By Jennifer Porter Gore
Overview: American Heart Association research finds women with fibroids face much higher long-term risk of cardiovascular disease. Black women are disproportionately affected and often dismissed when seeking care.
(WIB) – For many Black women, years of heavy bleeding, pelvic pain, and exhaustion during menstruation are dismissed as simply “having bad periods.” But a growing body of medical research shows that uterine fibroids — noncancerous growths in the muscle wall of the uterus — are at the center of a major, and often overlooked, health crisis for women — especially Black women.
Groundbreaking research finds women who suffer from fibroids face an astonishingly higher long-term risk of heart disease, stroke, and peripheral artery disease — with Black women disproportionately affected.
The research, published Wednesday in the Journal of the American Heart Association, found the long-term risk in women diagnosed with uterine fibroids is over 80% higher than in women without fibroids.
Dr. Stacey E. Rosen, AHA president and senior vice president of the Katz Institute for Women’s Health of Northwell Health in New York City, says the study “highlights yet another aspect in the unique factors that impact women in regard to the leading cause of death among them — cardiovascular disease.”
Although fibroids aren’t cancerous, having them can be life-altering. Heavy menstrual bleeding can lead to iron-deficiency anemia, fatigue, and days of missed work or school. The discomfort also can affect patients’ ability to sit comfortably—much less exercise.
The condition has also been linked to fertility problems, pregnancy loss, and preterm births in pregnant women.
Black women with fibroids are more likely than white women to report that their pain was minimized or their symptoms dismissed altogether. And they were less likely to be offered a full range of treatment options, which means their rate of hysterectomies is higher than for white women.
Risk More Than Triples for Women Under Age 40
This elevated risk of heart disease showed up in women of all races and ages, but was particularly strong in women younger than 40. The risk for cardiovascular disease in this age group was 3.5 times higher in those with fibroids compared to those without fibroids.
“Nearly 26 million pre-menopausal women in the U.S. are impacted by uterine fibroids, and many do not experience any symptoms,” says study author Julia D. DiTosto, who is a doctoral candidate at the University of Pennsylvania Perelman School of Medicine. “Yet despite the high prevalence, fibroids are understudied and poorly understood.”
Uterine fibroids are so common that researchers estimate that up to 80% of women in the U.S. will develop the condition by age 50. Women’s health officials say fibroids are the leading reason women need hysterectomies.
Earlier Onset, More Severe Fibroids — and Fewer Treatment Options
Yet a landmark national survey and several follow-up studies found that Black American women have triple the rate of uterine fibroids, and the tumors develop roughly 10 years earlier on average than in white women. Black women are also more likely to have larger and more numerous tumors.
JAMA researchers studying the link between fibroids and cardiovascular disease analyzed a U.S. database of health information from 2000 to 2022. They studied more than 450,000 women whose average age was 41 and who were diagnosed with fibroids. Those women were compared to just over 2.2 million women who had not been diagnosed with the fibroids.
After 10 years of follow-up analysis, women with fibroids were found to have an 81% higher risk of developing cardiovascular disease compared to women without fibroids. Also, at the 10-year mark, more than 5% of women with fibroids had already experienced a cardiovascular event, compared to 3% of women without fibroids.
The researchers stress that more data is needed before formally changing the current medical guidelines for assessing cardiovascular risk.
“The strength of the relationship between heart disease risk and uterine fibroids was striking,” DiTosto says. The results, she says, “support having thoughtful conversations between women and their providers about heart health in the context of a fibroid diagnosis.”
Rosen, the AHA president, says the study can provide the foundation for a breakthrough in an aspect of women’s health that is often overlooked.
“It also is an opportunity to recognize the very important role all of a woman’s health care clinicians can play in her overall health, including heart health,” she says. “Because many women may use annual ‘well-woman’ visits to their gynecologist or their general practitioner as their primary point of care, these visits offer exceptional opportunities that go beyond gynecologic health.”
The condition also has been linked to fertility problems, pregnancy loss, and preterm births in pregnant women.
“Because uterine fibroids are associated with an increased long-term risk of Atherosclerotic Cardiovascular Disease, women with fibroids should receive early, regular, and proactive cardiovascular screening,” AHA expert Dr. Eman A. Hamad, told Word In Black. “Black women require even more vigilance, as they are disproportionately affected by fibroids and also experience higher rates of hypertension, diabetes, obesity, and ASCVD, often at younger ages,” she says.
Black women with fibroids should request several tests. These include a comprehensive cardiovascular examination, an assessment for symptoms of heart or vascular disease, blood pressure tests, and measurement of BMI and waist circumference, among others.
Based on a patient’s lifestyle, family history, and social determinants, if cardiovascular disease risk factors are identified, the patient should be referred to a cardiologist.