Edgar G. Mathis, of Manor Texas, wrote in 1900 that he had operated on a Black woman to remove a large uterine fibroid and felt to the need to document the condition, “noting the meager literature concerning this rare form of neoplasm” among African Americans.  Mathis’ operational notes – now more than a century old – read like the constant stream of articles, blogs, and research related to Black women and fibroids.  That rare condition is shared, according to recent data from the Black Women’s Health Imperative (BWHI) and Hologic, by more than 26 million Americans. 

“Because of the health disparities, devastating impact, and effects of uterine fibroids — and to save and extend the lives and well-being of Black women — BWHI commissioned the white paper to amplify the voices of Black women to advance health equity and shift the public perception and policies for social change,” said Tammy Boyd, JD, MPH, chief policy officer and counsel for Atlanta-based BWHI.  “The widespread prevalence and disabling nature of uterine fibroids among Black women often surprises some clinicians.”

Boyd found the existence of disparities in diagnosis and care of uterine fibroids result in Black women waiting longer than white women before seeking treatment: normally 4 years of more – which potentially exacerbates their conditions.  This results in Black women experiencing more incidents of severe pelvic pain and anemia due to heavy bleeding.

“By any measure, these statistics and outcomes are dire and indicative of a pressing public health crisis,” Boyd said.

Still, little is known about what causes fibroids or how to definitively treat them – without resorting to hysterectomies.  In fact, many Black women still approach anything gynecological as off limits, taboo, or shameful.  As a result, the “female trouble” our elders whispered about, remains a painful and hidden heritage. 

During a 2-day roundtable by the Society for Women’s Health Research (SWHR) in Washington, D.C., expert researchers, gynecology-focused health care providers, patients, patient advocates and policy leaders discussed key deficits in research, clinical care, and federal policies.  They noted advancements in treatment, including non-hormonal medical therapies that were also fertility-friendly, and the potential if Vitamin D to provide protective effects against fibroid growth without negatively impacting ovarian function.

Additionally, SWHR highlighted the research of The Study of Environment, Lifestyle, and Fibroids – the first prospective study to identify incident fibroid cases based on ultrasound screenings and is specifically designed to investigate African ancestry, vitamin D deficiency, and reproductive tract infection as risk factors for fibroid incidence.

Many offerings of the discussion centered around the science of fibroids, but in equal measure were bed-side manner suggestions that would foster trust between Black women and their physicians. 

“We suggest reconsidering a patient’s use of the word ‘normal’ or ‘fine’ when describing menstrual flow or pain because they may not realize that their normal may actually warrant medical concern,” said SWHR Director of Science Programs Irene Aninye. “Quantifying the use of feminine products or the duration of pain and its influence on daily activities is likely to better inform an assessment.”

With so much to unpack, The Washington Informer offers a quick glimpse at information and resources available to our readers to approach fibroids head on, and seek a relief from “female trouble,” without delay or embarrassment.

Read, Learn, Heal.

Dr. Shantella Y. Sherman

Dr. Shantella Sherman is a historian and journalist who serves as the Informer's Special Editions Editor. Dr. Sherman is the author of In Search of Purity: Eugenics & Racial Uplift Among New Negroes...

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