Living and surviving the Black woman’s curse

From childbirth to menstruation, pain has often been treated as an unavoidable part of womanhood. It is regarded as something to be managed quietly rather than investigated. It also is often said that, women are built to endure. For many Black women living with fibroids, that expectation of endurance can become particularly costly.

Uterine fibroids are benign growths that develop from the muscle tissue of the uterus. They are common and may cause no symptoms at all. For some women, they can result in heavy or prolonged menstrual bleeding, severe cramps, pelvic pain and pressure, anaemia, pain during sex, and difficulties with fertility.

What makes the conversation more urgent for Black women is the disproportionate burden. Research consistently shows that fibroids occur more frequently in Black women, tend to appear at younger ages and can be larger, more numerous and more symptomatic. A 2024 review noted that fibroids may affect up to 70 per cent of women by age 50, with Black women experiencing a significantly higher burden than White women.

The disparity has become so familiar that fibroids are sometimes described as the “Black woman’s curse.” But while the phrase captures the frustration of women who have lived with the condition, it can also make fibroids sound like an inevitable fate which, they actually are not. What is undeniable, however, is that many women continue to live with symptoms for years before seeking or receiving appropriate care.

Moyo Awotile knows what that experience can look like.

Her journey began in 2018 when she missed her period and consulted a doctor. An ultrasound revealed that she had fibroids, alongside another reproductive health condition. At the time, she did not fully understand how significant the diagnosis would become. She continued with her life, but over the years, her periods became increasingly difficult. The pain intensified, her menstrual cycle became irregular, and there were occasions when the cramps were so severe that she could barely eat. Eventually, she found herself returning to Avon Medical in search of a lasting solution.

Moyo’s experience reflects one of the less discussed realities of fibroids: Women, gradually adapting to their lives around their symptoms. A period becomes something to plan for and the heavy bleeding dictates what clothes can be worn and how long one can stay away from home. Pain affects work, social activities and relationships. Fatigue may be accepted as normal, even when it is related to blood loss and anaemia.

Medical guidance is clear that heavy or painful periods that disrupt normal activities warrant medical attention. Yet, conversations about menstrual health remain uncomfortable in many communities, leaving some women to normalise symptoms that should prompt a medical consultation.

There is also a wider gap in what is known about fibroids among Black women in Africa. A review of research on Black women in sub-Saharan Africa found significant gaps in evidence on prevalence, incidence and risk factors, highlighting the need for more research on the condition within African populations.

For women who eventually require treatment, the decision can come with its own fears. Fibroid treatment is not one-size-fits-all. Depending on the size and location of the fibroids, severity of symptoms, age, reproductive plans and other individual considerations, options can include medication, monitoring, uterine artery embolization, minimally invasive procedures or surgery. Myomectomy, for example, removes fibroids while preserving the uterus, while hysterectomy involves removing the uterus and is generally considered when other options are unsuitable or have not worked.

For Moyo, surgery became the eventual choice and she underwent an open abdominal myomectomy. During the procedure, doctors found multiple fibroids weighing more than 1.5 kilograms in total. Herstory did not end when the surgery was over because, recovery became another important part of her experience.

She recalls the support she received from her family, colleagues and others around her, and describes community as an important part of the process. The medical team at Avon Medical also continued to follow up with her after the operation, including a scheduled review two weeks later.

That emphasis on care beyond the procedure is significant because recovery is often missing from public conversations about fibroids. A successful operation may remove the immediate physical problem, but the patient still has to navigate pain, mobility, anxiety, follow-up appointments and the gradual return to everyday life.

Moyo’s most striking reflection came after she had recovered. She realised an improvement in her quality of life and a renewed sense of peace of mind.

Her story also illustrates why conversations about fibroids need to go beyond diagnosis. Avon Medical’s documentary, “Overcoming Fibroids: A Journey of Care and Compassion”, attempts to make that shift by focusing not only on what fibroids are, but on what it means to live through diagnosis, treatment and recovery. Its role in Moyo’s story provides one example of how healthcare can extend beyond a procedure to include communication, reassurance, follow-up and support.

But the larger issue extends beyond one woman, one hospital or one treatment. For women, especially, black women, fibroids remain an important health concern that deserves more open discussion, better research and earlier intervention.

Calling fibroids a “curse” may describe how the condition has felt for generations of women, but it should not define what the future looks like. A diagnosis does not have to become a life sentence, and treatment should not be measured only by whether a fibroid has been removed. It should also be measured by whether a woman can return to work without fear, move through her day without pain, manage her life without anxiety and regain the quality of life she may have slowly surrendered to the condition.

Perhaps that is the conversation worth having now and not simply how many women have fibroids, but how many have spent years adjusting their lives around them, and how many could live differently if they had the information, support and care to seek help earlier.