Most studies done and published on fibroids have been done outside the African environment where the prevalence of fibroid is highest and the burden of this disease has the greatest impact.
It is well documented in many publications that blacks have a higher incidence of fibroids, experience more severe symptoms and present late for evaluation with larger fibroid tumors than other races.
Over the years many investigators have been trying to find the actual cause of fibroids formation and why the disparity among races. Those studies have yielded little data except risk factors which are linked to fibroid formation.
These risk factors include but not limited to:
- Race (Black women are more afflicted with fibroids than whites)
- Age (fibroids tend to form as the woman advances in age)
- Nulliparity (a woman who has never been pregnant)
- Early onset of menstruation
- Family history
- Weight and BMI
- Metabolic symdrome—blood pressure, triglycerides, fasting plasma glucose
- Pregnancy has a protective effect. Child bearing during the mid-reproductive years (25 to 30 years) provides the greatest protection against fibroid formation.
- Vitamin D deficiency
Fibroid growth patterns vary among individuals and races. Pathologically, they present as well circumscribed single or multiple masses with whirled, shiny, bulging, rubbery cut surface. They can undergo a variety of degenerative changes. It is composed of irregular bundles of spindle cells and a prominent extracellular matrix.
The presence or absence of Estrogen and Progesterone hormones and their receptors tend to regulate fibroid growth.