUCTS – HAS ANYTHING CHANGED?

Thank you for being a loyal listener over time! Nothing is changed in terms of what studies show in the areas of black hair products and effects on hormonal influence on a girl or woman’s life. Today’s focus is simply a broader understanding of fibroids.

HOW CAN DOCTORS DETECT FIBROIDS SOONER & WHAT ARE THE SYMPTOMS OF FIBROIDS?

Women undergoing annual gynecologic evaluation and those presenting with pelvic or menstrual symptoms should undergo a bimanual pelvic examination by their healthcare provider. This exam often can indicate the presence of fibroids. Radiologic studies including a pelvic ultrasound or pelvic MRI are also tools in diagnosing and managing fibroids.

Not all fibroids need intervention via surgical or medical management. If a woman is not having worsening or severe symptoms resulting from fibroids, her fibroids can be simply monitored over time for changes.  Some mild and moderate symptoms of fibroids can be managed by natural remedies such as healthy living, weight management, exercise, & clean eating.  Symptoms with greater immediate health consequence can be managed by prescription medication or surgical and radiologic techniques.

Women can have many vague symptoms which need evaluation by a healthcare provider in order to determine the correct diagnosis.  The vague symptoms, which can indicate multiple diagnoses, include  fatigue, anemia, nausea, dizziness on occasion, painful intercourse, heavy menstrual bleeding, bleeding  in between menstrual cycles or after sexual intercourse, urinary frequency or incontinence, painful menses, pelvic pain, and infertility or miscarriage.

WILL DIET AND EXERCISE DECREASE THE SIZE OF FIBROIDS OR IS SURGERY THE ONLY WAY?

While no scientific study has shown measurable difference in outcome (i.e. decreased fibroid size) based on change in diet or exercise, many women report improvement in the severity of their symptoms when eliminating meat from their diets.

This is intuitively logical as much of the meat sold in the U.S. has had hormonal injections and other chemical processing which can affect human hormonal metabolism. Exercise is a primary means of maintaining and achieving weight management. Obesity is a known risk factor for hormonal imbalance and the development of fibroids.

HOW CAN MEN BE SUPPORTIVE OF WOMEN DEALING WITH FIBROID SYMPTOMS – SPECIFICALLY IN THE BEDROOM?

For a loving male partner to support his woman who has fibroids, he must be aware of her symptoms. Some women experience abnormal bleeding, including during or after intercourse. In this case, the couple can anticipate in advance to avoid an otherwise embarrassing situation. Some women have pelvic pain with or after intercourse. These women can take anti-inflammatory over the counter medications prior to intercourse. They can also explore with their partner sexual positions that may be more comfortable.

WHY IS THIS SO COMMON AMONG BLACK WOMEN?

The exact cause of fibroids is still not known. However, Black women are disproportionately affected by obesity, which is a separate risk factor. Also, as we discussed in May 2016, the use of certain Black hair products is suspected to also play a role in fibroid risks.

IF REMOVED, CAN FIBROIDS RETURN? IF SO, WHAT ARE THE CHANCES?

Fibroids, by definition, always arise from the uterus. Any woman who is reproductive age (i.e. not in menopause) and has her uterus can develop fibroids. Fibroids can absolutely grow after other fibroids have been surgically removed. The risk depends on many individual factors for each woman. Women who desire pregnancies uncomplicated by fibroids are encouraged to begin attempting pregnancy soon after having surgery to remove fibroids. The postoperative healing time is usually six months.

IS THERE A HOLISTIC APPROACH TO GETTING RID OF FIBROIDS?

There is lots of “holistic advice” for shrinking and eliminating fibroids. However, it is important to note that no scientific studies have ever shown that holistic remedies have been proven to “cure” the fibroid dilemma. Well spoken of remedies are primarily those of dietary change and addition of herbal supplements.

For the most part, these suggestions are harmless, even if they do not result in the desired “cure.” Suggestions include vegan diet, use of dong quai, wild yam, black cohosh, raspberry leaf and other herbal supplements. Women taking any other medications should check for potential interactions with herbs and their medications. All women should consult a healthcare provider as they strategize the management of their fibroid condition.

WHAT NUTRITIONAL AND ENVIRONMENTAL FACTORS SHOULD WOMEN AVOID IF THEY HAVE FIBROIDS?

Women with fibroids can prevent the worsening of symptoms by following clean eating and “go green” environmental practices. The “go green” practices include reducing the use of toxic chemicals on the body, hair, and household. Clean eating involves eliminating processed foods from nutritional intake. These strategies minimize a woman’s exposure to potentially toxic and known toxic chemicals.

Dr. Amerson answers listener questions below:

Why is it that only Black women that seem to have fibroids? I know no white women

with fibroids.

The condition of a fibroid uterus occurs to women of all ethnicities, races, religions,and geographic regions.

Do hair relaxers impact fibroid tumours?

A published study was conducted for a twelve-year time period on over 20,000 African-American women found a correlation between the use of hair relaxers and the development of fibroids of the uterus. Look for the data in the American Journal of Epidemiology as well as the 2016 report by Black Women for Wellness.

Could fibroids be from medications and genetically altered food?

Fibroid development and growth may be accelerated by food (in particular, meat) which has been exposed to hormonal injections. Medications are not known to affect the risk for fibroids.

Can fibroids show up in the breasts?

When a benign tumor presents in the breast, it is called a fibroadenoma. This is a separate phenomenon. The tissue is entirely different in origin, and in appearance under the microscope. The causes of each condition are also separate.

Why didn’t the doctor mention anything about the connection between fibroids as as it pertains to birth control pills?

There is no connection between fibroids and birth control pills. No studies have ever linked the use of birth control pills to fibroid development. While birth control pills can control some cases of heavy bleeding, the cases that are effectively managed by this option are often the result of hormonal causes of heavy menses, not due to fibroids.

Do hair products cause fibroids?
Read the report by Black Women for Wellness entitled, “Natural Evolution: One Hair Story” to get the full facts on the toxic products that may be contained in Black hair care products. Some of these chemicals are DMDM hydantoin, linalool methylparaben, and propylparaben.
Can the doctor talk about endometrial ablation? I had fibroids and had that procedure. Best thing I could have done.
Endometrial ablation is a same day surgical procedure for women who do not desire future pregnancies & are experiencing heavy menstrual cycles. The procedure results in light to absent cycles after the uterine inner lining is destroyed. When fibroids disfigure and distort the inner lining of the uterus, this procedure is generally ineffective. Thus, each woman must be counseled by her healthcare provider based on size and location of her fibroids.

What medications can shrink fibroids? Most doctors want to do a hysterectomy.

Most doctors do not want to do a hysterectomy. It depends on the doctor’s surgical skills, training, approach to the practice of medicine, and cultural competency (see my talking points). Each woman is responsible for researching the best doctors in her region who can remove fibroids and seeking them out.
I mentioned medication which can shrink fibroids in appropriate circumstances. Other cases of fibroids (which have no resulting symptoms) do not need any surgical intervention at all.
How would a hysterectomy impact a woman in her mid-forties?
All women undergoing surgery face risks of complications during and after surgery. The risks depend on the woman’s medical history, type of hysterectomy, and many other factors evaluated prior to surgery by the surgeon. In a woman’s mid 40s, if she has completed childbearing, then a hysterectomy would mean she no longer has menstrual bleeding. She should enter menopause just as she would naturally, not prematurely.
Good morning, Doctor, once the uterus is removed, if the ovaries remain could that assist with menopause?
When a woman’s womb is removed (i.e. hysterectomy), but her ovaries are intact, she does not change hormonally. Our womb does not produce hormones; it is the sacred space where a child is carried to maturity during pregnancy. All female hormonal production centers in the ovary. Therefore, only the removal of both ovaries would cause a woman to enter “menopause” due to surgery.

Good morning. I have fairly large fibroids and was recently told they are starting to “calcify.” What exactly is this and how will this affect my body if I don’t have a hysterectomy (besides having a hard stomach)? Anything I can to prevent this besides surgery?

Fibroids often undergo calcification, which is not dangerous and poses no threat to a woman’s health. Large fibroids can cause urinary frequency, pelvic pain, and anemia (resulting from heavy menstrual bleeding). It would have been preferable if the fibroids had been detected much earlier (before they grew to a large size) because more options would be available. You can ask your healthcare provider whether you are a candidate for uterine artery embolization, which is a noninvasive procedure that can shrink fibroids.

Dr. Afriye Amerson is a board-certified obstetrician & gynecologist. During her training at George Washington Medical School, Dr. Amerson also studied Eastern and African healing arts. She became a Reiki Master, and practices holistic healing as well as traditional Western medicine. You can get more information on Dr. Amerson via www.afriye.com.

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