Uterine fibroids are the most common pelvic tumor seen in women. It is the most common reason why women have heavy menstrual periods. These benign tumors also cause significant pelvic pain which can radiate in to the lower back, hips, buttocks, and down the legs. Fibroids also often cause increased urinary frequency and waking up at night to urinate. In short, fibroids can be extremely disruptive to women.
This burden is disproportionately felt by women of color who suffer with fibroids significantly more often than other racial groups. Up to 80% of African-American women have these tumors and this disruption in their lives can be very difficult. How does one cope through episodes of bleeding where blood pours out of their body causing accidents to their clothes, their linens, their furniture? These episodes can strike without warning; causing women to wear extra gear, even diapers to prevent accidents in blood. They often carry around extra clothing with them at their job, in their car, wherever they might go. They often have to plan work and social events around their menstrual. This added blood loss each month often leads to chronic fatigue from the iron deficiency anemia from these fibroids.
Despite all of this misery, Black women continue to work through it; in other words “keepin’ it moving.” The reasons behind the “keepin’ it moving” are many. Some go to work because of a very strong work ethic. Some because they had to for financial reasons. Consistently being out at work could jeopardize their employment. For some women, despite the significant symptoms they cause, fibroids are not an illness. Therefore, if you’re not severely “ill”, you take the fibroid symptoms as they come, “keepin’ it moving”, and you go to work. For others, they work in a male-dominated workplace where suffering with heavy periods and pelvic pain are a woman’s lot in life, and their female identity is constantly scrutinized. Maybe they work through it to combat negative stereotypes of women or women of color in the workplace.
While battling fibroids, women of color have had to contend with near-perfect attendance, exemplary work performance, while at the same time trying to maintain a reasonable work-life balance. African-American women often feel not only a sense of responsibility to themselves, but also for women who may come after them. This is particularly true if it is at a job that is underrepresented by minority employees. How will they be respected by their male counterparts if they call off repeatedly, or ask others to cover for them, or go home unexpectedly despite the ravages of their periods? For them, there was no other choice but “keepin’ it moving.”
A 2013 study in the Journal of Women’s Health looked at ~1,000 women suffering with fibroids. The average time to seek treatment was 3 ½ years and 1 in 4 of these women waited 5 years or more. The main reason why these women “kept it moving” was centered on three main points: they didn’t want surgery, they didn’t want to lose their uterus, and they were not given any other option besides surgery.
Unbeknownst to these women and millions of other women throughout this country there was another choice. A choice that is completely nonsurgical and done as an outpatient. One that allows women to keep their uterus, but one that often goes unmentioned to these suffering women. This procedure is called Uterine Fibroid Embolization (UFE) and has been available for the past 25 years, but is performed by a different type of medical doctor: an Interventional Radiologist.
It’s time that we start to understand the struggles of and truly care for the well-being of Black women. Understanding Black women’s experiences is critical in trying to address the health inequities surrounding communities of color. These women that are struggling with uterine fibroids deserve to know all of their options and not just the surgical ones presented to them by Gynecologic surgeons. To learn more about uterine fibroids and what women suffering with these tumors go through, please go to our website ATLii.com.
John C. Lipman, MD, FSIR is a renowned fibroid expert and Adjunct Clinical Assistant Professor in the Department of Obstetrics & Gynecology at Morehouse School of Medicine.