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Fighting Fibroids

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Doctor in Hospital Room
Photo Credit: Thomas Northcut

At 26 Tasha Mitchell stopped taking birth control pills to get a break from the side effects she had been enduring since her teens. “I just wanted to get off it once and for all,” she says. “I just wanted to be natural.” But two to three months after Tasha stopped, her menstrual cycle failed to normalize. Her period became very heavy and lasted for two weeks, and she experienced spotting between cycles. Her gynecologist encouraged her to stay on the Pill to regulate her flow, but Tasha was adamant about ditching her prescription. For six weeks she saw an acupuncturist, who improved her cycle somewhat but then sent her back to the doctor to find out if she had uterine fibroids, benign knots of muscle tissue that can grow just within, on or outside the uterus and normally occur during a woman’s child bearing years.

Since she had butted heads with her first gynecologist, Tasha found a new one, who discovered a fibroid two centimeters long inside her uterus. This physician recommended a myomectomy, a surgical procedure to remove the fibroid, and put her back on the Pill to regulate her cycle. But Tasha’s period only got heavier. “I’m not gonna lie; I thought I was going to die,” she says.

One day on the train to work, she felt so weak that she went to the emergency room and was shocked when she was admitted to the hospital. In just one month Tasha’s fibroid had more than doubled in size, and her heavy periods had left her with blood iron levels so low that surgery was not safe. She needed iron shots and an injection of Lupron Depot, a medication often administered before fibroid surgery that can shrink the tumors and halt menstruation by bringing on temporary menopause. Tasha’s doctor also prescribed six weeks of bed rest so her body could recover.

“Having the surgery was the easiest part,” Tasha says ofher unusually straightforward procedure. “They didn’t have to cut—they dilated the cervix and removed the fibroid that way.” After that operation she went home and was back at work in two weeks. Today Tasha’s menstrual cycle is normal, and she has a 1-year-old son.

Fibroids’ Astonishing Impact

Also called uterine leiomyomas, fibroids vary in size from microscopic to that of a grape, a lemon, a cantaloupe or even a watermelon. Some women never even know they have them; others experience heavy bleeding, cramping, abdominal pressure and swelling, frequent urination, painful intercourse, fatigue, miscarriages and infertility. “Heavy and more frequent bleeding is the number one issue,” says M. Natalie Achong, M.D., of the Yale University School of Medicine’s departmentof obstetrics, gynecology and reproductive sciences. Although Tasha’s surgery was uncharacteristically easy, the disruptions she experienced along her journey to diagnosis and treatment are not uncommon to Black women. A groundbreaking 2013 Mayo Clinic study of women ages 29 to 59 with symptomatic fibroids found that fibroids significantly impact Black women’s lives—far more so than previously understood.

“If you look at fibroids compared with other diseases, the degree to which fibroids affect your entire life is astounding,”says Elizabeth Stewart, M.D., the study’s lead author and chairof the division of reproductive endocrinology and infertility at Mayo Clinic and Mayo Medical School. “Women are missing work; it’s impacting their career advancement and interfering with their relationships.” While numerous theories exist about why fibroids develop—from high estrogen levels to genetics to environmental chemicals, possibly including hair relaxers—experts say there is no definitive proof of a root cause. Risk factors include age, family history and obesity, as well as eating a lot of red meat and ham, getting your period early and not bearing children. Also not understood: why Black women get fibroids three times more often than White women.

Taking Charge of Our Health

Black women’s fibroid troubles tend to begin during our twenties as opposed to the thirties and forties, when White women typically experience them. This imperils our plans to have kids.“There’s a whole emerging cohort of women, particularly professional women in their thirties. They know they have fibroids—maybe for ten years, maybe since they were in college or were teenagers—and they’re conflicted about what to do,” Achong says. “They’re having symptoms every month, or maybe even weekly, but they don’t know what to do because they’re not in a relationship and they want to have children, so they have to keep their uterus.” The study also suggests that Black women have a harder time getting a diagnosis, good information about treatment alternatives and a solution, Stewart says. Understanding our options requires that we adopt a much more hands-on approach than other conditions and diseases demand. Here are the most common medical procedures.

For more from this feature, pick up the May issue of ESSENCE now!

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