Uterine fibroids are extremely common, but the experience of living with them varies widely among racial groups. Some people never notice they have fibroids, while others face heavy bleeding, pain, anemia, fertility challenges, and symptoms that may disrupt their daily life. For Black women, the burden is especially severe.
1. Prevalence & Symptom Severity
Fibroids are extremely common. Up to 90% of Black people with a uterus will develop them by age 50, and that rate is even higher amongst Black women. For Black women, Fibroids…
- Can appear when you are younger, grow larger, and multiply faster
- Produce symptoms that are often more severe, including:
- Heavy bleeding and anemia
- Pelvic pressure and pain
- Fatigue that affects work, relationships, and daily life
Additionally, Black women wait a full year longer for treatment compared with white women.
- These delays often stem from:
- Limited access to specialists
- Prior negative healthcare experiences
- Symptoms being dismissed as “normal”
2. Biological Differences:
New studies show that fibroid disparities arise from patterns instead of a single gene.
- Fibroids in Black women more often carry MED12 mutations
- Tumors contain more extracellular matrix (ECM)
- Even before fibroids form, Black women’s uterine muscle tissue shows higher ECM activity
- These biological differences may influence how certain medications work
- Biology is one part of the story and not the whole explanation
3. Social & Structural Drivers
Biology alone cannot explain why Black women experience worse outcomes with uterine fibroids. Social and structural factors play a major role in this disparity.
- Structural racism affects access to specialists and minimally invasive surgery
- Implicit bias leads to the dismissal of pain and heavy bleeding
- Historical trauma in OB‑GYN care affects the trust Black women patients have, and ultimately delays seeking treatment
- Allostatic load, such as chronic stress from racism, may influence fibroid development
- These factors contribute to higher complication rates:
- 3× more likely to be hospitalized
- 7× more likely to need a myomectomy
- 2× more likely to undergo a hysterectomy
- More likely to receive more invasive surgery instead of the minimally invasive options that White women receive
These findings highlight an urgent need for more research, better clinical training, and stronger systems of care for fibroids, especially for Black women. Biological differences and social determinants of health must be understood together. When this is done, discoveries can translate into better outcomes, earlier diagnosis, and treatment approaches that truly meet the needs of Black women.
Sources:
Uterine Fibroids in Women of Color