Why are Black women developing fibroids at faster rates? Read a certified nutritionist’s take on this prevalent issue and ways women can combat it.
If I had no day job, I literally would consider taking to the streets as a professional conspiracy theorist carrying placards that read: “Don’t let them take your vagina, sis!” or “Watch out for the pussy snatchers!” Instead as a certified nutrition specialist and behavioral coach who has clientele that is comprised almost 100 percent of Black women over the age of 30, I am in my busy virtual office every day listening to the horrific stories of Black women who have developed fibroids, and developing holistic regimens to help them rebalance hormonally.
Lately it’s been hard to not go down the conspiracy theory rabbit hole because during the course of one day in my nutrition practice, I am hearing the same story from different women.
Yesterday I got on the phone for a meet and greet with a potential client. She was a 45 year-old Black woman and anxious because she was told by her OB-GYN to get a hysterectomy after fibroids had been found in her uterus. She recently had a period so painful that it sent her to the emergency room. There, another doctor told her that her uterus and fallopian tubes were actually healthy and she did not need a hysterectomy (but pointed out that she did have fibroids that may need to be removed).
“Fire your OB-GYN,” I told her. “She’s supposed to work for your interests; for her to jump straight to a hysterectomy is uncalled for. Fire her, and find someone who will treat you with care.” I then offered her information about a database where she could search for a woman of color OB-GYN, and gave her questions to ask this new doctor about information which is surprisingly often not given to patients: How many fibroids are there? Where are they located? What types of fibroids are they? I also warned her that finding a black OB-GYN unfortunately would not guarantee that she would be treated any better and encouraged her to be open to a doctor—of any race—who would treat her with care. I told her to come see me after to work on a plan for her diet and lifestyle to help her rebalance hormonally. I could hear her shallow breathing subside. “It’ll be okay, sis,” I said.
The same day, another client of mine, a Black woman, also in her forties, had a similar story. In her case, she had tons of dairy in her diet and had grown up eating processed foods as a kid and teenager which resulted in horrible periods (an early sign of estrogen dominance). Her OB-GYN suggested that she get on birth control, which pummeled her body with synthetic hormones, making the estrogen dominance worse. Surprise, surprise: she enters her thirties and grows a gang of fibroids and a cyst. Her fibroids are removed and then her OB-GYN has the brilliant idea to put her back on birth control, subjecting her body to the same synthetic hormones that fueled the growths. No surprise when a year later, her fibroids return, to be removed once again.
She then gets pregnant—intentionally because she wants to start a family—and has a miscarriage. (I’ve had other clients who successfully had a child after these procedures, but had to have a hysterectomy due to the bleeding after pregnancy.) At no point did any doctor discuss with her diet or lifestyle changes to help prevent the regrowth of the tumors.
The trauma of these events leaves some of my clients absolutely numb, but I can always sense the deep pain that is lurking beneath the surface. Some clients are more raw, and openly and freely weep in my virtual office, and I sit with them through it and help sift through the emotions.
I woke up literally the next day to an email from another client who initially came to me complaining of her gastrointestinal issues that no doctor had been able to resolve. She was miserable, had spent hundreds of dollars on supplements, and was looking for an answer. Her email, sent at 1 a.m. was only one sentence: “I found out I have fibroids, and I want to get pregnant soon.” A high percentage of women with fibroids experience gut issues and have a high level of an enzyme called beta glucuronidase in their gut profile, which causes their bodies to literally recycle estrogen, furthering their hormonal imbalance. I sent her a reassuring email that we would address it in her next session.
In case you aren’t getting the big picture: For Black women, it’s real out here in these streets. Most of us are not only dealing with the trauma of racism, police brutality, and a fear that we too could be shot dead in our own homes; we are also fighting a war within our wombs. And this war doesn’t play fair.
Many of us are completely uninformed about our periods and fibroids, and lack knowledge about our bodies; thus we take a doctor’s word as law. Someone needs to explain why Black women are developing fibroids at faster rates, and why doctors all seem to have some silent code when dealing with us in particular that causes them to jump straight to removing our vaginas.
In an episode of my podcast “Staying Ageless,” I spoke with Dr. Alan Warshowsky, a board certified OB-GYN who left his original work performing surgical procedures to start a holistic practice to help women heal without invasive surgeries. He explained that many doctors actually jump to suggest a hysterectomy for a patient because it’s an easier surgery that requires much less finesse than say, a myomectomy or other procedures that focus on removing the fibroids only. For an inexperienced surgeon, he explained, they may opt for a hysterectomy simply because they have less experience with the more difficult procedures.
But that’s not the entire story. A 2014 article in the American Journal of Obstetrics and Gynecology delved deep into the differences in treatment for Black women and asserts that given the magnitude of this problem and rising costs of healthcare, fibroids should be considered a public health issue. It reads:
“In addition to having a greater lifetime incidence of fibroids, African American women have a 3-fold increased age-adjusted incidence rate and 3-fold increased relative risk of fibroids when adjusted for other confounding factors. African American women have fibroids diagnosed at earlier ages, are more likely to be symptomatic, and are likely to have different responses to medical treatment than white women. The size and growth rates of fibroids are greater in African American women, and they are more likely to undergo surgical intervention than other racial groups. Approximately 42 per 1,000 women are hospitalized annually because of fibroids, but African American women have higher rates of hospitalization, myomectomies, and hysterectomies compared with white women.”
The article also states that African American women are two to three times more likely to undergo hysterectomies for fibroid tumors than other racial groups, and although the rates of hysterectomies for Black women and white women were similar from from 1988 to 1990, fibroids as the primary indication for a hysterectomy was much higher for African American women (61% vs 29% for white women). I imagine that gap has increased now in 2020.
So what do we do about this? How do we stop the war on our wombs and allow Black women to exercise their God-given right to give birth if they chose to? I believe and have proof through the progress of my clients that we have to take matters into our own hands by educating our community and addressing this condition holistically.
In order to truly heal any condition, you need to know the root cause. Fibroids are generally a condition of estrogen dominance in relation to other hormones. Often, we have signs of estrogen dominance early—most noticeably in heavy periods. But women are taught to believe that our cycles are supposed to be heavy and painful and that we should grin and bear it.
I want to make a public service announcement right now: this period myth is seriously detrimental and sets us up for problems years down the line. To determine if you are estrogen dominant, pay attention to symptoms— migraine headaches, cramping, vomiting, nausea, heavy periods, periods lasting for more than seven days, or large clotting. For Black women we also need to heed warning signs that indicate lactose or casein intolerance: stomach upset after consuming dairy, throat infections, ear infections, and asthma. If you have any of these signs, you need to remove dairy from your diet and track how your body responds.
Often women have these symptoms for years and then later, fibroid growths appear. Seventy-five percent of Black people are lactose intolerant, and yet the Dietary Guidelines for Americans still promote dairy to people of color. Not only is this practice racist; it is costing us our wombs and overall health. The majority of women who I meet who become my clients consumed large amounts of dairy—cheese, milk, ice cream, etc.—had horrible period symptoms because of it, got put on birth control, and then later found out they had fibroids.
In order to prevent and properly treat fibroids, we need to address treatment holistically. With my clients, I focus on removing hormonal inputs in the diet via meat and dairy, eliminating intake of refined sugar, and minimizing exposure to toxins that mimic estrogen (such as pesticides and chemicals found in plastic bottles and cleaning products). In addition to increasing intake of fruits and vegetables which boosts overall fiber consumed in the diet, I use targeted supplementation to support proper estrogen metabolism.
As it relates to fibroids, it’s important to understand the precursor hormone for the stress hormone cortisol is progesterone. Under chronic stress, the body continues to produce cortisol, and the progesterone in the body is used to make more and more of it, so there’s less progesterone in the body to adequately balance out levels of estrogen, thereby perpetuating the cycle of estrogen dominance. Black women especially are under a unique firestorm of trauma and it’s slowly eroding our health. As such, I also offer my clients lifestyle recommendations to better manage stress (like exercise and incorporating mindfulness techniques such as prayer, meditation, and journaling).
This war within our wombs requires attention to the macro issues that generally point to a broken healthcare system: bias and racism in healthcare, better training of healthcare professionals, less emphasis on invasive procedures simply because they have a higher price tag, and even access to care. We also need to reimagine “birth control” and come up with solutions that don’t ruin women’s health in the long term. Other countries, especially ones in Europe have long transitioned to less invasive procedures for fibroids, while here in the United States, we are still recommending to women that they remove the most vital organ essential to their womanhood and overall health. America needs to do better.
