What causes uterine fibroids
Uterine fibroids are the most common pelvic tumours worldwide. Women with uterine fibroids can present with abdominal pain or pressure, abnormal uterine bleeding and infertility. The exact cause of fibroids up until now is still not known. However, many theories have been put forward.
Most recently it has been shown that there is a relationship between first-degree relatives and fibroids. That is, if a mother has fibroids, then more than likely her daughter will have them, just as is the case with some cancers such as breast cancer. In addition, scientists have recently located a gene that is responsible for fibroids. Any abnormalities of this gene that occurs during development can lead to uterine fibroids later in a woman's life.
Since the 1980s, scientists have found a link between the female hormone oestrogen and the development of fibroids. Both men and women possess the hormone oestrogen, however, it is in much greater quantities in women. Women who are exposed to oestrogen for long periods of time can develop uterine fibroids. For example, a woman who has never become pregnant will be exposed to large amounts of oestrogen and is at an increased risk of developing fibroids.
Progesterone is a hormone that is released when a woman becomes pregnant. It has been shown that this hormone is protective against fibroids and actually decreases the risk of fibroid development. As a result, the more pregnancies a woman has, the less her chances of development of fibroids.
OTHER RISK FACTORS
For some unknown reason, black women are three times more likely to suffer from uterine fibroids when compared to white women. They tend to have more severe symptoms and also have more surgeries for either removing the fibroids or the uterus.
Jamaica of late has been a country where some of our women have been termed as 'fluffy'. This 'fluff' or obesity is associated with uterine fibroids and numerous studies have confirmed this.
Consumption of red meat and ham have also been shown to increase the risk, while the consumption of vegetables and fruits have been shown to decrease the risk of fibroids.
The more dairy and alcohol a woman consumes also increases her risk. There is no association with caffeine.
Interestingly, a history of smoking in the past, for some unknown mechanism, has been shown to decrease the risk of fibroids.
Lastly, hypertension has been shown to be linked to fibroids.
Whether it is genetic, hormonal, individual risk factors, or a combination of all, the exact cause of fibroids still remain unanswered. We are hoping that in the near future we can identify a cause.
In the interim we can try to decrease fibroids, by decreasing the modifiable risk factors such as diet and exercise.
• Dr Daryl Daley is an obstetrician and gynaecologist at the May Pen Hospital. Email: firstname.lastname@example.org