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The Straight Truth: Hair Relaxers and Fibroids

 

The incidence of fibroids in the United States is 2-3 times higher in black women than white women, with their likelihood of developing the benign uterine tumors estimated at 80% and 70%, respectively. Researchers have spent several decades investigating this racial disparity, and they continue to seek answers, as the phenomenon has not yet been fully explained. However, certain epidemiological links have been established through the research, yielding information that could help reduce the incidence of this all-too-common condition among black women – provided they are aware of it. Hair relaxers are an example.

In the late ‘90s and early 2000s, researchers investigating the racial bias of uterine fibroids hypothesized that endocrine-disrupting chemicals in hair relaxers could impact a woman’s risk of developing the condition. They found evidence to support this hypothesis in surveys amassed by a large-scale U.S. cohort study, The Black Women’s Health Study. The surveys, collected from 59,000 premenopausal African-American participants, asked questions about the use of chemical hair straighteners, including: age of first use, frequency of use, number of scalp burns experienced, and type of formula(s) used.

Of the women surveyed in The Black Women’s Health Study, 94% reported having used hair relaxers for at least 1 year. Of all the participants, researchers observed that women who used hair relaxers were 1.17 times more likely to have uterine fibroids than those who did not use hair relaxers. Almost a third of the women who reported using hair relaxers did so on a frequent basis, at a rate of 7 or more times per year. With this group, the incidence of fibroids increased to 1.23 times that of women who do not use hair relaxers. Research determined that the womens’ age at first hair relaxer treatment and the type of relaxer they used (lye vs. no-lye) did not impact the incidence of fibroids; however, both duration of hair relaxer use and the number of burns experienced were positively correlated with the occurrence of fibroids.

Hair relaxers contain a variety of toxic chemicals: lye-based relaxers contain sodium hydroxide; “no-lye” relaxers contain calcium hydroxide and guanidine carbonate; “thio” relaxers contain thioglycolic acid salts; and almost all varieties contain endocrine-disrupting phthalates, which often appear on a label as “fragrance” or “perfume”. All types – including the “no-lye” relaxers – have been known to cause burns and lesions on the scalp (despite advertising claims to the contrary), and such injury facilitates the entry of the chemicals into the body.

Phthalates, a group of hormonally-active compounds, can be absorbed topically (through the skin) or through inhalation. Studies have shown that certain phthalates have an estrogenic effect on cells. Fibroid tumors are estrogen-dependent, so chemicals like phthalates that disrupt the body’s natural estrogen production can potentially spur the development of fibroids.

Since cosmetic products are not subject to regulation by the Food and Drug Administration, manufacturers are not required to disclose all of a product’s ingredients on the label. Thus, while endocrine-disrupting chemicals like phthalates are ubiquitous in cosmetic products, their presence may not be readily evident. There are, however, certain indicators that point to the presence of phthalates. In a 2011 study, the research team of Wise et al. noted:

Because the vast majority of hair relaxers list ‘fragrance’ as an ingredient, and 100% of popular fragrances tested in a 2002 study were found to contain phthalates, most hair relaxers likely contain these chemicals. In addition, some hair relaxer products directly list phthalates as one of their chemical ingredients. (Wise et al. 2012)

Of course, phthalates are not the only endocrine-disrupting substance that black women – or consumers, in general – encounter on the day-to-day: chemicals known for their reproductive toxicity appear in products all around us, and without knowledge of their presence, consumers will continue to be subjected to the detrimental effects of those chemicals.

That said, the link between hair relaxers and increased fibroid risk is a significant discovery, both because it could partially explain the racial bias of uterine fibroids and because it serves as actionable information that enables women to moderate their exposure to the toxins that could contribute to the growth of fibroids. With this knowledge, women can make an informed decision about whether the potential cost of hair straightening treatments simply outweighs the beauty benefits.

 

>> SEE ALSO:  What Causes Fibroids: The Known Risk Factors

 

SOURCES:

Wise, L. et al. “Hair Relaxer Use and Risk of Uterine Leiomyomata”, American Journal of Epidemiology. 2012; 175(5):432-440

“New Study Finds Exposure to Toxic Phthalates in Decline; Consumer Demand for Safe Cosmetics a Factor”, Campaign for Safe Cosmetics, Jan 15, 2014 . Online. http://www.safecosmetics.org/about-us/media/press-releases/new-study-finds-exposure-to-toxic-phthalates-in-decline-consumer-demand-for-safe-cosmetics-a-factor/#sthash.YhCKOLu2.dpuf

 

 

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Exploring The Connection Between Fibroids And Obesity

 

Fibroids_weightgainThe relationship between weight and uterine fibroids (also known as leiomyomas) is a complex one. However, while it is not fully understood, a link between obesity – which is typically defined by a Body Mass Index (BMI) ≥24 – and fibroid risk has been identified in multiple research studies. In fact, data suggest that obese women have two to three times the risk of developing fibroids than women of average weight.

Racial Disparities In The Impact of Obesity

Some research suggests that the relationship between BMI and fibroid risk differs between black women and white women. One study produced evidence that premenopausal black women may have higher ovarian hormone levels than white women (Woods et al., 1996). Another revealed that in black women, estradiol levels decrease as BMI increases in black women, whereas this was not the case for white women (Manson et al., 2001).

The Black Women’s Health Study, an ongoing prospective cohort study in the U.S. that was initiated in 1995, found the prevalence of obesity (BMI ≥30 kg/m2) to be nearly twice as high in black women as in white women. The incidence of uterine fibroids is also significantly greater in black women than white women, and the researchers involved concluded that this was not a coincidence: they hypothesized that a connection with the weight factor could partially explain the disparity in the disease burden. Looking more deeply at the results of the cohort study, the research team of Wise et al. noted that “weight gain was positively associated with risk among parous women (those who have given birth) only”.

Understanding the Hormone Connection

To understand the role that weight plays in fibroid development, one must start by looking at the common denominator: hormones. Ovarian hormones, particularly estrogen, play a key role in the development of fibroids. Obesity has been tied to hormonal and metabolic changes in women of reproductive age, included altered estrogen metabolism.

In a May 2012 article for Today’s Dietitian, Krystene DiPaola, MD, a reproductive endocrinologist and infertility specialist at the University of Cincinnati Academic Health Center, explains, “We do know that fibroids respond to estrogen, and that estrogen isn’t produced only in the ovaries but also in peripheral fat in the form of estrone,” she explains. “The estrone can, in higher doses such as in overweight women, affect fibroid growth and cause them to be more symptomatic.”

Does Diet Make a Difference?

The question then becomes, is it possible for an obese woman to minimize the occurrence or recurrence of her fibroids by losing weight? Unfortunately, research has not yet yielded a definitive answer to this question. However, some study data suggest that diet modification – and particularly the weight loss that may result – can make a difference in the presentation of fibroids. Because hormones are the driving force behind fibroid development, dietary choices that promote hormonal balance can potentially impact the development of fibroids and the severity of their associated symptoms.

DiPaola believes any nutritional modification that may lower peripheral fat stores, and therefore reduce estrogen production from those fat stores, only helps women with symptomatic fibroids. “In terms of my personal opinion,” DiPaola says, “the dietary component towards the treatment of fibroids can do nothing but help and may augment the traditional therapies to treat this condition.”

 

>> SEE ALSO:  The Fibroids-Diet Connection

 

SOURCES:

Takeda, T. et al. “Relationship Between Metabolic Syndrome and Uterine Leiomyomas: A Case-Control Study”, Gynecologic and Obstetric Investigation. July 2008; 66:14–17

Woods, MN. et al. “Hormone levels during dietary changes in premenopausal African-American women”,
Journal of the National Cancer Institute. Oct 1996; 88(19): 1369-74

Manson, JM. et al. “Racial differences in sex hormone levels in women approaching the transition to menopause”, Fertility and Sterility. Feb 2001; 75(2): 297-304

Wise, L. et al. “Influence of Body Size and Body Fat Distribution on Risk of Uterine Leiomyomata in U.S. Black Women”, Epidemiology. May 2005; 16(3): 346-354

Tempest, M. “Uterine Fibroids and Nutrition — Studies Suggest Healthful Dietary Modifications May Cut Risk and Ease Symptoms”, Today’s Dietitian. May 2012; 14(5): 40 http://www.todaysdietitian.com/newarchives/050112p40.shtml#sthash.tuDCxUd2.dpuf

 

 

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