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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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Do’s And Don’ts For Talking To Your Doctor About Fibroids

 

Knowledge is power. When it comes to your health, your doctor has a lot of it – and a lot of empowering knowledge to share. At the same time, you know your body best. You know if things are “off”, and – in order for your doctor to effectively do his/her job – you need to share what you know about your state of health.

If you’ve been diagnosed with (or suspect) fibroids, you have a lot of options. Your visit with your gynecologist is an opportunity to learn about and discuss those options, as well as to gather information that will help you better understand your condition. To get maximum benefit from your appointment, observe these “do’s and don’ts”.

THE “DO” LIST

DO EXPLAIN YOUR SYMPTOMS – ALL YOUR SYMPTOMS

Being forthcoming about your symptoms will help both you and your doctor to better understand the nature of your condition. Among the estimated 25%-30% of women who have symptomatic fibroids, the nature and severity of symptoms can vary, depending on the size and location of fibroids. For example, urinary urgency often results when a large fibroid is growing next to – and pressing against – the bladder. In the initial phase of diagnosing your condition, gathering information about symptoms like this will give your gynecologist a clearer idea about the nature and location of your fibroids. In turn, he or she can help you understand how the symptoms you describe are impacted by your fibroids.

DO ASK YOUR BURNING QUESTIONS

If you’ve been newly diagnosed with fibroids, you probably have a number of pressing concerns and questions.  Bring them up! No matter how strange, gross, or personal you may consider a question to be, you’re probably not the first woman to ask it. In a 2012 survey of women aged 29–59 with symptomatic uterine fibroids that was conducted by Harris Interactive, concerns frequently cited by participants included:

  • Physical concerns, including: the potential for physical impairment, worsening of symptoms, future fibroid growth, health complications such as cancer, and impact on fertility
  • Employment-related concerns, including concerns about the ability to perform job-related duties and fear of missing work
  • Relationship concerns, including how fibroids will impact personal relationships, sex life, and home life

Your concerns are valid, and your doctor’s visit is the best time to get them addressed. Don’t be shy: whatever the question, chances are, you’re not the first fibroid patient to ask it!

 DO ARTICULATE YOUR PRIORITIES

Numerous treatment options are available to women with uterine fibroids, including pharmacological treatments, surgical and minimally-invasive options, and complementary and alternative therapies. In order for your doctor to recommend a course of treatment that fits your needs, he or she has to know what those needs are.

Perhaps the most important piece of information in this regard would be whether or not you want to get pregnant at some point in the future. Hysterectomy is notoriously overprescribed as a treatment for fibroids, yet it is obviously a poor option for women who desire to eventually get pregnant: a uterine-conserving procedure is usually a more suitable option in such cases.

DO EDUCATE YOURSELF

Too often, we hear women who have undergone hysterectomy saying they “wish they had known” about less invasive options for treating fibroids. While your gynecologist should – in theory – inform you about all of your treatment options, the best way to ensure the decision you make is an informed one is to inform yourself. Do some research in advance of your appointment, so you can use the visit as an opportunity to ask questions about the treatments you’ve investigated. There are numerous reputable websites that are loaded with information about uterine fibroids and new treatment options: a couple of good places to start are www.womenshealth.gov (published by the NIH) and www.reproductivefacts.org (published by the American Society for Reproductive Medicine. A hysterectomy is not for everyone, so get to know what other treatments are available to you; your subsequent discussion with your doctor will likely be more productive, as a result.

DO WRITE DOWN YOUR QUESTIONS IN ADVANCE

Most of us have, at some point, left a doctor’s office thinking “oh no, I forgot to ask about (insert pressing concern)”. It’s hard to remember everything you mean to ask when you’re in the midst of an exam or office discussion. Do yourself a favor and write those questions down. If you’re not sure what you want to ask, print out our handy list of “Questions To Ask Your Doctor” and bring it to your appointment.

 

THE “DON’T” LIST

DON’T SKIP THE GORY DETAILS

It’s not unusual to hear a woman with symptomatic fibroids share an anecdote about “sitting in the tub and just bleeding out” or describing how her bathroom regularly “looked like a warzone”. Sure, these are not dinner-table conversations, but the “colorful” details about symptoms like blood loss can actually be helpful to your doctor in diagnosing fibroids. Heavy menstrual bleeding is generally considered the definitive symptom of fibroids; but what constitutes “heavy” can be somewhat subjective for women experiencing the symptom. For this reason, describing gross realities like this can actually clarify the severity of your symptoms.

DON’T BE AFRAID TO SEEK A SECOND OPINION

If you don’t think that you have all the answers to your questions or you are not satisfied with the options that have been presented, you may want to get a second opinion.  It’s great to trust your physician; what’s more important, however, is that you feel comfortable with the decision you and he/she reach together. There’s no harm in seeking further information through a second opinion, even if you completely trust your doctor.

 

>> SEE ALSO:  Where Can I Learn More About Fibroid Treatment Options?

 

SOURCES:

Stewart, E. et al. “The Burden of Uterine Fibroids for African-American Women: Results of a National Survey”, Journal of Women’s Health. 2013; 22(10):807-16

 

 

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