Lupita Nyong'o Revealed She Has Painful Uterine Fibroids. Here's What That Means.
In the Instagram post, Nyong'o said she had 30 fibroids removed only to be told there is nothing she can do to keep them from coming back.
Her post is part of a campaign to raise awareness for uterine fibroids, support research funding and push forward Congressional bills. Nyong'o shared this news as a way to break the 'silent suffering' that's forced on women.
And while Nyong'o is a well-known person dealing with the often-painful condition, millions of other women deal with it, too. Both in silence and at endless doctor's appointments.
For instance, Tanika Gray Valbrun started experiencing extremely heavy periods early in her teen years.
'I was that girl who always had to carry pads with her, felt like I was always on my period, had to wear two panties and biker shorts, always had an extra bag with me,' she told HuffPost.
In addition to the heavy bleeding, Valbrun also experienced painful periods, her abdomen protruded and she felt a constant need to use the bathroom.
It wasn't until she was about 25 that she received a diagnosis: uterine fibroids. Many doctors appointments and treatments followed, and though she is still on this medical journey, the source of her issues is no longer a mystery.
Although fibroids are quite common, they remain relatively unknown or misunderstood for many. 'Uterine fibroids are benign tumors that grow from smooth muscle cells, so they're often found in the uterus,' said Dr. Sawsan As-Sanie, an associate professor in the department of obstetrics and gynecology at the University of Michigan Medical School. 'They can be in the lining of the uterus, the wall of the uterus or on the surface.'
Also called leiomyomas or myomas, fibroids vary in shape, size and number. Some grow slowly over many years while others might remain the same size for a long time and then start to grow rapidly.
'Looking back, I think about how many times I had accommodated my life for fibroids,' Valbrun said. 'I was always strategizing what to bring or how to dress because I would be bleeding. I never wore white clothing, even though I love whites and light colors.'
Below, experts break down the facts and misconceptions around uterine fibroids.
Who is most likely to have fibroids?
'Fibroids are highly prevalent, and they become more common as patients get older,' As-Sanie noted.
The National Institutes of Health estimates that up to 70% of white women and 80% to 90% of Black women will develop fibroids by the age of 50.
'Really, anyone with a uterus can experience uterine fibroids, but they disproportionately impact Black women at a higher rate,' Valbrun said. 'Black women are more likely to experience them, and their fibroids are more likely to occur when they're younger, grow more quickly and cause more symptoms.'
Age is a big risk factor with fibroids, as their prevalence increases as patients grow older and then declines in post-menopausal women. Although fibroids are most common in women ages 30 to 40 and in Black women, As-Sanie said that she sees them in patients of all ages, races and ethnicities.
'Mine started in my teenage years, so it's not just an issue for women in their childbearing years,' Valbrun added. 'And even though race is a risk factor, it's not just a Black woman's disease ― just like endometriosis is not just a white woman's thing.'
There are genetic factors as well. A family history of fibroids is associated with a three times greater risk of developing fibroids compared with women without that history, As-Sanie explained. She noted that obesity and nulliparous (the medical term for having never given birth) can also be factors.
What are the symptoms?
Despite their prevalence, fibroids don't cause symptoms in the majority of people who have them.
'Only about a quarter of women who have uterine fibroids have symptoms that are bothersome enough that they end up needing intervention,' As-Sanie said.
The most common symptoms are related to menstruation, such as heavy bleeding and pelvic pain.
'Any amount of bleeding that interferes with quality of life deserves an evaluation,' As-Sanie noted. 'We tell patients if they're soaking through a pad or tampon more frequently than every one to two hours, that should warrant evaluation. That amount can lead to anemia, low blood counts.'
Valbrun said that she's had to have at least five blood transfusions over the years to address her severe anemia.
'I was always craving ice and soap, so much that I would be constantly trying to smell them,' she recalled. 'My doctor told me it's called pica, and it's what happens when your body is deficient in iron.'
In addition to menstrual pain, fibroids can also cause pain during sex and at random times. As Valbrun reported, they may lead to swelling in the uterus and abdomen as well.
'Patients can also have what we call 'bulk symptoms' ― pressure from fibroids if they get large enough, feelings of bloating, urinary frequency and urgency, and even constipation or other bowel issues,' As-Sanie said. 'Fibroids are also associated with pregnancy-related complications like miscarriage and infertility.'
How are fibroids diagnosed?
'In terms of diagnosis, fibroids are generally diagnosed or at least suspected during a pelvic exam,' As-Sanie said, noting that the uterus often feels enlarged.
If fibroids are suspected, then the next step usually involves imaging, commonly with a pelvic ultrasound ― though tests including sonohysterography, hysteroscopy, hysterosalpingography and laparoscopy can also offer information.
'Some patients come in reporting symptoms, but for others it might be diagnosed during a routine exam,' As-Sanie noted. 'They may have had no clinical symptoms. Or if they're having trouble becoming pregnant, fibroids may be discovered as they look into their fertility problems.'
What is the treatment for fibroids?
If you're diagnosed with uterine fibroids, the next steps depend on your symptoms. You might not need treatment if your fibroids are small and aren't causing symptoms or if you're nearing menopause.
'If someone's not having symptoms, we typically just survey them over time,' As-Sanie said. 'They should get regular checkups to monitor for development of symptoms if they're not having them. Often we'll get repeat imaging every year or couple years to monitor for fibroid growth.'
For patients with symptoms, it's important to examine the symptoms they're having and what their goals are.
'With heavy bleeding, this can often be managed with medications ― like hormonal birth control pills, progestin-only birth control methods, other pills and injections,' As-Sanie said.
Although those methods are effective for many patients, they don't work for others. And over time other interventions might become necessary.
Myomectomy is the surgical removal of fibroids, and uterine artery embolization (sometimes called uterine fibroid embolization) is a less-invasive procedure that involves injecting tiny particles into the blood vessels to stop blood flow to the fibroids and cause them to shrink.
'There are also different types of ablations where you can use forms of energy to basically burn them away or make them smaller,' Valbrun said. She added that the recovery process after fibroid-related procedures can be lengthy, noting that it took her about eight weeks to recovery from her myomectomy.
Some fibroids are too small to be removed, and even after you've had fibroids removed or shrunk, there's always a possibility of regrowth or new ones appearing. And some patients have so many fibroids that it wouldn't be feasible to remove all of them. As a result, the only total cure is hysterectomy.
'The choice of what treatment is appropriate in patients very much depends on both a combination of things, like their age and desire to preserve fertility, as well as fibroid size and location,' As-Sanie said. 'Hysterectomy is generally considered a last resort when other things haven't worked, but it is considered curative and it's quite common in the U.S. And uterine fibroids and abnormal bleeding are the most common non-cancerous reasons that women have hysterectomies.'
What should you do if you suspect fibroids?
'Any symptoms of heavy bleeding and/or pelvic pain that are bothersome enough that they're interfering with your quality of life warrant evaluation,' As-Sanie said. 'There's no amount of bleeding or pain we would say is automatically 'normal.' If you're not able to work as effectively or enjoy your life, that is by definition considered abnormal and deserves evaluation.'
Fibroids are relatively common, but they're also just one of many potential causes for increased levels of pain and bleeding. It's important to see a medical professional to help figure out what might be at the root of your problems and determine the best course of treatment.
Many experience pregnancy complications or infertility related to fibroids, but medical interventions can help. So if you're hoping to give birth someday, know that fibroids don't necessarily prevent that.
'For many women who have fibroids but no symptoms, we don't automatically recommend treatment in order to get pregnant or have a successful or healthy pregnancy,' As-Sanie said. 'The relationship between fibroids and fertility and pregnancy is complicated, but there are many women who have fibroids ― even fibroids that cause symptoms ― that can become pregnant and carry a healthy pregnancy without needing intervention.'
And remember that there's nothing shameful about fibroids or any other gynecological issue.
'Patients often feel like it's embarrassing, and their families ― or even physicians they've seen ― have dismissed or minimized their pain as being a normal part of a woman's experience,' As-Sanie said. 'This is unfair and unhelpful to women.'
She urged patients and medical providers to help break down the stigma around menstrual disorders.
'We need to improve awareness and diagnosis, as well as reduce the bias and stigma by talking about pain and bleeding so that young girls and women don't dismiss it as normal or think it's too shameful to talk about,' As-Sanie emphasized. 'That way they can get earlier diagnoses and treatments.'
What else should people know about uterine fibroids?
Valbrun is dedicated to raising awareness and clearing up misconceptions about uterine fibroids. In 2014, she launched The White Dress Project to spread the word, increase funding for medical research and offer support to other people who are living with fibroids.
'I want to make people feel like they are not alone,' she said. 'And I wanted the support for myself because I never saw any organized walks or runs or people asking me to buy a T-shirt about fibroid awareness. It feels very lonely to feel like you're the only one on the bathroom floor in the fetal position. You're the only one canceling on your girlfriends, the only one not spending the night at a guy's house even though you want to.'
The name stems from her desire to reclaim the color white as a symbol of hope and empower herself and others to feel comfortable wearing white ― or to do it anyway in an act of rebellion against the limits fibroids can impose. The White Dress Project hosts community events, offers educational resources, supports research and advocates for policy in support of fibroid awareness.
Michigan state Rep. Kyra Harris Bolden (D) has also gotten involved in advocacy after being diagnosed with fibroids in 2020 and undergoing a myomectomy.
'It took me seven weeks to get back to what I felt was 100%, but ever since then, I've been on this quest to just bring more awareness to fibroids,' she told HuffPost. 'After I shared my story on the House floor during Uterine Fibroid Awareness Month, I got an outpouring of messages from women sharing their fibroid experience and how horrific it had been.'
Bolden has also partnered with organizations to spread awareness, worked on legislation and even helped get funding allocated for fibroid research in the Michigan state budget.
'This condition affects so many women but isn't widely talked about,' she said. 'If I had known it was so common, I probably wouldn't have waited until my condition got so bad to seek treatment and could've had a less invasive surgery.'
Valbrun also wants to spread the word about the different treatment options for fibroids.
'A lot of times, hysterectomy is the only option offered for women to deal with fibroids,' she said. 'Black women are more likely to be offered hysterectomy. I was told to have a hysterectomy when I was 26 and use a surrogate if I wanted children, and it was really disheartening. Fortunately, I found another doctor who told me about my other options.'
Of course, many patients are great candidates for a hysterectomy, especially if they are done having children or don't want to give birth, but Valbrun wants to make sure people feel informed and empowered about this decision rather than pressured.
'Remember that you are powerful and have a say,' she said. 'Nobody knows your body like you do.'
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Food & health TikTok Cancer Mental healthFacebookTweetLink Follow Chia seeds, goji berries, strawberries and raspberries: A TikTok user going by the name 'impamibaby' is filling her pretty wooden breakfast bowl with fiber-rich foods and filming it, inspiring her audience to eat more of the nutrient she says has made her bloating disappear. She's '#fibermaxxing' — the practice of eating meals that help people meet or exceed their daily fiber intake recommendations in the name of improving their gut health, losing weight and more. Videos with the tag have garnered tens of millions of views and likes. They generally feature people making and eating meals chock-full of fiber-rich foods, and are sometimes overlaid with text detailing the amount of the nutrient in their dish and the health benefits. TikTok has served up more than its fair share of questionable eating trends — looking at you, NyQuil chicken and #SkinnyTok — but every now and then, it surprises with something actually worth trying, registered dietitian Lauren Manaker said. Right now, that's fibermaxxing. 'Most Americans aren't getting nearly enough fiber in their diets, and that's a problem,' Manaker, owner of Nutrition Now Counseling, a nutrition communications business based in Charleston, South Carolina, said via email. The Dietary Guidelines for Americans recommend adults consume 22 to 34 grams of fiber daily generally dependent on age and gender, but more than 90% of women and 97% of men in the United States don't meet these recommendations, according to the guidelines. 'Whether it's adding chia seeds to everything, sneaking veggies into your meals, or finding new ways to love whole grains, fibermaxxing might just be the trend we didn't know we needed,' Manaker said — especially as rates of colon cancer, to which low fiber intake has been linked, she added, have been rising among people ages 20 to 54. Gastroenterologist Dr. Kyle Staller agreed, adding that adequate fiber intake has 'been a recommendation that has not changed for years.' 'Despite lots of science that comes and goes and trends that come and go, fiber is an oldie but goodie,' said Staller, director of the Gastrointestinal Motility Laboratory at Massachusetts General Hospital and associate professor of medicine at Harvard Medical School in Boston. But like anything else — and especially TikTok trends — fibermaxxing can definitely have drawbacks if you make substantial changes too quickly, Staller said. There are two types of dietary fiber: soluble and insoluble, experts said. Soluble fiber dissolves in water and absorbs it to form a gel-like substance, and is more associated with some of the digestive benefits of fiber, experts said. Insoluble fiber, on the other hand, doesn't dissolve in water and helps people have more frequent and heavier bowel movements. 'A balance of both is key for overall health,' Manaker said. 'If you get too much of one type and not enough of the other, you might experience digestive issues like bloating or constipation.' Most fibrous foods contain both types. Foods richer in soluble fiber include apples, bananas, citrus fruits, barley, carrots, oats, beans and psyllium, which derives from the husks of seeds of the Plantago ovata plant, according to the Mayo Clinic. Those with mostly insoluble fiber include vegetables such as green beans, cauliflower and potatoes; whole-wheat flour or wheat bran; nuts; and beans. Many TikTok videos on fibermaxxing feature meals made from a variety of these foods, such as colorful salads mixing different leafy greens and vegetables. Versions of TikTok user impamibaby's breakfast are common among fibermaxxers, and they're rich in insoluble fiber. Within those two types of fiber, there are other forms and characteristics of fiber also critical for gut health, Staller said. The viscosity of the fiber, for one, affects how well it flows through your digestive tract, while fiber fermentability influences how much your gut microbiome can actually ferment the fiber into helpful compounds to use as an energy source, he said. 'Then finally, how is the fiber packaged?' Staller added. Foods that are more processed, cut up, raw or cooked — all those forms have different effects on your digestive health, even if the foods contain the same type of fiber. However, you don't need to worry about doggedly tracking all these things in your efforts to increase your fiber intake. Eating a variety of whole or minimally processed foods will give you enough of what you need, Staller said. The link between higher fiber intake and decreased rates of colon and rectal cancers may be explained by a couple of factors, according to Jennifer House, a registered dietitian nutritionist and founder of First Step Nutrition in Alberta. When fiber increases stool bulk, it decreases the amount of time waste is in contact with the intestinal tract. 'Also, our gut bacteria ferments fiber, and it creates something called short-chain fatty acids,' such as butyrate, she added, which can nourish critical cells in the colon and inhibit cancer cells and inflammation. Recent research also suggests people with colon cancer may have greater odds of surviving if they increase their fiber consumption, Staller said. Fiber can also reduce your risk of other chronic illnesses and health conditions, experts said — including type 2 diabetes, high cholesterol, cardiovascular disease and premature death. And by improving your digestion, you're also reducing your risk of constipation-induced issues such as hemorrhoids and pelvic floor problems. Part of why fiber can help prevent or manage those conditions is because it aids in blood sugar regulation by slowing digestion — to a healthy degree — and the absorption of sugar into the bloodstream, reducing blood sugar spikes after meals, Manaker said. Fiber helps maintain a healthy weight, which is possible due to that blood sugar regulation and to fiber keeping you fuller longer, likely reducing overall calorie intake, Manaker added. Some TikTokers claim fibermaxxing can also help 'detoxify' your gut. Some of the experts don't love that word, given all the pseudoscience it's associated with in diet culture. But since fiber helps you poop, it 'literally does help remove toxins from your body,' House said. Additionally, some fibrous foods, such as leafy vegetables and nuts, support liver health, which plays an important role in detoxification, Manaker said. Experts are also increasingly learning more about the connections between our gut health and mental health, House said — finding that diets high or low in fiber-rich foods do affect your mood. If you want to start fibermaxxing, first know that 'going from zero to 60 when you don't consume any fiber at all is probably not going to go well,' Staller said. That's because when fiber pulls water into the digestive tract, the tract expands, causing discomfort and bloating in people who aren't accustomed to a normal fiber intake. Start low and slow by maybe adding some berries to your usual cereal breakfast or swapping one of your meals for one higher in fiber, House suggested. See how you feel after doing that for a week or two before you increase your intake. Some types of fiber don't work for everyone, Staller said, so listen to your body and adjust accordingly. Working with a dietitian, if possible, is best when navigating significant dietary changes. Fiber supplements — particularly those solely or predominantly made of psyllium husk — can be helpful if you have problems eating enough fiber or medical problems that need to be addressed more aggressively, such as high cholesterol, sources said. But they shouldn't replace fibrous foods as you'd be missing out on all the nutrients, minerals and vitamins they have to offer. There are several ways you can start incorporating more fiber into meals you already eat, such as swapping white rice, bread or pasta for whole-grain versions, Manaker said. The Dietary Guidelines for Americans site has a list of hundreds of commonly available foods and how much fiber they contain per standard serving size. Be sure to drink plenty of water, too — if fiber doesn't have any water to bring with it into your digestive tract, that can cause more bloating, gas and constipation due to dry stools, sources said. Sign up for CNN's Eat, But Better: Mediterranean Style. Our eight-part guide shows you a delicious expert-backed eating lifestyle that will boost your health for life.