Black women and pregnancy: Fibroids by Kimberly Seals-Allers, author of The Mocha Manual to a Fabulous Pregnancy
Reviewed by the BabyCenter Medical Advisory Board
Last updated: January 2010

What are fibroids?
Fibroids are noncancerous tumors that grow from muscle tissue in the uterus. Fibroids, also called uterine leiomyomas or myomas, can grow on the outside of your uterine wall, within the uterine wall, or into the uterine cavity.
Women can have fibroids in one or more of these locations. The growths can be as small as a pea or as large as a basketball. But they are almost always benign, no matter how large they get.

If a fibroid or cluster of fibroids is particularly large or is growing on the outside of the uterine wall, it can push the uterus into an abnormal position. It can also put pressure on the bladder or intestine, causing symptoms such as frequent urination, constipation, pelvic pain, or backache. Fibroids may also cause heavy menstrual bleeding.
Fibroids can interfere with fertility, and they occasionally cause complications during pregnancy. For example, if a large fibroid blocks the opening of a woman's uterus, she may have to deliver her baby by c-section.
African American women are more likely than other women to get fibroids, but any woman of any race can get them.
Why is it especially important for black women to know about fibroids?
In the United States, African American women have the highest rates of fibroids. They're two to three times more likely to have uterine fibroids than Caucasian women. Fibroids also occur more often, develop sooner, grow larger, and are more likely to cause severe pain in black women than in women of other racial groups.
It's unclear why fibroids are more common and severe in black women than in women of other racial groups in the United States. In fact, no one knows for sure what causes uterine fibroids. But several studies and theories point to a number of probable and possible factors.
What are the risk factors associated with fibroids?
Family history: Individual family genetics may affect your chances of getting fibroids. If your grandmother, mother, or sister had fibroids, you may be more likely to have them.
Age: Fibroids generally first occur in women in their 30s, but they occur earlier in African Americans than in other women. It's not unusual for black women to get fibroids in their 20s. Fibroids often shrink and cause no symptoms in women who have gone through menopause.
Race: While it's known that American women of African descent are more likely to have fibroids than women of other ethnic groups, such studies have not been done in Africa.
Hormone levels: Fibroid growth seems to depend on estrogen or progesterone or perhaps both. Some studies show that fibroids are more likely to get smaller when estrogen levels go down (as they do after menopause).
Body weight: Some studies suggest that obesity might play a role in fibroid development. This is particularly important for African American women, who are 1.4 times more likely to be obese than non-Hispanic white women.
Childbirth: Studies have found that women who have delivered a baby are less likely to have fibroids. The risk probably goes down even more for women who have had two or more babies.
Lifestyle: Some studies have indicated that exercise and a healthy diet may lower the risk of fibroids, while studies have consistently showed that consumption of alcohol raises the risk.
Should I be checked for fibroids before I get pregnant?
If you're an African American woman and you don't know whether you have fibroids, you might consider getting checked. Visit your healthcare provider and ask for an ultrasound, which can often detect fibroids. If it turns out you do have them, you and your provider can watch for signs of potential complications.
If you already know you have fibroids and plan to conceive, you should schedule a preconception appointment with your provider.
Can fibroids cause infertility?
Fibroids occasionally interfere with fertility. Those located in the uterine cavity may actually distort the inside of the uterus and prevent pregnancy, so they're of particular concern. Fibroids in the wall of the uterus may interfere with fertility but seem to have less of an impact.
If you know you have fibroids or a family history of them, you may want to consider trying to conceive sooner rather than later, because the tumors tend to grow and become more of a problem as you get older, though they usually shrink after menopause.
What are the risks to me and my baby if I have fibroids during pregnancy?
Women who have fibroids usually have a normal pregnancy and vaginal delivery, but fibroids can sometimes cause complications. It all depends on how big they are and where they are.
"'Location, location, location' is key with fibroids. I've seen women with a fibroid the size of a cantaloupe that appears to sit on top of the uterus like a top hat. This fibroid may not complicate the pregnancy and delivery. Women need to know that the presence of fibroids doesn't mean you can't get pregnant or have a healthy pregnancy," says Gail Jackson, an ob-gyn with a private practice in the Cedars-Sinai Medical Towers in Beverly Hills.
Depending on their size and location, fibroids sometimes raise the risk of miscarriageduring the first or second trimester. Those in the uterine cavity may be more likely to cause miscarriage.
Some studies have shown that fibroids may make stillbirth, preterm labor and delivery, abnormal fetal position, and separation of the placenta from the uterine wall (abruption) more likely. But not all studies confirm these associations.
The most serious complications may occur when the placenta grows near or over the surface of a fibroid inside the uterus. If this happens, the growing baby might be deprived of sufficient nutrients and have a low birth weight, and the membranes (amniotic sac) may rupture prematurely. In other cases, fibroids may obstruct the birth canal, complicating labor and delivery.
It's very unlikely that your fibroids will hurt or deform your baby. "There's probably one case in an old obstetrics textbook, but it is so rare that it's not worth thinking about," says Andrea Jackson, an ob-gyn at the Physician & Midwife Collaborative in Alexandria, Virginia.
For pregnant moms, fibroids are often simply a nuisance. Because a fibroid can grow to over eight inches in diameter, a pregnant woman with sizable fibroids may look much larger than another woman at the same point in her pregnancy. "Be prepared for comments about how big you look, and don't let them bother you," Jackson says.
Can I deliver vaginally if I have fibroids?
Fibroids don't prevent you from delivering vaginally. However, you may need to have a c-section if the fibroids are in the lower part of your uterus, because they could block the baby's descent. You're also more likely to need a c-section if you have several fibroids, which could stall labor by preventing the uterus from contracting properly.
Will pregnancy make my fibroids worse?
Fibroids may grow or shrink during pregnancy, but in most cases they remain the same.
A small percentage, however, can more than double in size. These fast-growing fibroids sometimes outgrow their blood supply and begin to break down, a condition called "red degeneration."
Red degeneration causes severe pain and occasionally light vaginal bleeding, along with vomiting, nausea, and a low-grade fever. The pain, which is felt over the area where the fibroid is, may radiate down the back. It usually begins at the end of the first trimester or the beginning of the second – usually around 20 weeks – when the uterus is rapidly growing in size, but it can start up later in the pregnancy too.
"If the pain is severe, it can stimulate the uterus to start contracting. This can cause preterm labor. In that case you may be hospitalized or put on bedrest until all signs of preterm labor are gone," says ob-gyn Gail Jackson.
The frequent pain also causes confusion in pregnancy – is it the fibroids or preterm labor? – so women who have fibroids find themselves at the doctor's office more frequently, notes Geddis Abel-Bey, an ob-gyn with a private practice in Queens.
How can I safely deal with pain caused by my fibroids?
Pain is the most common symptom experienced by women whose fibroids flare up during pregnancy. When pain strikes, try resting on a comfortable couch or in bed with a hot water bottle or heating pad on your abdomen.
If the pain is ongoing or getting worse, call your healthcare provider. You can ask about prescription or over-the-counter pain medication that's safe for pregnant women.
Get tips and support from other women with uterine fibroids by visiting the Fibroids groupin the BabyCenter Community.
Should my fibroids be treated before I get pregnant?
Your healthcare provider might recommend treatment if you're having trouble conceiving or the location of the fibroids could lead to complications in pregnancy. Several treatments – from surgery to medication – are available, but women planning to get pregnant can consider only a few of them. The common surgical remedy of hysterectomy (removal of the uterus) makes pregnancy impossible, and the effects of the newer M.R.I.-guided ultrasound treatment on a woman's ability to become pregnant and carry a baby to term have not yet been determined.
Here are the two treatment options most commonly recommended for women who want to become pregnant in the future:
Myomectomy: This is the only surgical treatment available for women planning to conceive. A surgeon removes the fibroids but leaves the uterus intact. This procedure can be done abdominally, through an incision; laparoscopically, through a small incision into the navel; or hysteroscopically, through the cervix. After the procedure, there's a 25 percent chance of growing a new fibroid within ten years.
Medication: GnRH agonists and antagonists are two types of hormone therapy drugs that can dramatically lower estrogen levels. They are used to shrink or temporarily stop fibroids from growing, which is often enough to resolve fertility issues.
Since these medications often cause unpleasant menopause-like symptoms, such as hot flashes, vaginal dryness, and reduced bone density, you can take them for only six months at the most. They're typically prescribed for a short course several months before you plan to conceive. (Most providers recommend against taking GnRH agonists and antagonists during pregnancy.)
For more information on fibroid treatments – including options for women who are finished having children – read BabyCenter's article on uterine fibroids.
What will happen to my fibroids after I give birth?
Immediately after delivery, the fibroids may trigger significant bleeding, which will make iron supplements – or, in the most rare cases, a blood transfusion – necessary. If your provider thinks the location and size of your fibroids makes postpartum bleeding likely, ob-gyn Gail Jackson suggests asking friends and family to donate blood ahead of time and have it on order.
If your fibroids grew during pregnancy, they may shrink back to their prepregnancy size within a few months after delivery. Sometimes fibroids even become smaller than they were before pregnancy. After pregnancy the uterus undergoes considerable shrinkage, and during this process, some fibroids may shrink dramatically and become much smaller than they were before pregnancy.

SOURCE: http://www.babycenter.com/0_black-women-and-pregnancy-fibroids_10326261.bc?showAll=true

REACTION: The way body eliminates the excess fibrin (fibroids) is easy since fibrin is a protein it just digests it. But, your body needs what are called enzymes to do the digesting. Enzymes are energized protein molecules that are in all living cells you do not exist without them, they are the catalyst of life. Our bodies produce enzymes but not enough. The other supply of enzymes is the raw foods you eat. Refining and cooking foods destroys enzymes, raw foods are what you want.

The best ratio of raw foods in your diet to get those enzymes is 70% plus daily. Eating this way will not only help your body digest unneeded fibrin but it will also cut down on the inflammation in your body which encourages fibroid growth in the first place. To speed up the process of digesting fibroids add only a USA made enzyme supplement. You want Fibrinolytic as they digest fibrin in the muscles where many fibroids are found.
In some ways to prevent fibroids women should avoid using contraceptives pills should be shosen on your doctor’s advice or on the advise of the family planning experts because, contraceptive gives addition estrogen to the body system which apart from the possibility of causing fibroid also put the women at a higher risk of getting breast cancer. Pregnant women should also avoid the delay of pregnancy for too long a period during the reproductive age, stay clear from veneral diseases, should also avoid frequent and excessive D&C, prevent menstrual abnormalities.
Research has found that fibroids are the exclusive culprit in infertility or miscarriages in about 5% of the women who experience these situations. Doctors believe both infertility and miscarriage due to fibroids are because of the type of tumor and the placement of the tumor on or in the uterus.