Health hot line - Women's Health Section

Ebony, Oct, 2003

FIBROIDS

MORE than half of all Black women have uterine fibroids, which are non-cancerous tumors that grow in the muscular wall of the uterus. Sisters are three times more likely to have fibroids and are diagnosed at younger ages, between 20 and 50. Black women also tend to have more fibroids that grow faster and larger than women of other groups.

Among the major symptoms of fibroids are heavy periods, anemia, pain, frequent urination, discomfort during intercourse, distortion of the uterus, infant malnutrition during pregnancy and infertility.

There is no known cause for fibroids, which tend to be hereditary and which are associated with obesity and increased estrogen levels. Women who have fibroids, which shrink at menopause when the estrogen levels drop, should get regular checkups to make sure the tumors aren't getting larger and that more of them haven't developed.

The location, size, the woman's age, number of fibroids and whether she wants to become pregnant are factors considered to determine what treatment, if any, is necessary. Only 10 to 20 percent of women require treatment. Most doctors don't recommend treatment unless the fibroids cause excessive bleeding or pain.

Previously, women were given few treatment options to remove fibroids, with the most effective procedure being a hysterectomy, which is major surgery that removes the uterus and sometimes the ovaries--consequently ending fertility. Nearly half of all hysterectomies are related to fibroids.

Today, there are other treatment options to shrink or remove fibroids and spare the uterus. One method of reducing the size of fibroids is called uterine fibroid embolization, during which a catheter is inserted into a small incision in the upper thigh and guided by x-ray to arteries that feed the fibroids, thus causing fibroids to shrink. One-third of patients who had the procedure and tried to have children were able to conceive, and the pregnancies were carried to term.

Some women opt for a myomectomy to remove fibroids, while others choose to shrink fibroids through myolysis, during which a needle is inserted through an incision in the abdomen to cauterize or seal the fibroids from blood vessels, so they shrink. Medical officials say because it is a relatively new procedure, it is not clear how it affects fertility.

Another choice is a hysteroscopy, a procedure in which a surgeon removes fibroids using a tube inserted into the vagina. Patients usually go home the same day and recovery time is short. The treatment shouldn't impair fertility, doctors say.

It should be noted, however, that about 15 to 30 percent of fibroids grow back within 10 years after removal.

STRESS

EVERYONE feels the physical and mental strains of stress at some point in their lives. But the lives of African-Americans are disproportionately impacted by stress, spurred in part by financial worries and racial discrimination, experts say.

Although stress is a natural phenomenon, it is the heightened degree of stress that can cause some serious problems. Doctors say too much stress could be linked to heart disease, hypertension and cancer, including breast cancer, because stress apparently affects the body's immune system.

Stress means different things for different people, according to the National Mental Health Association, and occurs when people are unable to handle daily life events, some of which are related to finances.

University of Michigan sociology and epidemiology professor Dr. David R. Williams says Blacks are more susceptible to stress caused by financial concerns because African-Americans generally fall into a lower income bracket and earn approximately 40 cents less in income to every dollar that White families earn.

Additionally, too much stress can contribute to such conditions such as insomnia, headaches and chronic fatigue. Stress can also lead to detrimental coping methods, such as excessive eating, alcohol and drug use, and not adhering to medical recommendations that have been successful, Williams says.

There is ongoing research to find more effective ways to deal with the potentially deadly condition. Meanwhile, experts continue to encourage everyone to develop stress-coping regimens that include getting ample rest, exercising routinely and maintaining a balanced diet.

DIABETES

IN the midst of increased focus on the severity of diabetes, the disease continues to attack the African-American community, including women, at alarming and increasing rates. Currently, one in four African-American women over 55 has diabetes. And with the life-threatening problem of obesity, especially among Black children, the numbers are expected to grow rapidly, with the disease striking people at a much younger age.

According to a recent study presented at the American Diabetes Association annual meeting, obese girls are at a higher risk of adult-onset Type 2 diabetes than their male counterparts. And insulin resistance, a pre-diabetic condition in which the body doesn't respond to insulin properly, was significantly more common in girls than boys. To make matters worse, doctors say this pre-diabetes condition also is associated with adult-onset cardiovascular disease.