The Impact of Fibroids on Quality of Life

A Conversation on Health.

We can't turn a blind eye to the growing number of women worldwide grappling with fibroids. With some experiencing them from a young age, it's imperative to explore how fibroid treatments impact not only quality of life but also mental well-being.

Uterine fibroids, also known as leiomyomas, stand as the most common benign tumours in women globally. Indeed, they affect 70%–80% of women by the age of 50, with a higher prevalence among women of colour. 

Symptomatology of Fibroids

Fibroids manifest symptoms in up to 50% of affected women, which may include heavy and prolonged bleeding, bulk symptoms such as pelvic pain or pressure and bladder and bowel dysfunction, low back pain, and dyspareunia (painful intercourse). These symptoms significantly alter and impact overall quality of life.

Nevertheless, despite their widespread occurrence, the physical and psychological impacts on women are frequently overlooked in both medicine and society. Fibroids can cause psychological distress, as heavy and painful periods may hinder daily activities. Anaemia (not having enough healthy red blood cells or haemoglobin to carry oxygen to the body's tissues) resulting from fibroids can cause fatigue and affect overall well-being. Bloating due to the size of fibroids can range from discomfort to pain. Additionally, fibroids occupying space in the abdomen can affect various bodily systems, leading to gastrointestinal, musculoskeletal, neurological, and urinary symptoms. Furthermore, the weight of certain fibroids can result in pelvic floor dysfunction and impact sexual health.

Insufficient Research on Fibroids

Certainly, there is insufficient research on fibroids, despite the fact that they affect so many women worldwide. Additionally, there is a lack of education available for young girls, which would help them understand the issue and provide support for symptoms. Unfortunately, this is a widespread issue in women's health, where research is lacking and understanding and acknowledgment are almost non-existent.

Causes of Fibroids

The precise cause of fibroids remains unknown. However, they are linked to the hormones oestrogen and progesterone, which are produced by the ovaries. Fibroids typically develop and grow as long as the ovaries continue to produce these hormones. They may even enlarge during pregnancy. Conversely, fibroids tend to shrink when hormone levels decrease, such as after menopause, when hormonal changes occur in the body. This is why I believe that understanding the significance of hormonal changes is essential for women and society, as they can lead to various illnesses and dysfunctions that inevitably impact quality of life. The quality of food, pollution, and excessive use of chemicals can potentially impact the development of fibroids, although further research is needed to understand this link better. The connection between nutrition and various aspects of women's health has been overlooked until now, and it is crucial for governments to support more scientific research in this sector.

Exploring the Psychological Impact

Uterine fibroids are known to cause significant psychological stress. For instance, numerous studies indicate that women with fibroids have higher prevalence of depression and anxiety. For example, a study conducted in London by Glover surveyed 200 women with fibroids and discovered that 35% of them scored in the borderline or clinical range for depression, while 61% scored similarly for anxiety. 

The burden and distress faced by women with fibroids are akin to those experienced by individuals with other chronic diseases. What remains unclear is the ongoing lack of awareness among professionals and the absence of support for women experiencing symptoms in the workplace.

Racial Disparities in Fibroid Care

Fibroids are believed to occur more frequently in women of Afro-Caribbean and African American descent. Additionally, they are more common in overweight or obese women, as excess weight can elevate oestrogen levels in the body.

Recent studies have revealed racial disparities in fibroids at the molecular level, including differences in gene expression of genes, proteins, and micro-RNAs. Given these biological distinctions, it is reasonable to hypothesise that fibroids in black women may respond differently to medical therapy. If the pathophysiology of fibroids varies by race, there is a necessity for trials comparing fibroid therapies in black versus white women. 

African American women are 2 to 3 times more likely to undergo hysterectomy for fibroid tumours than other racial groups. Despite the fact that black women are 3 times more likely to develop fibroids and, on average, develop them 3 years younger than white women, there is still a significant lack of studies focusing on women of African heritage in the US, and a similar situation exists in the UK.

Challenges in Fibroid Treatment

Current treatments for fibroids are often limited, leading to hysterectomy as the primary solution for many women. Unfortunately, racial health inequality exacerbates this issue. We require more targeted research that takes into account individuals' backgrounds and differences to develop effective treatments. As a society, we need to realise that there are many different ways to know and understand what is wellness and what it means to be healthy. Cultural background, class, religious belief systems, and economic conditions impact and inform the way people communicate and convey who they are and what they need.

I believe that addressing the complexities of women's health requires a multifaceted approach that recognises and respects individual experiences, backgrounds, and needs. It is imperative that we prioritise research efforts to better understand and treat conditions such as fibroids, taking into account racial disparities and socioeconomic factors. Furthermore, as a society, we must advocate for comprehensive healthcare policies that ensure equitable access to quality care for all women, regardless of their race, ethnicity, or socioeconomic status. By fostering a deeper understanding of women's health and embracing diversity in healthcare practices, we can work towards a future where every woman receives the support, treatment, and respect she deserves for her well-being and vitality.

 As I conclude, know that you are not alone on this path to better health and wellness. Your journey is unique but together we form a community of strength and support.

Let’s thrive together,

Cristina x

FOR MORE INFO CHECK http://www.britishfibroidtrust.org.uk/

Sources;

Glover L, Novakovic A, Hunter M. An exploration of the nature and causes of distress in women attending gynaecology outpatient clinics. J Psychosom.

The impact of fibroid treatments on quality of life and mental health: a systematic review Brooke Neumann, D.O.,a Bhuchitra Singh, M.D.,b Joshua Brenna.