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Let’s talk periods. We mean menstruation, not punctuation. For most little girls, the monthly cycle becomes a fact of life around the age of 12, and shortly thereafter, they are introduced to the monthly cramps that often accompany menstrual cycles. But while typical cycles are 4 to 5 days, unfortunately, there are common ailments that prolong the duration, blood flow, and pain of menstruation creating a range of problems which can become extremely challenging. One such condition is fibroids. What are they? Known in medical parlance as leiomyomas, myomas, or leiomyomata, fibroids are noncancerous knots of smooth muscle that grow in the uterine wall. Why does this matter? The presence of fibroids both disrupts the normal blood flow and produces conditions that create clotting which extend the duration and increase the blood flow of the period, often beyond 7 days. Fibroids are also responsible for severe abdominal pain, often prolonged and excruciating in intensity. They can also lead to urinary incontinence, constipation, and an enlarged and protruding stomach.

There’s more bad news. Due to the intensified blood flow over longer durations, many women with fibroids end up suffering from anaemia, a deficiency in healthy red blood cells that are necessary to provide oxygen to the body’s tissue. The menstrual flow is often so intense that people who suffer with fibroids must use tampons and maxi pads simultaneously and are forced to change their sanitary protection more frequently. At night this means multiple trips to the bathroom which of course disrupts the sleep schedule. When sleep disruption persists over several days, when coupled with anemia, this can lead to intensely low energy and related symptoms like brain fog, fatigue, and more dangerous symptoms like tachycardia. To summarize, this means that many women with fibroids are not merely contending with the unbearable physical pain of their cycles, but also their curtailed movements, fatigue, and the social vulnerability and embarrassment that comes with having one’s life revolve around always knowing the proximity of the nearest toilet.

According to Dr. Elizabeth A. Stewart, fibroids are present in at least 25% of all women and “would be found in over 80 per-cent of all women if one looked carefully enough.” Stewart contends that we know less about them than other similar smooth muscle cells in the lungs or heart. We think the reason is obvious. While the academic and economic neglect of women’s health issues are well documented, fibroids are known to afflict black women far more than other racial groups. This fact means that fibroids reside at the intersection of sex and race where a focus on black women and girls has long been a low priority for western medicine. According to the 2023 study published in Environmental Health Perspectives by Christine R. Langton, Quaker E. Harmon, and Donna D. Baird (Women’s Health Group, Epidemiology Branch, National Institute of Environmental Health Sciences, Durham, North Carolina, USA) and Kristen Upson (Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA), African American women experience fibroid onset an estimated ten years earlier than US white women and therefore bear a disproportionate health burden from fibroids. Furthermore, according to the Black Women’s Health Imperative, “Relative to white women, black women are 2-3 times more likely to have fibroids, to develop them at younger ages, to have bigger fibroids, to have more fibroids, and to have more symptoms. The rate of hospitalization for fibroids is three times higher for black women than white women.” To state the obvious, we are quite certain that the same results will be revealed in Canada, should Canadian medical doctors ever get around to producing focused studies on black Canadian women! Another factor explaining the prevalence of fibroids in black women is the scientific evidence that fibroids are connected to vitamin D deficiency, a condition that commonly afflicts black people because an abundance of melanin in brown skin reduces vitamin D production.

As for treatment, while many doctors were guilty in the past of rushing women towards hysterectomies (the surgical removal of the uterus), there are operations and alternative treatments that should be considered first. But sadly, it’s foolish to assume that your gynaecologist knows everything he/she should to support you on this healthcare journey.

So, what are we up against? For one thing, many doctors may be adept at diagnosing fibroids (abdominal and transvaginal ultrasounds generally come into play) but fail their patients when it comes time to discuss pain management and alternatives beyond hysterectomies. While the removal of the uterus may work for some, for women who are contemplating pregnancy down the road, hysterectomies ensure that you will not be able to carry your own child and, if the ovaries are removed, you may also not be able to use your own egg. Another surgical alternative is uterine artery embolization, a procedure that may shrink fibroids by cutting off their blood supply. But if your symptoms have progressed to include anemia and tachycardia, it’s time to discuss iron infusions with your doctor.

So, since menopause may be years away, what else should we be doing right now? Well, as Dr. Mark advocates through his The Doctor’s Pharmacy podcast, media work, and many bestselling books, “Food is the most powerful medicine on the planet,” and it has the power not only to prevent, but to reverse disease. Therefore, one place to start is with an anti-inflammation diet. That means avoiding foods like dairy and sugar which produce mucous and inflammation in the body. It also means eating a plant-based diet, food rich in omega-3 fatty acids, and integrating anti-inflammatory foods and spices like ginger, turmeric, and black pepper. Recent research indicates just how much nutrition is ground zero for the women who may develop fibroids later in life. The 2023 study of Christine R. Langton et al. determined that female infants who were fed soy-based infant formula within two months of birth for six months had an elevated risk of fibroid incidence later in life in comparison with those who were never fed soy formula. The research team hypothesizes that the culprit is the exposure to estrogen-like compounds during sensitive developmental windows.

So, what should we be doing? First, if you are an adult with a uterus, it’s essential that you have an excellent gynaecologist who can provide the care, information, and testing to educate you, diagnose you, lay out your treatment options, and provide treatment or direct you to experts who can. Second, consider consulting a doctor who practices functional medicine and who can guide you along your nutritional path and suggest alternative remedies like castor oil packs and acupuncture. Third, although you absolutely have a right to your privacy, do speak up at work and let your employer know if your fibroids have resulted in a disability. Certain days a month may be no-go or work from home days, and for many in the age of Zoom, we think that’s just fine.