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Chemical relaxers linked to high uterine fibroid risk among African-American Women? I doubt it

The views expressed are those of the author and are not necessarily those of Scientific American.

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photo by Alecia Hoyt Photography

I sport an afro or natural hair, but I use to have a perm.  About a year ago, I shared my hair journey with Afrobella at Essence. com: Natural Hair Diary: Danielle N. Lee, Scientist.   When I was younger, I sat between my mother/older cousin/aunt/grandmother’s legs with jar of grease, cup of water, and tin of barrettes at the ready.  Each morning I braced myself for the rough brushing, parting, plaiting, and smoothing down of edges with blue or green grease.  By junior high school I was a big girl and I could wear my hair down.  Each week I got my hair washed and then I held on tightly to my ears and held my head down obediently as my ‘kitchen ‘was attended to – a press and curl.  For the rest of the week I was in charge of rolling, combing, and oiling my scalp each day.  By high school and college, I was getting chemical relaxers or perms.  As we – Black females – transition from elementary to junior high or middle school and then to high school, our hair styles change, as does the hair rituals and regiments.  Relaxers seem to be a rite of passage for Black females.  It was something that mature, often professional women did.  The box recommends touch-ups every 6-8 weeks. I hated getting relaxers so much that I would stretch it out 3-4 months.  Finally, one day 13 years ago instead of getting a touch up, I had my beautician cut all of the chemically processed hair off.  I was left with 2-3 inches of new growth or virgin hair.

I was eleven when I got my very first relaxer.  That was also the age I was when I got my first period.  But little more than a year before either of these landmarks I was having my first traumatic ‘lady problems’ episode.  I had spent two days bending over, clutching my right side, and  crying in pain.  It was when I starting vomiting that my mother took me to the pediatrician.  I tried my best to stretch out on the table as Dr. Dancy pressed on my lower abdomen. I screamed in pain.  Since I hadn’t had my first cycle yet, and I wasn’t wearing a training bra, they all feared appendicitis.  My mother nearly died when she was 12 years from a ruptured appendix.  I saw the fear in her eyes when the doctor said, take her to the hospital, now!

I spent 4 days in the hospital. I was ultra-sounded, X-rayed, and palpated in every imaginable matter.  They quickly eliminated appendicitis, but they were still uncertain as to my ailment. I was hooked to an IV, had my blood drawn daily and put on a restricted diet. What I remembered most was being SO Hungry.

In the end, they determined I had ovarian cysts. Cysts?! That sounded a whole lot like cancer to me and I was afraid. They assured me that cysts were not cancerous. I had to be careful and that they would keep on eye on them as I grew up and started having my periods.  Other than monthly cramping (Midol or Pamprin took care of all that PMS stuff) my lady issues seemed uneventful.

Until one day, completely out of the blue, I started bleeding and wouldn’t stop.  At first I had no cramps. I was driving in the work car and felt warmness and then it felt like something passing through me.  A few minutes later, sudden and severe pain kicked. I realized what was happening. I’m bleeding! Am I having a miscarriage?  I didn’t know.  Thankfully I was with female co-workers and they calmly handled the manner and rushed me to the Emergency Room.

There I was being poked and prodded and this time with speculums and transvaginal ultra sound wands, and stuck with IV and blood collection needles. It was pretty traumatic.  It was there that I heard the radiologist whisper to herself – Fibroid.  I was stabilized and sent home to recuperate.  Two weeks later I went to my OBGYN who looked over the hospital charts and did another exam.  Nothing spectacular.  What about fibroids? I asked. I heard the radiologist say she thought she saw fibroids.  He looked a the MRI results and the less-than conclusive ultra sound (I was in a lot of pain and was swelling, the ultra sounds couldn’t get clear images), and looked over my history.  His response: Nah, I don’t think that’s it. Maybe just an adverse reaction to Depo-Provera. It can do that?! I asked. Yes, he said.  Until that moment I had none of the symptoms typical of uterine fibroids.  And after that incident I never did.

Uterine Fibroids are tumors, usually benign – not cancerous, that grow from the uterus.  Most women diagnosed with fibroids complain of very heavy periods, lots of PMS cramps, lower back pain and painful intercourse.  Other than a growing bloated feeling, I felt fine – and I chalked that up to my weight gain.  But more than a year after the incident, I went in for my annual exam and my nurse practitioner remarked, “Uh oh” as she was palpating me on the right side. “Uh oh, what?” I asked. She said my womb felt “full”, like a fibroid was present.  She authorized diagnostic tests and 2 weeks later it was confirmed. I had uterine fibroids.

This is a uterine fibroid. My fibroid, in fact.

In addition to the main bulb which was about the size of a small grapefruit, my fibroids were knobby and growing 'appendages'.


That is my uterus in the top right section of this picture. The fibroids were growing outside of it. Sometimes they grow inside of the uterus or within the walls of the uterus.

I was the latest among my girlfriends who had discovered she had fibroids.  Among 30-something African-American women, uterine fibroids are common.  Very common.  But no one knows exactly why uterine fibroids develop or why Black women seem to get them more than women from other racial/ethnic backgrounds.  Some studies suggest it could hormonal – since it affects women of child-bearing age but who have no children most often.  It also seems to happen to over-weight women more.  Check, check, check, and check.

Because of the disparity, there have been some studies trying to understand why and how uterine fibroids disproportionally affects Black women.  Since it is a reproductive tract related problem, studies focus on physiological explanations.  Hormones seem to be at play, though it is not certain what the mechanisms are.  We do know that after menopause fibroids shrink and the complications associated with them disappear.  If, the tumors are hormone-sensitive, which I believe they may be, then diet and weight make since.  Body fat is metabolically important to gonadal hormones, especially estrogen-family hormones. Estrogen is very sensitive to body fat and circulating fat levels in the blood stream.  In fact, the switch that signals the female body to start puberty is fat-sensitive.  Once the female body reaches a certain weight and body fat composition, her hypothalamus and pituitary gland send signals to the ovaries (and the rest of the body) that this little girl is ready to be a woman.  Primary or vertical growth begins to halt and now that energy is directed to secondary sexual characteristics like growing breasts, and hips, and preparing for monthly menses.  Fat is so important to female menses that under-weight women and also some athletic women fail to have periods sometimes.

So when this came across my Twitter feed from The Root

DNLee About the Author: DNLee is a biologist and she studies animal behavior, mammalogy, and ecology . She uses social media, informal experiential science experiences, and draws from hip hop culture to share science with general audiences, particularly under-served groups. Follow on Twitter @DNLee5.

The views expressed are those of the author and are not necessarily those of Scientific American.

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Comments 8 Comments

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  1. 1. Tucker M 11:16 am 03/2/2012

    Fascinating stuff; great article. But sooo many typos, in practically every paragraph!

    This sort of critical commentary is vital. Don’t let typos dilute your credibility; that would be a real shame.

    Link to this
  2. 2. DNLee 12:00 pm 03/2/2012

    Thanks Tucker. I can fix typos. But if typos dilute the credibility of a PhD to a reader, then they probably weren’t that stoked about what I have to say.
    My blog is my space. All are welcome. But I don’t do rude or snippy in my home.

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  3. 3. InterestedThirdParty 1:06 pm 03/3/2012

    I wouldn’t say that typos dilute your credibility, but they can speak to how much time and effort you give to articulating a certain view point.

    You may have spent the required time and done due diligence (which i believe you did) to deliver an opposing viewpoint to what this “study” concludes, but typos send the message that maybe you don’t really care enough about the content you are writing.

    It goes back to the old saying “Let all your work be your best work”. Now piratically, some pieces may be hit or miss as far as point of view, but never let such a small thing like typos detract from that.

    As far as being interested in your content, I am very interested in both the study and your take on it. I agree that it’s major flaw is that it’s incomplete. Being that my partner has both had perms most of her young life and fibroid tumors, i’m very interested in any study that might validly show a link.

    Like you she’s gone natural and at the very least, I don’t have to worry about what perms/relaxers are doing to her scalp much less her uterus.

    Thanks for bringing this to an interested readers attention.

    Link to this
  4. 4. InterestedThirdParty 1:09 pm 03/3/2012

    And of course, there’s no edit function so I can’t go back and edit my own typos. Let me take some of my own medicine.

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  5. 5. Iamfever 2:50 pm 03/3/2012

    Hey Danielle!
    I just wanted to let you know that your post held my attention through the whole read. My eyes were glued to the screen waiting to see what you found from previous research. You have really a special talent.

    I never knew that someone had those type of symptoms with an uterine fibroid. Ever since my first period, it’s been a painful struggle every month; I end up vomiting because the pain is so terrible, and taking pain killers hoping that they’ll stop (but the aches persist).
    I’ve gone to doctors for it and they’ve just told me, “It’s probably just an ovarian cyst, it will dissipate over the next couple weeks. There is nothing to be concerned about.” and I’m thinking, I’m not concerned, I just want the pain to be gone.

    After reading this, I think maybe I should be concerned.
    I could have a uterine fibroid, it would explain a lot.

    Link to this
  6. 6. Mills 8:24 am 03/7/2012

    Lack of sun appears to be a factor – “Vitamin D Shrinks Fibroid Tumors in Rats” (

    Link to this
  7. 7. DNLee 7:45 pm 03/7/2012

    Thanks for sharing. According to this report Vitamin D *may* help shrink tumors, but that is not the same as saying lack of sun is a factor for African-American women being disproportionately affected by fibroids.

    Link to this
  8. 8. conniehilliard 3:05 pm 05/29/2012

    Dr. Lee, I did finally track down the origin of the fibroid/hair relaxer story. It appeared in an American Journal of Epidemiology article in 2011, and was entitled: “Hair Relaxer Use and Risk of Uterine Leiomyomata in African-American Women.” Yes, we as black women should lay off the relaxer. But the article’s conclusions are flawed. These researchers were trying to figure out what was “different” in black women relative to their white counterparts in order to understand the high rates of uterine fibroids among African-American women. The brainstorming went from hair to the chemical hair relaxers black women use. The reason I mention this is because the authors drew the wrong conclusions.

    There is growing evidence that wheat-gluten and dairy products trigger fibroids in black women. To know whether it is true for any particular woman, she should lay off all dairy products and substitute gluten-free for regular wheat products for several months. The fibroids will in all likelihood disappear. What I’m suggesting requires no surgery, nor expensive pharmaceuticals. The gluten/dairy-free dieter will probably also lose some weight in the process, because gluten may trigger an opioid-like addiction in blacks the way alcohol did with the early Indians. In West Africa and during slavery, the black diet did not contain either gluten or dairy products. It was primarily rice, cassava and corn-based. I say more about these issues on my blog:

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