Uterine fibroids in African women are among the most common yet under-recognised reproductive health conditions, often developing earlier and causing more severe symptoms than in other populations.
This article explains what fibroids are, why African women are disproportionately affected, common symptoms, causes, diagnosis, and available treatment options, using evidence-based research to support the discussion.
Uterine fibroids, medically known as leiomyomas or myomas, are non-cancerous growths that develop in or around the uterus. They arise from the smooth muscle tissue of the womb and can vary in size—from as small as a seed to as large as a melon (NHS, 2023).
Fibroids usually develop during the reproductive years, particularly between the ages of 30 and 50, and tend to shrink after menopause due to reduced hormone levels (Mayo Clinic, 2024).
Why Are Uterine Fibroids in African Women More Common?
Research consistently shows that Black and African women are two to three times more likely to develop fibroids than women of other ethnic groups. They also tend to:
Develop fibroids at a younger age
Have larger and multiple fibroids
Experience more severe symptoms
Require surgical intervention more often (Stewart et al., 2017)
Several factors contribute to this disparity:
1. Genetics
Fibroids often run in families. Women with a first-degree relative (mother or sister) with fibroids have a significantly higher risk (Laughlin-Tommaso, 2018).
2. Hormonal Influence
Fibroids are hormone-sensitive, particularly to oestrogen and progesterone, which are often higher or more active during the reproductive years (Bulun, 2013).
3. Vitamin D Deficiency
Vitamin D deficiency—more prevalent in people with darker skin due to reduced synthesis from sunlight—has been strongly linked to increased fibroid risk and growth (Baird et al., 2013).
4. Diet and Lifestyle
Diets high in red meat and ultra-processed foods, and low in fruits and vegetables, are associated with increased fibroid risk, while plant-rich diets appear protective (Wise et al., 2016).
5. Delayed Diagnosis and Health Inequality
In many African and Black communities, menstrual pain and heavy bleeding are often normalised, leading to late presentation and larger fibroids at diagnosis (WHO, 2022).
Studies show that uterine fibroids in African women are influenced by a combination of genetic predisposition, hormonal factors, vitamin D deficiency, and delayed diagnosis.
Common Symptoms of Fibroids
Some women have fibroids without symptoms. However, when symptoms occur, they may include:
Heavy or prolonged menstrual bleeding
Passing large blood clots during periods
Severe menstrual pain
Pelvic pressure or pain
Abdominal enlargement (“looking pregnant”)
Frequent urination
Constipation
Pain during sexual intercourse
Difficulty conceiving or recurrent miscarriages
Chronic heavy bleeding can lead to iron-deficiency anaemia, which is a major cause of fatigue, dizziness, and weakness among women with fibroids (NHS, 2023).
Types of Uterine Fibroids
Fibroids are classified based on where they grow:
Intramural fibroids – grow within the uterine wall (most common)
Submucosal fibroids – grow into the uterine cavity and are strongly linked to heavy bleeding and infertility
Subserosal fibroids – grow on the outer surface of the uterus, often causing pressure symptoms
Pedunculated fibroids – attached to the uterus by a stalk
Are Fibroids Cancerous?
Fibroids are benign (non-cancerous). Less than 1 in 1,000 fibroids are associated with cancerous changes, making malignancy extremely rare (ACOG, 2021).
How Are Fibroids Diagnosed?
Fibroids are usually diagnosed through:
Pelvic examination
Ultrasound scan (first-line investigation)
MRI scan for detailed mapping when surgery is considered
Can Fibroids Be Managed Naturally?
Natural and lifestyle-based approaches may help reduce symptoms and slow fibroid growth, particularly in mild cases:
Maintaining a healthy body weight
Eating a fibre-rich, plant-forward diet
Reducing red meat and processed foods
Correcting vitamin D deficiency
Managing stress and improving sleep
While these approaches are supportive, they do not eliminate fibroids completely, especially larger ones (NIH, 2022).
Medical and Surgical Treatment Options
Treatment depends on symptom severity, fibroid size, age, and fertility goals:
Pain relief and medications to control bleeding
Hormonal treatments
Myomectomy – surgical removal of fibroids while preserving the uterus
Hysterectomy – complete removal of the uterus (considered a last resort)
Raising awareness about uterine fibroids in African women can lead to earlier diagnosis, better treatment choices, and improved quality of life.
Conclusion
Uterine fibroids are a common but often misunderstood condition, especially among African women. Higher risk, earlier onset, and more severe symptoms make early awareness, routine screening, and informed healthcare decisions essential. Fibroids are not cancer, and many women live full, healthy lives with proper management. The burden of uterine fibroids in African women is higher due to a combination of genetic factors, hormonal influences, lifestyle patterns, and delayed access to healthcare.
Frequently Asked Questions (FAQs)
Are fibroids preventable?
Can fibroids shrink on their own?
Do fibroids always affect fertility?
References (Harvard Style)
ACOG (2021) Uterine Fibroids. American College of Obstetricians and Gynecologists.
Baird, D.D. et al. (2013) ‘Vitamin D and the risk of uterine fibroids’, Epidemiology, 24(3), pp. 447–453.
Bulun, S.E. (2013) ‘Uterine fibroids’, The New England Journal of Medicine, 369(14), pp. 1344–1355.
Laughlin-Tommaso, S.K. (2018) ‘Epidemiology of uterine fibroids’, Clinical Obstetrics and Gynecology, 61(1), pp. 3–11.
Mayo Clinic (2024) Uterine fibroids: Symptoms and causes.
NHS (2023) Fibroids. Available at: NHS UK.
NIH (2022) Uterine Fibroids. National Institutes of Health.
Stewart, E.A. et al. (2017) ‘Uterine fibroids’, Nature Reviews Disease Primers, 3, Article 17074.
WHO (2022) Women’s health inequities and access to care. World Health Organization.
Wise, L.A. et al. (2016) ‘Dietary factors and risk of uterine leiomyomata’, American Journal of Clinical Nutrition, 103(1), pp. 1–10.