We are delighted to announce the launch of our new fibroids booklet. This booklet was developed in response to our fibroids survey which  showed that:

• There was a general low level of awareness of fibroids amongst participants prior to their diagnosis
• There was a good level of awareness of the main symptoms of fibroids but a low level of awareness of other symptoms.
• Participants were aware that ethnicity was a risk factor for fibroids but less aware of other risk factors.
• 80% of participants stated that they needed information but only 53% said that this was available to them.
• 63% of women said they didn’t feel that they had enough information to make an informed decision about their treatment

In addition to the above some participants stated that their biggest challenge in managing their condition was the lack of information and conflicting information about fibroids. For example, one participant said, “there is not enough information, particularly with regards to surgery alternatives and diet changes.”

What the booklet covers

Our booklet provides much-needed information on all aspects of fibroids from symptoms and risk factors to treatment and prevention. It aims to ensure that women have accurate, reliable information about this condition and importantly discusses the treatment options available. We hope this booklet will be a one-stop-shop for anyone with questions or concerns about fibroids.

We appreciate all those who have helped us

We’re delighted to have had some excellent reviewers work with us. We would like to say a big thank you to Dr Nigel Hacking, Consultant Interventional Radiologist at Southampton University Hospital and Miss Rosol Hamid, Consultant Obstetrician & Gynaecologist and Head of Women Services at Croydon University Hospital for providing very helpful comments and suggestions.

We would also like to thank Celia Osu and Tenequa Wildy for their useful feedback and  our case studies for their willingness to share their experience and raise awareness. Finally, we are grateful to The Brielle Agency for proofreading our work and to Adrinqa for their creativity in designing the booklet.

You can download a pdf below and hard copies will be available soon.

Fibroid_LF_booklet_v0.4

We’re currently working on developing a fibroids booklet to address some of the issues that came out of our fibroids survey last year. From the survey we found that:

• There was a general low level of awareness of fibroids amongst participants prior to their diagnosis.
• There was a good level of awareness of the main symptoms of fibroids but a low level of awareness of other symptoms.
• Participants were aware that ethnicity was a risk factor for fibroids but less aware of other risk factors.
• 80% percent of participants stated that they needed information but only 53% said that this was available to them.
• 63% of women said they didn’t feel that they had enough information to make an informed decision about their treatment

In addition to the above some participants stated that their biggest challenge in managing their condition was the lack of information and conflicting information about fibroids. For example, one participant said, “there is not enough information, particularly with regards to surgery alternatives and diet changes.”

What our booklet will cover

Our booklet will provide much-needed information on all aspects of fibroids. It will cover the symptoms of fibroids allowing women to quickly pick up on the possibility that they might have fibroids ensuring an early diagnosis which may mean less invasive treatment, the prevention of unnecessary pain and avoiding loss of fertility. It will also raise awareness of the risk factors and provide information on what changes women can make to their lifestyle to reduce their risk of developing fibroids and it will help women identify whether they are at a high risk of developing fibroids and therefore whether they should be more vigilant about recognizing symptoms and changing their lifestyle to reduce their risk. Finally, it will also cover treatment options so women are aware of what options are available to them.

We appreciate all those who have helped so far

We’re delighted to have had some excellent reviewers work with us. We would like to say a big thank you to Dr Nigel Hacking, Consultant Interventional Radiologist at Southampton University Hospital and Miss Rosol Hamid, Consultant Obstetrician & Gynaecologist and Head of Women Services at Croydon University Hospital for providing very useful and helpful comments and suggestions.  Additionally we’d also like to thank The Brielle Agency for proofreading our work .

We need your help for the final review

Now we are looking for members of the public to read the final draft before it goes off to our wonderful designers, Adinqra, and provide us with feedback on what needs to be improved. If you’d like to help please contact us on info@thelakefoundation.com

We are absolutely delighted to welcome Dr Nigel Hacking to our fibroids Ask the Expert Panel. Dr Hacking is a Consultant Interventional Radiologist at Southampton University Hospital in the UK and specialises in Uterine Fibroid Embolisation (UFE). He was one of the pioneers of UFE and has one of the largest experiences in the world. He set up and runs both UK Fibroid Experts and Fibroid Caribbean and performs UFE in the UK at Southampton and London as well as in Trinidad and Nairobi.  He also helps train Interventional Radiologists from the UK and overseas to set up their own services. He has published in peer reviewed journals and has recently edited a textbook entitled ‘Radiological Interventions in Obstetrics and Gynaecology’.  For over 10 years he has spoken at most of the most prestigious Interventional Radiology conferences around the world each year on Fibroid Embolisation and other topics.

We are delighted to have him on board and if you have any questions about fibroids please do submit them to our panel here

On Saturday, we attended the Croydon Tabernacle Women’s Breakfast to deliver presentations on both breast cancer and fibroids.  This was a lovely event that brought together the women of Croydon Tabernacle to discuss important health issues over a delicious breakfast.

We were given a one hour slot to discuss two important health conditions. We started with breast cancer and gave attendees some background discussing what is cancer, what happens in breast cancer, the different types of breast cancer, stages, diagnosis, treatment, risk factors and current statistics.  Once we had set the scene with a bit of background we then provided attendees with information on what they can do to prevent breast cancer or ensure an early diagnosis. Here we focused on three areas, understanding the signs and symptoms, taking part in breast cancer screening and adopting a healthy lifestyle.  We finished the breast cancer session with a lively Q&A and then moved on to fibroids.

Wonderful programme. Very educational, informative and interesting. I learnt a lot – Bosola

For our fibroids session we covered what are fibroids, the types of fibroids, causes, risk factors, symptoms, diagnosis, treatment, facts and figures and prevention. It was stressed that fibroids are not usually life-threatening but can be very painful and affect fertility. We discussed the importance of understanding the risk factors and symptoms and that if they have symptoms they should visit their doctor. Information was also given on the lifestyle changes that women can make to reduce their risk of developing fibroids – being more active and eating a healthy diet.  Furthermore we noted that fibroids are more common in black women and when black women develop fibroids they tend to be more aggressive, bigger, multiple and develop at a younger age than their white counterparts.

We finished off our presentation by stressing that if women are diagnosed with fibroids they should ensure they have enough information to make an informed decision about how they’d like to manage and treat their fibroids. Women were advised to speak to a gynaecologist who specialises in fibroids to get the best possible advice.

After our session, Pastor Yinka Ayeni gave an excellent, inspiring presentation on self-esteem.

We thoroughly enjoyed this event and would like to thank Croydon Tabernacle for inviting us to attend and for their very warm welcome.

In October, we launched our Fibroids Ask the Expert, a resource that aims to provide anyone with a question or concern about fibroids with accurate reliable information from an expert in the field. Since its launch we have received a number of really interesting questions which our experts have been delighted to answer. We thought it would be useful to share some of the questions and the answers with you.  So, this week’s blog is a fibroids Q&A.

Question: “How much are fibroids are likely to shrink after menopause?”

Answer:  “Fibroids may shrink after menopause, but not always.  There have been reports of fibroids shrinking by 50% after menopause and that symptoms improve or disappear completely after menopause.  This isn’t an instant process though and our understanding is that if shrinkage occurs it is usually gradual.”

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Question: “My sister was diagnosed with fibroids one being 11cm, is that large?”

Answer: “A fibroid of 11cm is on the large side. Fibroids can vary in size from as small as a coin (about 2cm) to as large as a watermelon (about 19cm).”

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Question: “Would Doctors consider the use of proteolytic enzymes as a part of the fibroid shrinking protocol?”

Answer:  “Proteolytic enzymes have the potential to “shrink” fibroids, however to answer your question, a doctor’s protocol is relative to his/her academic training.  If the physician has been trained in biomedical sciences, he/she are less likely to promote this approach, unless perhaps to assist in decreasing the fibroid size prior to surgical intervention.  Nonetheless, there has been no major studies conducted that support a significant impact between proteolytic enzymes and fibroid shrinkage.  This is just another reason medical doctors may be less likely to support this protocol.  Naturopathic or homeopathic doctors would be more inclined to consider proteolytic enzymes in addition to other forms of treatment to address fibroids, however this decision needs to be made in consultation with your selected physician.”

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Those are just a selection of some of the questions we have received. If you have a question about fibroids, no matter what, please do submit it  here or email us

We get a lot of questions from women about what they can do to prevent fibroids. This week’s blog post follows our recent post on exercise and fibroids prevention. Today, we’ll look at diet.

Fibroids are non-cancerous tumours that develop in or around a woman’s womb. They can cause a number of symptoms including pelvic (tummy) pain, infertility, heavy and/or painful periods, back pain, anaemia, constipation, frequent urination and pain during sexual intercourse.

The exact cause of fibroids is unknown but research does suggest that they are caused by a combination of genetic, lifestyle and hormonal factors.  Those most at risk of developing fibroids are: black women, those who are overweight, women of child bearing age (particularly women who are 25-45 years old), those with a family history  and women who haven’t given birth.

Diet and Risk Reduction

When trying to understand what we can do to reduce our risk of developing fibroids diet is an interesting and important factor.  As obesity is a major risk factor then logically if we adopt a healthy lifestyle and lose weight then we can reduce our risk of developing this condition. But, are there particular foods that contribute to fibroids development and are there foods that are protective? Let’s take a look at what the research tells us about this.

Red Meat 

When it comes to foods that increase risk of developing fibroids, research suggests that red meat plays a major role. One research  study has shown that frequent consumption of beef and other red meat increases a woman’s risk of developing fibroids by 70%. This finding is similar to a study conducted in India which found that women who consume red meat are three times more likely to develop fibroids compared to vegetarian women or women who are mostly fish eaters.  This is in stark contrast to a recent  study that found no association between meat consumption and fibroids, although in this study researchers looked at all meat and didn’t look specifically at red meat.

Fruit and Vegetables 

The Black Women’s Health Study conducted in the US explored the impact of fruits and vegetables on a woman’s risk of developing fibroids. In this study, 22,583 black women were monitored from 1997 to 2009 and their food intake monitored.

This study found that overall fruit and vegetable intake was associated with a reduction in risk and the strongest reduction in risk was associated with a high intake of citrus fruit.  Additionally, they found that vitamin A from animal products (liver and dairy) was linked to  a reduction in risk too.

These findings were similar to that of a small Chinese study which explored the association of fibroids with diet, physical activity and stress.   This study took place between 2009 and 2011 and researchers found that fruits and vegetables significantly reduced risk of developing fibroids with women consuming the most fruits and vegetables (eating fruit and vegetables more than three days a week) being 60% less likely to develop fibroids.

Finally, a study conducted in 2009 found that a high intake of green vegetables  reduced the risk of developing fibroids by 50%  and fruit consumption reduced risk by 20%.

Vitamin D 

In 2013, one of the first studies looking at whether vitamin D is linked to fibroids was conducted and this study found that women with sufficient levels of vitamin D were 32% less likely to develop fibroids than women who are vitamin D deficient. Furthermore, another study published in 2013 found that women with fibroids had significantly lower levels of vitamin D compared to women not affected.  These studies suggest that vitamin D is protective.

Conclusions

It is clear that diet is very important in the development of fibroids. By adopting a healthy diet we can reduce our risk and women should pay attention to their fruit and vegetable consumption, reducing their red meat intake and making sure they have enough vitamin D.

It’s important to note that surveys conducted in the US have found that African Americans consume less fruits and vegetables than their white counterparts, it is important that we change our lifestyles and work on increasing our fruit and vegetable intake, our health depends on it.

Fibroids are benign tumours that develop from the smooth muscle cells of the womb. They are the most common tumour amongst women with an estimated 30 – 40% of women between the ages of 25-45 expected to develop them.

Research has shown that fibroids are more common in black women with an estimated 55-80% of  black women affected . In addition, black women are known to develop fibroids at a younger age, are more likely to develop larger and multiple fibroids, and tend to develop more severe symptoms.  The reason for this is unknown but it is thought to be a combination of genetic, environmental and lifestyle factors.

Through our interactions with black women we have anecdotally found that whilst fibroids are very common there seems to be a lack of information and support for women who are affected.  To explore this issue further we conducted a survey that aimed to explore the needs of women with fibroids, determine if there is a need to develop information and support and if so,  the survey aimed to inform our development of a fibroids information and support programme.

The survey explored four areas:

• The level of knowledge of fibroids prior to diagnosis
• Treatment and diagnosis
• The effect of fibroids and its treatment on quality of life
• The availability of support and information

The key findings from  our survey were:

Awareness of fibroids prior to diagnosis

• There was a general low level of awareness of fibroids amongst participants prior to their diagnosis
• There was a good level of awareness of some of the main symptoms of fibroids but a low level of awareness of other symptoms
• Participants were aware that ethnicity was a risk factor for fibroids but less aware of other risk factors

Pathway to Diagnosis

• The majority of participants delayed seeing their GP for six months or more after first noticing symptoms
• After visiting their GP, most women received a confirmed diagnosis within 4 weeks but over a quarter stated it took 12 months or more to receive a confirmed diagnosis

Treatment

• Despite 79% of participants having a discussion with their GP about treatment, 63% stated they didn’t feel they had enough information to make an informed decision about their treatment
• The majority of participants (42%) had surgery to treat their fibroids
• A quarter of respondents were very happy with their follow-up and aftercare whilst 33% stated that they were not at all satisfied.

The Effect of Fibroids and its Treatment on Quality of Life

• Participants reported that fibroids and its treatment significantly affected their quality of life, affecting them not just physically, but emotionally
• Many participants did not feel they had enough support  to assist them in managing or overcoming the  emotional, physical  and medical impact of fibroids

The Availability of Information and Support

• The biggest gaps in the availability of support were in information and peer support with a small gap in emotional support

Conclusions from the Survey and Next Steps

The survey suggests that a significant number of women with fibroids do not have access to the support and information that they require. The Lake Foundation will focus its efforts on addressingthe gaps in the availability of information and support by developing a relevant support system for women, particularly black women, with fibroids.

We have started this process with the launch of our ‘Fibroids Ask the Expert’ in October. This resource provides women with the opportunity to obtain accurate reliable information from experts in the field. In 2015 we will begin to develop a range of publications and explore a support programme for women with fibroids.

We get a lot of questions from women about what they can do prevent fibroids. In this week’s blog we’ll look at the effect of exercise on the development fibroids.

Fibroids are non-cancerous tumours that develop in or around a woman’s womb. They can cause a number of symptoms including pelvic (tummy) pain, infertility, heavy and/or painful periods, back pain, anaemia, constipation, frequent urination and pain during sexual intercourse.

The exact cause of fibroids is unknown but research does suggest that fibroids are caused by a combination of genetic, lifestyle and hormonal factors. Those most at risk of developing fibroids are: black women, those who are overweight, women of child bearing age (particularly women who are 25-45 years old), those with a family history of fibroids and women who haven’t given birth.

Exercise and Risk Reduction

When looking at these factors and trying to understand what preventative steps women can take, exercise seems like a logical factor to explore for two main reasons. Firstly, being overweight increases risk of developing fibroids so a woman can reduce her risk by maintaining a healthy weight through exercise. Secondly, fibroids are a hormonal condition with oestrogen and progesterone playing a role in their development. When we look at similar hormonal conditions that have been widely studied, such as breast and endometrial cancer, exercise has been shown to be beneficial in reducing risk. This is thought to be because exercise has a number of effects on our hormones which ultimately can lead to a reduction in the level of hormones circulating in our body and a  balancing of our hormones.

What Research Tells Us

A recent small study published in 2013 by Peking University in China looked into the association between physical activity and fibroids. They found that women who participated in moderately intense occupational activity (physical activity at work) had a significantly lower risk of developing fibroids.

In 2006, The National Institute of Environmental Sciences in Washington DC published the results of their research study exploring the effect of exercise on the development of fibroids. This study included 1189 women (734 black women, 455 Whites) aged 35-49. Whilst their study did have some limitations they found that women who did the most physical activity (more than 7 hours a week) were significantly less likely to develop fibroids than those who did the least amount of exercise (less than 2 hours a week). They also found that the association between exercise and fibroids was similar for both black and white women.

Finally, in 1986, the Harvard School of Public Health published their study which compared the prevalence of fibroids in former college athletes (2,622 women) to non-athletes (2,776 women). They found that the non-athletes were at a 40% greater risk of developing fibroids than their athletic counterparts.

Conclusion

Research and theory demonstrate that regular exercise is an effective way to reduce your risk of developing fibroids. By introducing as much exercise as you can into your weekly routine you can make a significant difference to your risk.

The UK’s Department of Health recommends that we do a minimum of 150 minutes of exercise per week; this is a good target to aim for.

Fibroids are very common in black women with an estimated 55% of black women expected to develop them. This is significantly more common than in white women with black women being 2-3 times more likely to develop fibroids than their white counterparts.

The reason that fibroids are more common in black women is not fully understood but it is thought to be a combination of genetic and lifestyle factors.

The quest to understand why fibroids are more common in black women is an ongoing one, and one area that was explored a couple of years ago by researchers at Boston University was whether relaxers (chemical hair straighteners) increase a women’s risk of developing fibroids.

Relaxers are seemingly a good place to start when it comes to identifying factors that put black women at a higher risk of developing fibroids. This is a product that is specifically used by black women and is used by millions of us worldwide.  But, more importantly, as fibroids can be stimulated by the hormones oestrogen and progesterone and relaxers are known to contain chemicals that behave like hormones (phthalates), then logically we can hypothesise that use of relaxers may have an impact of the development of fibroids.

As part of the Black Women’s Health Study in the US, researchers explored whether relaxers may play a part in the development of fibroids. This study included 23,580 black women from across the US and they found a very slight increase (17% increase) in the rate of fibroids when women who  used relaxers were compared with women who had never used relaxers. They also found that there was a slightly positive trend when they looked at how often people used relaxers, how long and how many relaxer burns they experienced. So for example women who had used relaxers for more than seven years had the highest rate of fibroids, but this was still only slightly higher (23% higher) than women who never used relaxers.

Looking at this we could say that the findings suggest that relaxers may play a part in the development of fibroids but when you delve deeper it is harder to say for sure. Firstly, the study shows an association between fibroids and relaxers it doesn’t actually confirm that relaxers cause fibroids. Also, researchers found through DNA testing that black women with more African ancestry used relaxers more than those with more European ancestry and once they took ancestry into account there was less of a link between fibroids and relaxers. What this means is that the association between relaxers and fibroids in this study may have had nothing to do with the relaxers  playing a part in the development of fibroids but it was actually the degree of African ancestry that is the important factor.

The researchers therefore stated that:

“ We cannot rule out the possibility that greater African ancestry, thought to increase genetic predisposition to uterine leiomyomata  (fibroids), explains part or all of the observed association”.

Additionally, researchers didn’t have any information on the brands of relaxers women used or the exact chemicals that women would have been exposed to and how much they were exposed to. This makes it hard to say if women were in fact exposed to the hormone-like chemicals that are of concern when it comes to fibroids.

The take home message is that relaxers probably do not play a major role in the development of fibroids and if they do their impact is very small.  It would appear that the main risk factor is African Ancestry.

We do know that there are some lifestyle factors that can reduce a women’s risk of fibroids. These include exercise, maintaining a healthy weight, reducing your red meat consumption and eating a diet high in green vegetables.  So, we can all reduce our risk by adopting a healthy lifestyle

You can read the original research paper from the Black Women’s Health Study below.