Black women experience fibroids at a slightly higher rate than women of other races, with eight of every ten Black women being diagnosed with these generally-noncancerous uterine growths. More often than not, when experiencing severe symptoms of the gynecological issue, the aforementioned group of women faces healthcare disparities and poor recommendations for treatment options, even botched surgical procedures that leave them with unsightly and unnecessary scars.
Dr. Pierre Johnson, a Chicago-based, board-certified OB-GYN, who is known as the "fibroid slayer," often uses his social media platform to inform women of their power to choose, including the option to receive minimally invasive surgical removal of fibroids, among other procedures. He has performed more than 500 surgeries with a 0% conversion rate and also proctors for laparoscopic companies across the country in an effort to encourage other surgeons to practice the process. While his medical work has given him the tools necessary to help women, Johnson has also made it his mission to candidly discuss healthcare inequities, bust myths and encourage women to do their own research to advocate for themselves. He sat down with 21Ninety to explore some of these concepts on a deeper level.
Black Women and Fibroids
While Black women do experience fibroids at a higher rate than other women, Johnson said that the numbers do not vary much between ethnic groups, with seven out of every ten white women experiencing them and Latinas at a number in the middle of the two groups.
“Fibroids are just very prevalent,” Johnson told 21Ninety. “Why it’s slightly higher in Black women, we really don’t know. We do know that there is a chance that there is a genetic component to it, but it’s not all genetics, there are different environmental factors that can contribute to it.”
However, he noted that what Black women may experience at a disproportionately higher rate are health care inequities and medical racism.
“When you look at how fibroids can impact Black women more, it goes directly into some of the dark fabric of our country with medical, health care disparities, racism and a lot of other different things. It disproportionately affects Black women -- if you look at the hysterectomy rate for Black women as opposed to any and everybody else in the country, it’s markedly higher, and especially higher in the southern states. It spills over into the issue of healthcare disparities because of a lack of access to quality healthcare and a lack of resources.”
All Fibroids Are Not Created Equal
While it’s not exactly a phrase that belongs on a t-shirt, Johnson stressed that not all fibroids are created equal. He also said that not every case of fibroids needs to be addressed. In fact, according to Johnson, fibroids are only detected when a woman is experiencing symptoms. These symptoms can include painful intercourse, heavy vaginal bleeding, frequent urination, abdominal pain and infertility. An ultrasound is the only screening used to detect fibroids, so it’s highly possible that a woman who gets regular pap smears could be living with non-invasive fibroids and never know it.
“Fibroids are not created equal,” Johnson said. “Fibroids are problematic for either one or two reasons -- size or location.”
Johnson said that fibroids could be large or small, but regardless of size, the problem presenting fibroids are those that push into the cavity of the uterus.
“Either way, fibroids do not belong in the cavity of the uterus, if that happens they typically cause symptoms and that causes problems.”
In deciding your treatment or removal options, Johnson said a woman must first assess what her fibroids are doing.
“If the fibroids are there and they’re not causing her bad symptoms or causing infertility then you don't need to do anything about it. An option is to be conservative and do nothing.”
However, if a woman is experiencing severe symptoms, Johnson said she could consider medication or a variety of procedures including surgical removal of the fibroids. It’s in this area where he cautions personal choice and research the most. Symptoms such as bleeding may be treated with medications that decrease bleeding. Then there are levels of options for medical procedures including non-invasive, minimally invasive, or in incredibly severe cases, a hysterectomy may be performed.
“It really depends on what the woman wants and what’s happening in her life,” he said.
Fibroids And Pregnancy
Fibroids can have an impact on pregnancy, including causing complications or even loss of pregnancy.
“Fibroids overall do decrease the rate of fertility, so if you take 1000 women with fibroids and 1000 women without, you’ll have a much higher yield of women getting pregnant in the group without fibroids," he said
Fibroid location can also cause premature labor.
“It doesn’t always happen this way -- it all depends on size and location. We can’t lump fibroids in one monolith, because they aren’t created equally.”
Busting Some Popular Myths
Can relaxers cause fibroids? Can I just change my diet and make it all go away? Will my fibroids just disappear when I hit menopause? Can anything be done to prevent developing fibroids?
According to Johnson, the answers are all no, however, while there isn't sufficient scientific evidence to prove that relaxers have any correlation to fibroids, Johnson was hesitant to provide a hard no on that claim.
“There is not enough information [to support the claim that chemicals in relaxers cause fibroids],” Johnson said. “We can’t completely say that, but there have been links to cancers with some women with relaxers. I think the data needs to be analyzed a little bit more, but I don’t think there is enough evidence to say that about fibroids, or at least I haven’t seen any such study. I can’t give a definitive true or false on that.”
And, as for dietary changes, while it’s always a great idea to practice clean and healthy eating, Johnson said there is no proof that your diet can affect fibroid growth or elimination.
“I operate on vegans, vegetarians, pescetarians, people that work out, people who aren’t in shape, you name it, I operate on them. That is a myth.”
Advocating For Yourself
While Johnson said that fibroids don’t have a causal link with anything, life with fibroids is not hopeless.
“There’s no diet or exercise or birth control -- there’s nothing in your daily life or activity that you can do to avoid fibroid formation that we know of. But, you most certainly can be very in-tuned with your body and understand that you can have fibroid formation and have a plan, that if fibroids are significantly impacting your life, you can do something about it.”
Johnson suggests that women who are experiencing problematic fibroids do research on their providers and options.
“Don’t let anyone tell you that you don’t have options,” he said. “If your doctor is not listening to you or not hearing your concerns or not giving you a multitude of options that work for you then you need to find a new provider. Oftentimes, we get complacent with our providers and that's when bad things happen.”
“Do your research,” he continued. “There are so many resources you can use to optimize your care -- utilize them, and if you’re not getting those answers and options, you gotta keep looking.”
Johnson said many of his patients have come to him after another doctor has told them they were infertile or needed a hysterectomy.
“Don’t let anybody just tell you that,” he said. “I haven’t had any women with extensive fibroids yet that I haven’t been able to salvage her uterus except for a patient who actually had cancer and those fibroids were cancerous -- it’s a rare thing, but it happens. Unless those fibroids are cancerous, they can be removed and your uterus can be preserved.”
Outside of his work directly in the medical field, Johnson is a co-author of the 2018 book, “Pulse of Perseverance: Three Black Doctors on Their Journey to Success,” and a major champion for health care equity through his program, Doc 4 Da Streetz, for which he serves as a “voice for the people in the fight to eradicate healthcare disparities by sharing his knowledge and skills with those in need,” according to his website.