Uterine fibroids are non-cancerous tumors that, according to Florence and Fatehi (2023), are the most common gynecological tumor in premenopausal women..Not all women who have fibroids experience symptoms, but common symptoms in those that do include pain, pressure, and abnormal vaginal bleeding.
The Office on Women’s Health (2021) confirms that risk factors for developing uterine fibroids include age, family history, ethnic origin, obesity, and diet. Fibroids tend to present in women between 30 and 40 years old, lasting until menopause, with peak incidence between 40 and 50 years old. After menopause, fibroids usually become smaller, suggesting that hormones play a role in developing the condition. A woman with a family history of fibroids is more likely to have fibroids. Regarding ethnicity, the Office on Women's Health (2021) mentions that African American women are more likely to develop fibroids than white women. Overweight and obese women are more likely to develop fibroids, likely due to the inflammatory nature associated with being overweight and obese. Diet is known to play a role in the development of fibroids. Women who consume higher amounts of meat have an increased risk of developing fibroids, whereas women who eat more vegetables are less likely to develop fibroids. Other risk factors include the start of menses at an early age and using contraceptives at an early age (Florence and Fatehi, 2023). Inflammation can also be considered a major risk for fibroids since the previously listed risk factors, such as obesity and diet, can cause inflammatory processes.
Leiomyomas can be described as fibrotic tissue and are affected by inflammation since they develop from fibrotic responses from inflammatory cells (Zannotti et al., 2021). This leads to the activation of fibroblasts that cue collagen production (Zannotti et al., 2021). Fibroblasts differentiate into myofibroblasts, which can create pathological fibrogenesis when dysregulated (Zannotti et al., 2021).
The reason why it may be more common in African Americans is because we tend to live in more inflammatory physical environments. Examples include living in more polluted environments since they tend to reside in areas closer to factories and in more crowded environments, experience food deserts, and live in areas with higher levels of violence. These elements are social determinants of health, and contribute to inflammation differently. Air pollution allows irritants to enter our respiratory system, causing inflammation in our airways. Crowded housing can increase waste production and the risk for unsanitary spaces, introducing pathogens that create inflammatory responses. Food deserts deny access to fresh foods with anti-inflammatory properties and increase the presence of inflammatory foods such as fast foods. Violence produces an emotional response created by our nervous system, which releases hormones, contributing to inflammatory processes. Addressing social determinants of health is important for addressing chronic diseases such as fibroids.
References:
Florence, A.M, Fatehi, M. (2023). Leiomyoma. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK538273/
Office on Women’s Health. (2021). Uterine Fibroids. U.S. Department of Health and Human Services. https://www.womenshealth.gov/a-z-topics/uterine-fibroids#:~:text=About%2020%20percent%20to%2080,their%2040s%20and%20early%2050s.
Zannotti, A., Greco, S., Pellegrino, P., Giantomassi, F., Carpini, G.D., Goteri, G., Ciavattini, A., Chiarmela, P. (2021). Macrophages and Immune Responses in Uterine Fibroids. Cells. 10(982). 1-18. https://pubmed.ncbi.nlm.nih.gov/33922329/
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